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CHECK REQUEST <br />Date Check Needed: July 8, 2010 <br />Mail Check ❑ Hand Carry Check ❑XX <br />General Description: Payment for survey work on Ribbon Trail <br />Dept. Contact: Lloyd Williams ext. 2679 <br />Vendor Name: Baker and Associates Surveyors, Inc. <br />Address: 1347 Market Street <br />City/State: Springfield. OR Zip 97477 <br />Phone: (541) 343-7243 Tax ID for 1099: 93-0779445 <br />Prepay ❑X Emergency ❑X Separate Check ❑X Route to: Lloyd Williams (PWE-WF) <br />Line Amount $5,295.00 <br />Line Description: This is for payment of survey work on Ribbon Trail, per invoice dated 3/15/2005 <br />Date: June 25, 2010 Requested by: Lloyd Williams <br />Commodity # G 17 39 ORDER <br />Line Account Codes 32I g33S XXXXX 97752zZ <br />XXXXX <br />Notes <br />no 2©// 0on5-27- <br />PWA-LRE c:\user\forms\property.frm 4/13/95 <br />S CAN N D-PWA <br />DATE: ?_4 ~z 4110 <br />INITIALS' <br />