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of o ~ ~ <br /> ~ <br /> ~A i l% k <br /> ~ Bureau of Labor and In ' <br /> <br /> ~ ' ~ ~ dus#rles <br /> rJ * ~ <br /> ~ R <br /> R - ~ ~ <br /> k <br /> x <br /> Brad Avakian <br /> ~ ~ 5 9,. Commissioner <br /> July 2, 2009 <br /> CITY OF EUGENE <br /> ENGINEERING DIVISION <br /> 99 E BROADWAY STE 400 <br /> EUGENE, OR 97401 <br /> PAYMENT RE E <br /> ~ IPT FC~R PUBLIC <br /> ~V~RKS FEE <br /> ~~RS 839-U25-UZ 1 U <br /> Name of Proj ect: CHAD DR E~TN EAST OF CHAD DR TD NORTH GA <br /> ME FARM RD <br /> #61346 <br /> This certificate is proof the CITY OF EUGENE ENGINES <br /> RING DIVISION :made a fee <br /> payment of $916.94 for the public works pra~ect named above based on the contra <br /> ct awarded to <br /> DELTA CONCRETE ~DBA} ~CCB#: 62971} on 15~Jun-09, leavin a balance of $0 for this <br /> g <br /> contract, <br /> As required by ORS 279C.825 and OAR 839-025w0214 the a e ' <br /> g ncy shall, upon completion of <br /> the contract, determine the final contract price, including than e orders and ad'ustments to th <br /> g ~ e <br /> contract. If the f nal contract price varies by $100,400 or more, the a enc shall submit an <br /> g Y y <br /> additional payment ar request for refund of fees, using form WH-44 to the bureau within 30 <br /> days of final payment to the contractor by the agency. <br /> 3 <br /> i <br /> C <br /> 3 <br /> f <br /> i <br /> ~~L o s 2oas <br /> PORTLAND EUGENE BEND MEDFDB,D <br /> 800 NE Oregon St. Suite 1045 1400 Executive Parkway, Suite 200 Worksource Bend 119 N Qakdale Ave. <br /> Portland, QR 97232-2180 Eugene, 4R 97401-2158 1645 NE Forbes Rd, Ste 106 Medford, OR 97501-2629 l <br /> X971) 673-0761 (541) 686-7423 Bend, OR 97701-4990 (541) 776-6270 <br /> i <br /> ax 971) 673-0762 FAX (541) 686-7980 X541) 322-2435 FAX X541) 776-6284 <br /> ~regan Relay TTY (800) 735-2900 FAX (541) 389-8265 ` <br /> r <br /> SALEM PENDLET4N j <br /> 3865 Wolverine St. NE; E-1 1327 SE 3rd St i <br /> Salem, aR 97305-1268 ~ <br /> Pendleton, OR 97801-4101 ~ <br /> X503) 378-3292 www oregon.gov/boli (541) 276-7884 ~ <br /> FAX X503) 373-7636 ' <br /> AN EQUAL QPPORTUN~TY EMPLOYER FAX X541) 276-5767 ~ <br /> i <br /> <br />