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Oregon Department of Transportation <br />7 ' N r ~ ~ ~ ~ PAGE N0. 1 <br />BILLING DATE <br />01/06199- 4:38 <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 #5485-JENNY LYNNES FOR INFORMATION CONCERNING <br />858 PEARL 4TH FLOOR THIS INVOICE CALL: <br />EUGENE OR 97401-2795 (503)986-3956 <br />AGENCY T/C. CURR. DOL. ~ DOL. DATE VENDOR N0./SUFFIX UNIT <br />73 350 13291 -63 9901 <br />ACCOUNT REVENUE AOENCV CUSTOMER CUSTOMER REV CUSTOMER <br /> SOURCE SOURCE AMOUNT DUE AMOUNT REMITTED REFERENCE <br />RVF10965-000 O1 844010 22 1.75 ~j~~ /_~~~ 15016 -''CON <br /> <br /> <br /> <br /> <br />AMOUNT D U E ~ ? -- =~~~-~ ~---...._ <br />i>r-t i5uaiti-ss~ <br />