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CO1~TR#~CT h'EE SECTION <br /> PREVAILI~iG ~AOE RATE UN#T <br /> BUREAU DF LABOR AND INDUSTRIES <br /> • i <br /> 80U ~1.E, OREGON T., #1045 <br /> • ~ <br /> PORTLAND, OR 9'T~3~-~IB~ <br /> • i ~F + ~V ~i:f. ~~~1~ ~~~-UY~1e 'ice. ~r~~~', Y._ ...,F ,Vy a... <br /> ~s t~F <br /> PI]~~~C ~Vp~ ~`~E ~I~F~I~MATI~IV FARM <br /> I'nr use by public agencies tkat have eantracted with ~ cantractar ou a putSlie works prajec# re~alated by <br /> ORS ~79C.8~D to ~'i~O.87Q, in compliance v~ltlt ~ ~'~4C.$~S. Also for use by public a~eueie~ that are ~ <br /> party to a public works project pursuant tv ORS ~7~O.S~U~6~~a)(R~ ar <br /> PUBLIC AGENCIES; Please complete and mail this farm to BCT~I at the above address, along with the public <br /> works fee ~f one-tenth of one percent of the contract price {contract amount x .~01}, payable to BOLT. The <br /> minlmuua fee l~ 5~~.~4; the artiiimum fee is ~7,5~~.Q~, Without the fo#lowing compZated information, the <br /> bureau may he urrahle t~ properly credit you for payment recei~+ed, <br /> PiJBLIC AGENCY: ity of <br /> Ea~enc - E~~inecrfn~ ~ AGENC'Y 1336 <br /> AGENCY' NIAILINO ADDRESS: ~9 E. roadw Suite 4UU <br /> CI~'Y, STATE, SIP: ~ugenc, 4re~oa~ 974D 1 _ _ _ <br /> AGEI~ICY CONTACT PERSON: I~ynn Bro~d~n P~IONE: ~5~ I~.G82-5238 <br /> PROTECT MANAGER, NAME: Zahn Bo PONE: 541 b82e53U0 <br /> PROJECT NAME: Pav' s si~ewal storm water draa~a~e and water~~alitybioswale~an Elmira Road <br /> am B Glyn Roams to IVi~lc Street and ~Ianle ~troet from ~ ' ' Read to Raase~volt B~utevard <br /> CONTRACT NAML (lf part oI lar~~r pra~ee#): ' <br /> PROJECT LOCA~~O1~; Imirs d. from Bcrtelse~Rd. to Nla~le S~_a~nd y~iayie St from Elmira to Rom _ <br /> PROJECT NO: Iob #4,75 (Contract #209-I~ DATE CONTRACT p'IRST AD~ERTISEII; 313~20(~9 <br /> DATE OONTRACT AARI}Efl: ~SJO1~200~ CONTRACTOR CCB#; X1290 <br /> COIYTRACTDR BUSING NAI~IF BRA}; 1~iarse Bros,, Inc, dba 1~'fe fiver <br /> CONTRACTOR AI~DIS$; '3~26U Old Hi~ay 34 <br /> CITY, 5TATE, SIP: Tangent, CR 97389 _ . <br /> <br /> t='~NTRACT AMOUNT: $~.034.~34_s43 FEE AiH4U1~T DC]E1~AID~ _ <br /> I€ less #han SSOI{, is It part of a 1ar~er prn~ect? Qyes pna Contract am~un# x .~01=fee doe <br /> please dupilcate this farm for futuxe use) <br /> ~ - ~ <br /> ~ ~ h~ ~ ~ <br /> 1 <br /> 0 . 1 <br /> <br />