Qrzgon Department of Transportation <br /> N ~ ~ ~ PAGE N0. 1 <br /> 7 ~ ILIING DATE <br /> 06/29/01 20:51 <br /> EPORT N0. <br /> FMBL824-1 <br /> TO ENSURE PROPER CREDIT, RETURN A COPY OF THIS FORM WITH YOUR REMITTANCE T0: <br /> OREGON DEPARTMENT OF TRANSPORTATION <br /> 355 CAPITOL STREET NE, RM434 <br /> SALEM OR 97301-3872 <br /> ; OST-CITY OF EUGENE PUBLIC WORKS ` <br /> <br /> j LGIP ACCOUNT #4909-PEGGY HAMLIN FOR INFORMATION CONCERNING <br /> <br /> ~ X858 PEARL 4TH FLOOR THIS INVOICE CALL: <br /> (503)986-3956 <br /> EUGENE OR 97440 <br /> _ _ _a <br /> <br /> j GENCY T/C CURR. DOC. DOC. DATE VENDOR N0./SUFFIX UNIT <br /> 73 350 OOOA132900-84 9901 <br /> REVENUE AOENCY CUSTOMER CUSTOMER REV CUSTOMER <br /> ACCOUNT SOURCE SOURCE AMOUNT DUE AMOUNT REMITTED REFERENCE <br /> RVF12323-OQO O1 844010 21 652:25 176Q8 - PE <br /> _ ~ ~ ~E, ~ . ~ _ ~ , ~ <br /> AMOUNT DUE ~ ; <br /> 734-1158A111-88) <br /> <br />