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o F o CONTRACT FEE SECTION <br /> ~ +P~ PREVAILING WAGE RATE UNIT <br /> Q': : ~ BUREAU OF. LABOR AND INDUSTRIES <br /> F = : 0 800 N.E. OREGON ST., #1045 <br /> N• :z <br /> - R 72 2-21 0 <br /> PORTLAND O 9 3 8 <br /> PHONE: (971) 673-0852 <br /> •185g. FAX: (971) 673-076.9 F'or Office Use OnlS~: <br /> Project D13 - - _ <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 mait 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, Suite 400 <br /> CITY, STATE, ZIP: Eugene, Oregon, 97401 <br /> AGENCY CONTACT PERSON: inn Bro`gden PHONE: (541) 682-5238 <br /> PROJECT MANAGER NAME: Patrick Cox PHONE: (541) 682-6854 <br /> PROJECT NAME: Delta Ponds Pathfrom Goodpasture Island Road to Robin-Hood Avenue Federal Project #X-HPP- <br /> TEA-2385(060) ' <br /> CONTRACT NAME (if part of larger project): <br /> PROJECT LOCATION: Delta Ponds from Goodpasture Island Road to Robin Hood Avenue <br /> PROJECT NO: 43'78 (Contract #2010-03)_ DATE CONTRACT FIRST ADVERTISED: 5/28/2009 <br /> DATE CONTRACT AWARDED: 07/27/2009 CONTRACTOR CCB#: 167954 <br /> CONTRACTOR BUSINESS NAME (DBA): Mowat Construction Company <br /> CONTRACTOR ADDRESS: PO Box 1330 <br /> CITY, STATE, ZIP: Woodinville WA 98072-1330 <br /> CONTRACT AMOUNT: $3,438,410.50 FEE AMOUNT DUE/PAID: `~~~r, <br /> If less than $SOK, is it part of a larger project? ?yes ?no Contract amount x .001 =fee due <br /> (Please duplicate this form for future use) ~1 3 <br /> <br /> WH-39 (Rev.. 03/09) <br /> <br />