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Oregon Department of Transportation <br />n ~ ` ' O ~ ~ ~ PAGE N0. 1 <br />f . V v IIIINO DATE <br />06/01/99 23:01 <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 />434 TRANSPORTATION BUILDING <br />SALEM OR 97310-0780 <br />OST-CITY OF EUGENE PUB WORKS <br />LGIP ACCOUNT #5105-JENNY LYNNES ~ FOR INFORMATION CONCERNING <br />858 PEARL 4TH FLOOR THIS INVOICE CALL: <br />EUGENE OR 97401-2795 (503)986-3956 <br />~ooL, ~ccT~ 51x5 <br />. DOC. <br />N0./SUFFIX <br />73 350 0000132910-21 9901 <br />REVENUE AGENCY CUSTOMER CUSTOMER CUSTOMER <br />ACCOUNT SOURCE SOURCE AMOUNT DUE AMOUNT REMITTED REV REFERENCE <br />--- <br />RVF10733-000 4.1 844Q10 22 14_,927.93 14248-.CON-E> <br />~!. ~ ~., <br />~~ ~t'i r)fvy tY' .T f ark ,f~ ~ ~ S~ .f ~ r~ ^3 <br />~~t~„ << ~s~~~ ir;~.~i~~,~~~aY f;:,v.t~.~~~ <br />