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~ • <br />' : ~ ~ ~ Infor~ma~ion <br />,V `7/ ~'O~ Bl~l~ ~fZ <br />Engineering: •:,Consulting ~ Tesfing <br />~Professional ~Service~.lndustries, .Inc. <br />www ps~usa com ~ ' <br />~. " t: 1 .. . .. . , ...,.. . ' , , 1?: <br />°':''. . .. ,,.. <br />Mail To: CITY OF EUGENE <br />DEPT. PUBLIC WORKS-ENGINEER DV <br />244 EAST BROADWAY <br />EUGENE OR 97401 <br />PSI <br />Springfield, OR USA <br />(541) 746-9649 <br />FederallD 37-0962090 <br />3RD REQUEST FOR PAYMENT <br />Bill To: CITY OF EUGENE' <br />DEPT. PUBLIC WORKS-ENGINEER DV <br />244 EAST BROADWAY <br />EUGENE OR 97401 <br />, ,~ ~.• <br />Customer # Purchase Order Project Number Date Invoice # Page <br />27363 722-80138_ . _ . _ _ . 06/30/08_;_ _ _567071 _0004 <br />Project: BARGER JOB#4433 <br />Date Rpt # Description Quantity Unit Cost Amount <br />06/16/08 0016 REPORT 1.00 15.00 15.00 <br />06/17/08 0017 ASPHALT INSPECTOR, PER HOUR 5.50 55.00 302.50 <br />06/17/08 0017 ASPHALT INSPECTOR, OT (HR) .50 82.50 41.25 <br />06/17/08 0017 ASPHALT EXTRACTION TEST, EACH 1.00 140.00 140.00 <br />06/17/08 0017 ASPHALT GRADATION TEST, EACH 1.00 80.00 80.00 <br />06/17/08 0017 RICE (SPECIFIC GRAVITY TEST)EA 1.00 65.00 65.00 <br />06/17/08 0017 MII..EAGE, PER MILE 22.00 .60 13.20 <br />06/17/08 0017 REPORT 1.00 15.00 15.00 <br />06/17/08 0017 SAMPLE PICKUP, PER HOUR 1.00 42.00 42.00 <br />06/17/08 0017 MILEAGE, PER MILE 22.00 .60 13.20 <br />06/17/08 0018 ASPHALT INSPECTOR, PER HOUR 5.00 55.00 275.00 <br />06/17/08 0018 ASPHALT EXTRACTION TEST, EACH , _. 1.00 ; _ 140.00 ° 140.00 <br />06/17/08 0018 ASPHALT GRADATION T'EST, EACH 1.00 80.00 80.00 <br />06/17/08 0018 RICE (SPECIFIC GRAVIT'Y TEST)EA 1.00 65.00 65.00 <br />06/17/08 0018 SAMPLE PICKUP, PER HOUR 1.00 42.00 42.00 <br />06/17/08 0018 MILEAGE, (SAMPLE PICKUP) 22.00 .60 13;20 <br />06/17/08 0018 MILEAGE, (TWO ADDITIONAL TRIPS 44.00 .60 26:40 <br />06/17/08 0018 REPORT -.1:00 15.00 15.00 <br />06/18/08 0019 ASPHALT INSPECTOR, PER HOUR 8.50 55.00 467.50 <br />06/18/08 0019 ASPHALT INSPECTOR, OT (HR) 3.00 82.50 247.50 <br />06/18/08 0019 ASPHALT EXTRACTION TEST, EACH 2.00 140.00 280.00 <br />06/18/08 0019 ASPHALT GRADATION T'EST, EACH 2.00 80.00 160.00 <br />--~ ~- - -- - r- . , <br />- " ~` Invoice Total: <br />*Continued* <br />TERMS: NET 30 DAYS. A SERVICE CHARGE OF 1.5% PER MONTH, WHICH IS AN ANNUAL PERCENTAGE RATE OF 18% WILL BE ADDED TO <br />_--__ALL PAST DUE ACCOUNTS. _ . _ _ . _ _ _ . <br />To assure proper credit to your account, please retum this remittance stub with your check made payable to Professional Service Industries, Inc. <br />Please mail remittance to: <br />Professional Service Industries, Inc. customer # invoice # Project Number Amount Enclosed <br />PO Box 71168 27363 567071 722-80138 <br />Chicago, IL 60694-1168 <br />