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Oregon Department pf Transportation <br />~~ ~~ ~ PAGE N0. 1 <br />ILLING DATE <br />11/03/98 21:5.4 <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 />I <br />i <br /> <br />GENCY T/C CURR. DOC. DOC. DATE VENDOR NO./SUFFIX UNIT <br />73 350 0000132910-21 9901 <br />ACCOUNT REVENUE AGENCY CUSTOMER CUSTOMER REV CUSTOMER <br /> SOURCE SOURCE AMOUNT DUE AMOUNT REMITTED ~ REFERENCE <br />RVF10733-040 Oi 8~4Q10 22 135,62.64 ~~3 l~ ~ ~~%~ ~ 14248-CON-E <br /> r~.n {;~~ <br />R. <br />? <br /> . ~g <br /> ~P~ <br />AMOUNT DUE _ _.>. ; :: .. ,,~"'~-Q <br />734-1158A(11-88) <br />