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ORDER WORKSHEET FOR PROPERTY PURCHASE <br /> I'0~ I~agDtD?q~ <br /> Date Check Needed: May 20, 1999 R~ ~ ®D~~a,,, <br /> Mail Check ? Hand Carry Check ?x <br /> i <br /> General Description: Acquisition of land for proposed park site on Ross Lane. <br /> Dept. Contact: Engineering -Russ Royer ext. 5264 <br /> Vendor Name: Western Pioneer Title Companx <br /> Address: 1200 Executive Parkway <br /> City/State Eugene, OR Zip 97401 <br /> i <br /> <br /> j Phone: 484-2900 Tax ID for 1099: arovided by escrow <br /> Prepay ?x Emergency ?x Separate Check ?x Route to: Russ Royer <br /> Line Amount: $285,41 1.94 <br /> Line Description: This is compensation for the purchase price of the park site on <br /> Ross Lane - approx 3.95 acres. The purchase includes tax lot numbers 6200 and <br /> 6300 on map number 17-04-12-34. The fund number should be 336-9335-78000 <br /> - if you need additional numbers, please check with Johnny. <br /> Date: 5/17/99 Requested by: Russ Royer <br /> Commodity # - ORDER # - <br /> Line Account Codes 33G 933 XXXXX 78ob® q'7~®~~ $ <br /> XXXXX $ <br /> Notes <br /> PWA-LRE c:\user\forms\property.frm 4/13/95 <br /> s~ <br /> <br />