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City of Eugene / Public Works <br />Parks & Open Space Division <br />1820 Roosevelt Blvd., Eugene OR 97402 <br />(541) 682 -4800; (541) 682 -4882 FAX <br />2010 Neighborhood Matching Grant Program <br />Request for Reimbursement f <br />Neighborhood Matching Grant Project Name: City of Eugene Contract #: "Do <br />Camas Ridge Learning Center 2010 -05321 72 z ( .. 3- 1)5d - Z— <br />Person making reimbursement request: Send payment to: ❑ Same name & address as requestor <br />Carrie Frazier Shaft Construction <br />cawullen(cDhotmail.com 2887 Alder Street <br />541- 868 -4859 Eugene OR 97405 -4143 <br />- -- 541- 729 -5654 - -- -- — - -- —° <br />Receipt Date <br />Supplier/Vendor <br />Supply I Service <br />Amount $$ <br />Sam Ter <br />P <br />4. <br />M1 , " <br />7 lv1 n, ,k: 1. <br />�...,,y1.,,..,.r <br />{ tiro t Cn F 1 ^ <br />ri t <br />8/15/10 <br />Rexius ticket 231960 <br />Concrete <br />$ 10.00 <br />8/29/10 <br />Rexius ticket 232027 <br />Dirt and rocks <br />$ 15.00 <br />9/4/10 <br />Rexius tickets 235491, 234540 <br />Concrete and dirt <br />$ 110.00 <br />9/13/10 <br />Rexius ticket 237025 <br />Yard Debris <br />$ 5.00 <br />8/28/10 <br />Jerry's Inv 26067/1 <br />Rebar Tie Wire <br />$ 114.29 <br />8/16110 <br />Jerry's Rec t Trace #110738 <br />13 light duty posts <br />$ 57.07 <br />8/20/10 <br />Jerry's Credit Memo #815099/2 <br />Returning 10 posts <br />$ - 43.90 <br />8/20110 <br />Jerry's Inv 81511712 <br />11 Heavy Weight Posts and supplies <br />$ 65.43 <br />8/14110 <br />Napa Inv 389530 <br />RV Blade Adapt <br />$ 21.29 <br />- 8114110— — <br />-Napa-Inv 389536 <br />Rv Blade Adapt Return <br />$ _ 2129 <br />8/14/10 <br />Napa Inv 389536 <br />Harness purchase <br />$ 31.99 <br />Total Request <br />I A 1 1 <br />$ 364.88 <br />App roved by Project Coordinator Approve 0y City NMq Coordinator <br />011- 0735 - 62900 - 644015 <br />Date submitt6d City Account Code <br />CUSTOMER COPY <br />