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o F o CONTRACT FEE SECTION <br /> 'Q~ PREVAILING WAGE RATE, UNIT <br /> Q.' ,a ° ~ BUREAU OF LABOR AND INDUSTRIES <br /> H;-, ;o <br /> ~ ; _ - z 800 N.E. OREGON ST., #1045 <br /> _ _ <br /> ~j PORTLAND, OR 97232-2180 <br /> 18 5 e PHONE: (971) 673-0852 <br /> <br /> ~i FAQ: (971) 673-0769 For Ofti~e use. oniy~: <br /> Project DB <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 /> i <br /> PUBLIC AGENCIES: Please complete and mail this form to SOLI 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 maybe unable to properly credit you for payment received. <br /> PUBLIC AGENCY: AGENCY <br /> MAILING ADDRESS: <br /> AGENCY CONTACT PERSON: PHONE: ( ) <br /> PROJECT MANAGER NAME: PHONE: ( ) <br /> PROJECT NAME: <br /> CONTRACT NAME if art of lar er ro'ect <br /> ( P g P J ) <br /> PROJECT LOCATION: <br /> PROJECT NUMBER: DATE AWARDED: <br /> CONTRACTOR BUSINESS NAME (DBA): <br /> CONTRACTOR CCB#: DATE CONTRACT 1sT ADVERTISED: <br /> CONTRACT AMOUNT: AMOUNT DUE: <br /> Contract amount x .001 <br /> (Please duplicate this form for future use) <br /> WH-39 (Rev. 07/08) <br /> _ _ <br /> <br />