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OF ~ <br /> ' <br /> <br /> ~ : o Bureau of Labor and Industries <br /> _ ~ z <br /> M - . <br /> " Brad Avakian <br /> i . <br /> f ¦ <br /> Commissioner <br /> 859 <br /> August ~ 4, 2009 <br /> CITY OF EUGENE <br /> ENGINEERING DIVISION <br /> 99 E BROADWAY STE 400 <br /> EUGENE, OR 97401 <br /> E <br /> PAYMENT RECEIPT FaR PUBLIC ~V~RKS FEE <br /> oRS s3~~oZ~~o~lo <br /> ~ ~ <br /> i <br /> 3 <br /> Name of Project: DELTA PONDS PATH GOODPASTURE IS RD ROBIN HOOD :AVE <br /> Name of Contract: DELTA PONDS PATH GOODPASTURE IS RD ROBIN HOOD AVE <br /> Data Base #61750 <br /> This certificate is proof the CITY OF EUGENE, ENGINEERING DIVISION made a fee <br /> payment of $3435.41 for the public works project named above, based on the contract awarded <br /> to MOWAT CONSTRUCTION CO ~CCB#:167954} on 27-Jul-09, leaving a balance of $0 for E <br /> this contract. <br /> As required by ORS 2790.525 and OAR 539-025-0210, the agency shall, upon completion of <br /> the contract, determine the final contract price, including change orders and adjustments to the <br /> contract. If the final contract price varies by $100,000 or more, the agency shall submit any <br /> additional payment or request for refund of fees, using form WH~40, to the bureau within 30 <br /> days of final payment to the contractor by the agency. <br /> 3 <br /> I <br /> i <br /> 3 <br /> i <br /> i <br /> i <br /> i <br /> j <br /> a <br /> i <br /> a <br /> ' I <br /> E <br /> I <br /> i <br /> PORTLAND EUGENE BEND MEDFORD <br /> 800 NE Oregon St. Suite 1045 I400 Executive Parkway,.Suite 200. Wo~ksource Bend. 119 N Qakdale Ave. <br /> Portland,. 0R 97232=2180' Eugene, OR 97401-2158 ~ 1645 NE Forbes Rd, Ste 106 Medford, OR 97501-2629 <br /> X971} b73-0761: , X541} ~$b-7623 : ~ ~ Bend, OR 97701-4990 1541} 776-6270 E <br /> Fax X971}673-0762 FAX (541} b86-7980 (5.41} 322-2435 FAX X541} 776-62$4 <br /> Oregon Relay TTY (800} 735,-2900 FAX X541} 389~82b5 <br /> SALEM PENDLETON <br /> 3865'Walverine St. NE; E-1 1327' SE 3r~ St. <br /> Salem, OR 97305-1268 Pendleton,.OR 97801-4101 I <br /> (503} 378-3292 www.oregon.gov/boll ~5 1 27b-7884 g~ <br /> FAX X503} 373-7636 FA 2 - <br /> AN EQUAL OPPORTUNITY EMPLOYER ~ ~ <br /> <br />