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~ ~ i Info~nation <br />/r~~ ~'o Build On <br />Engineering • Consulting • Testing <br />Professional Service Industries, Inc. <br />www.psiusa.com <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 />Customer # Purchase Order Project Number Date Invoice # Page <br />27363 <br />- <br />- - - - - ---- <br />- - - . 722-80138 <br />_- 06/30/08 _ 567071 _000_t_ <br /> <br />, <br />Proiect: BARGER JOB#4433 <br />Date Rpt # Description Quantity Unit Cost Amount <br />06/06/08 0001 FIELD DENSITY TEST, (HR) 2.00 52.00 104.00 <br />06/06/08 0001 MILEAGE, PER MILE 22.00 .60 13.20 <br />06/06/08 0001 REPORT 1.00 15.00 15.00 <br />06/06/08 0002 ASPHALT INSPECTOR, PER HOUR 4.50 55.00 247.50 <br />06/06/08 0002 MILEAGE, PER MILE 1.00 .60 .60 <br />06/06/08 0002 REPORT 1.00 15.00 15.00 <br />06/09/08 0003 FIELD DENSIT'Y, OT 1.00 78.00 78.00 <br />06/09/08 0003 MILEAGE, PER MILE 22.00 .60 13.20 <br />06/09/08 0003 REPORT 1.00 15.00 15.00 <br />06/09/08 0004 FIELD DENSITY TEST, (HR) 2.00 52.00 104.00 <br />06/09/08 0004 REPORT 1.00 15.00 ; 15.00 <br />06/09/08 0005 CONCRETE INSPECTION , PER HOUR -2.00 52.00 , <br />~ - 104.00 <br />06/09/08 0005 MILEAGE, PER MILE 22.00 .60 13.20 <br />06/09/08 0005 REPORT 1.00 . 15.00 15.00 <br />06/10/08 0006 SAMPLE PICKUP, PER HOUR 1.00 42.00 42.00 <br />06/10/08 0006 MILEAGE, PER MILE 22.00 .60 13.20 <br />06/10/08 0007 ASPHALT INSPECTOR, PER HOUR 3.00 55.00 165.00 <br />06/10/08 0007 ASPHALT INSPECTOR, OT (HR) 1.00 82.50 82.50 <br />06/10/08 0007 REPORT 1.00 15.00 15.00 <br />06/10/08 0007 MILEAGE, PER MILE 22.00 .60 13.20 <br />06/10/08 0008 FIELD DENSIT'Y TEST, (HR) 2.00 52.00 104.00 <br />06/10/08 0008 REPORT 1.00 15.00 15.00 <br />~EC ~ ~` Invoice Total: *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 />x.- -- ALL PAST.DUE ACCOUNTS.-- - --- - - - -. .._ - - - - -- - - - - -- - _ . _ <br />-- ----------. _. _ .----- - -- -- <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 # ~nvoice # Project Number Amount Enclosed <br />PO Box 71168 <br />Chicago, IL 606941168 27363 567071 722-80138 <br />