New Search
CONTRACT FEE SECTION <br />PREVAILING WAGE RATE UNIT <br />BUREAU OF LABOR AND INDUSTRIES <br />800 N.E. OREGON ST., #1045 <br />PORTLAND, OR 97232-2180 <br />PHONE: (971) 673-0852 <br />FAX: (971) 673-0769 For Office;Use Only <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 />PUBLIC AGENCIES: Please complete and mail this form to BOLI at the above address, alone 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 S250.00; 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: Citv of Eugene - Engineering AGENCY 1336 <br />AGENCY MAILING ADDRESS: 99 E Broadway Suite 400 <br />CITY, STATE, ZIP: Eugene. OR 97401 <br />AGENCY CONTACT PERSON. Lvnn Brogden PHONE 541-682-5238 <br />PROJECT MANAGER NAME: John Bonham PHONE: 541-682-5300 <br />PROJECT NAME 2010 Pavement Preservation Program <br />CONTRACT NAME (if part of larger project): <br />PROJECT LOCATION: PPP Vallev River Drive and Goodoasture Island Road from Willagillespie Road Pavement <br />Bond Measure Goodpasmre Island Road from Delta Highway to Kinesley Road <br />PROJECT NO: 4637 4435(Contract #2010-22) DATE CONTRACT FIRST ADVERTISED: 4.16/2010 <br />DATE CONTRACT AWARDED: 05/28%2010 CONTRACTOR CCB#: 2101 <br />CONTRACTOR BUSINESS NAME (DBA): Knife River Corporation-Northwest <br />CONTRACTOR ADDRESS: 32260 Old Highway 34 <br />ww"o IIN607- <br />CITY, STATE, ZIP: Tangent. OR 97389 <br />CONTRACT AMOUNT: $1,199,19919 FEE AMOUNT DUE/PAID: 14~l. Zd <br />If less than $50K, is it part of a larger project? Dyes ❑no Contract amount x .001 = fee due <br />(Please duplicate this form for future use) <br />T 46.67 3y7-' 4332- tcIgL~- ~ 5 i ir$I.S?3 <br />JU43S 3i{'3-^~33Z-GI$fn~- 47553 517.62 <br />WH-39 (Rev 0309) <br />SCANN D-PWA <br />DATE. 10 <br />INITIALS- <br />