New Search
S C~,1~! t~l ED-PWA <br /> DATE' <br /> INITIALS: <br /> ~ CONTRACT FEE SECTION <br /> ' PREVAILING WAGE RATE UNIT <br /> Q.• ~ BUREAU OF LABOR AND INDUSTRIES <br /> H ~ 800 N.E. OREGON ST., #1045 <br /> r PORTLAND, OR 97232-2180 <br /> PHONE: (971) 673-0852 <br /> FAX: (971) 673-0769 For Office Use Only;.:." <br /> Projecf DB <br /> PUBLIC WORKS 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 maximum 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 -Engineering AGENCY 1336 <br /> AGENCY CONTACT PERSON: I;ynn Brogden PHONE: (841) 682-5238 <br /> PROJECT MANAGERNAME: David Starns PHONE: (5412682=8306 <br /> MAILING ADDRESS: 244 E. Broadway <br /> PROJECT NAIVIE: 2008 Wastewater Manhole Rehabilitation <br /> CONTRACT-NAME (if-part oflarger-project): _ _ <br /> PROJECT LOCATION: The project includes several sites in various locations from the Santa Clara area south to <br /> Lorane Highway, and from Terry Street east to Patterson Street. - . <br /> PROJECT NUMBER: 4117 DATE AWARDED: 9/12/2008 <br /> <br /> ----CONTRACT-OR-BUSINESS.NAME-(DBA):---2G-Inc..-dba-2G--Construction - <br /> CONTRACTOR CCB#: 40559 <br /> CONTRACT AMOUNT: $79,019.94 AMOUNT DUE: ~ ~ ~ ~ <br /> Contract amount x .001 <br /> (Please duplicate this form for future use) <br /> WH-39 (Rev. 11/07) ~ /•~~J~; <br /> • ~ ~ ~ <br /> (p~ <br /> vi <br /> • <br /> <br />