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F- CONTRACT FEE SECTION <br /> PREVAILING WAGE RATE UNIT <br /> BUREAU OF LABOR AND INDUSTRIES <br /> _ : 800 N.E. OREGON ST., #1045 <br /> ~ ~ ~ PORTLAND, OR 97232-2180 <br /> • PFIONE: {971) 673-0852 <br /> . FAX: (971) 673-0769 For :office Use O'uly: . <br /> ProjectDB # <br /> PUBLIC WORK5 FEE INFORMATION FORM <br /> For use by public agencies that have contracted with a contractor on a public works project regulated by <br /> ORS 279C.800 to 279C.870, in compliance with ORS 279C.825. Also for use by public agencies that are a <br /> party to a public works project pursuant to ORS 279C.800(6)(a)(B) or (C). <br /> PUBLIC AGENCIES: Please complete and mail this form to BOLI at the above address, along with the public <br /> works fee of one-tenth of one percent of the contract price (contract amount x .001), payable to BOLI. The <br /> minimum fee :is $250.00; the mazimum fee is $7,500.00. Without the following completed information, the <br /> bureau maybe unable to properly credit you for payment received. <br /> PUBLIC AGENCY: City of Eugene - En~;ineering AGENCY 1336 <br /> AGENCY CONTACT PERSON: Lynn Broaden PHONE: (541) 682-5238 <br /> PROJECT MANAGER NAME: David Starns PHONES (541L <br /> -8306 <br /> MAILING ADDRESS: 244E Broadway <br /> PROJECT NAME: 2008 Wastewater Manhole Rehabilitation <br /> COI~TTRACT NAME (if part of larger project): <br /> PROJECT LOCATION: The project includes several sites in various locations from the Santa Clara area south to <br /> Lorane Hig_hway and from Terry Street east to Patterson Street <br /> PROJECT NUMBER: 4117 ~ DATE AWARDED: 9/12/2008 <br /> -CONTRACTOR-BUSINESS-NAME{DBA): 2G Inc.---dba-2G-Construction- <br /> CONTRACTOR CCB#: 40559 <br /> CONTRACT AMOUNT: $79,019.94 AMOUNT DUE: ~ ~5 ~ <br /> Contract amount x .001 <br /> (Please duplicate this form for future use) <br /> WH-39 (Rev: 11/07} <br /> ~ \ <br /> (p~ <br /> "'1 <br /> s <br /> <br /> . ~ ~ t~ <br /> ~ l._~ <br /> <br />