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pF <br /> ~ p to <br /> , p On Bureau of Labor and Industries <br /> <br /> N - Z 1, ~ 1 1 <br /> Brad Avakian <br /> ~8 5 g'~ Commissioner j <br /> i <br /> December 16, 2008 <br /> CITY OF EUGENE <br /> ENGINEERING DIVISION / BROGDEN <br /> 244 E BROADWAY <br /> EUGENE, OR 97401 <br /> PAYMENT RECEIPT FOR PUBLIC WORKS FEE <br /> (ORS 839-025-0210) <br /> Name of Project: EUGENE AIRPORT 2008 REHABILITATION SOUTH RAMP #59037 <br /> This certificate is proof the CITY OF EUGENE, ENGINEERING DIVISION / BROGDEN <br /> made a feepayment of $673.38 for the public works project named above, based on the contract <br /> awarded to KNIFE RIVER (DBA) (CCB#: 2101) on 6-Jun-08, leaving a balance of $0 for this <br /> contract. <br /> As required by ORS 279C.825 and OAR 839-025-0210, the agency shall, upon completion of <br /> the contract, determine the final contract price, including change orders and adjustments to the <br /> contract. If the final contract-price varies by $100,000 or more, the agency shall submit any <br /> additional payment or request for refund of fees, using form WH-40, to the bureau within 30 <br /> days of final payment to the contractor by the agency. <br /> I'QRTLAItiD` EiJGENE , , BEND MEDFORD <br /> 800 NE Oregon St. Suite 1045 1400'Executive Parkway, Suite 200 Worksource Bend 119 NOakdale-.Ave. <br /> Portland, OR 97232-2180 Eugene;lOR 97401-2158 1645 NE Forbes Rd, Ste 106 Medford, OR 97501-2629 <br /> (971) 673-0763 (541) 686-7623 Bend; OR 97701=4990 (541) 776-6270 <br /> Fax (971) 673-0762 FAX (541) 686-7980 (541) 322-2435 FAX (541) 776-6284 <br /> TTY (971) 673-0766 FAX (541) 389-8265 <br /> SALEM PENDLETON <br /> . 3865 Wolverine St. NE; E-1 1327 SE 3rd St. <br /> Salem, OR 97305-1268 Pendleton, OR 97801-4101 <br /> (503) 378-3292 WWW.OTegOri.gOV~bOIl (541) 276-7884 <br /> FAX (503) 373-7636 AN EQUAL OPPORTUNITY EMPLOYER FAX (541) 276-5767 <br /> <br />