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CONTRACT FEE SECTION <br />PREVAILING WAGE RATE UNIT <br />BUREAU OF LABOR AND INDUSTRIES <br />800 N.E. OREGON ST., #1045 <br />PORTLAND, OR 97232 -2180 <br />PHONE: (971) 673 -0852 <br />FAX: (971) 673 -0769 <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 may be unable to properly credit you for payment received. <br />PUBLIC AGENCY: City of Eugene - Engineering: AGENCY #: 1336 <br />AGENCY MAILING ADDRESS: 99 E. Broadway <br />CITY, STATE, ZIP: Eugene, OR 97401 <br />AGENCY CONTACT PERSON: Lynn Brogden PHONE: (541) 682 -5238 <br />PROJECT MANAGER NAME: Jenifer Willer PHONE: (541) 682 -5364 <br />PROJECT NAME: Crest Drive Neighborhood Street Improvements <br />CONTRACT NAME (if part of larger project): <br />PROJECT LOCATION: Crest Dr. from Blanton Rd. to Lincoln St., Storey Blvd. from Crest Dr. to Lorane Hwy and <br />Friendly St. from Lorannce Hwy to 28 Ave. <br />PROJECT NO: 4546 DATE CONTRACT FIRST ADVERTISED: 4/22/2009 <br />DATE CONTRACT AWARDED: July 2 2009 CONTRACTOR CCB #: 62971 <br />CONTRACTOR BUSINESS NAME (DBA): Babb Construction Co. dba Delta Const. Co. dba Delta Concrete <br />CONTRACTOR ADDRESS: 999 Division Avenue <br />CITY, STATE, ZIP: Eugene, OR 97404 <br />CONTRACT AMOUNT: $ 2,120:407.20 FEE AMOUNT DUE/PAID: 2,120.41 <br />If less than $50K, is it part of a larger project? ❑yes ❑no Contract amount x.001 = fee du�e / <br />(Please duplicate this form for future use) <br />WH -39 (Rev. 03/09) <br />