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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. <br />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 BOLI at the above address, along 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 $250.00; 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: City of Eugene -PW Parks & Maintenance AGENCY #: 2781 <br />AGENCY MAILING ADDRESS: 1820 Roosevelt Blvd. <br />CITY; STATE, ZIP Eugene OR 97402 <br />AGENCY CONTACT PERSON: Kris Aanderud, Contract Administrato - PHONE: (541) 682 -4966 <br />PROJECT MANAGER NAME: Jesse Cary -Hobbs PHONE: (541) 682 -4843 <br />PROJECT NAME: Ridgeline Trail Renovation <br />CONTRACT NAME (if part of larger project): <br />PROJECT LOCATION: Ridgeline Trail, Eugene <br />PROJECT NO: 965252 DATE CONTRACT FIRST ADVERTISED: 07/30/09 <br />DATE CONTRACT AWARDED: 08/20/09, CONTRACTOR CCB #: 99032 <br />CONTRACTOR BUSINESS NAME (DBA): Oregon Woods, Inc. <br />CONTRACTOR ADDRESS: PO Box 11680 i <br />CITY STATE ZIP Eugene OR 97440 <br />CONTRACT AMOUNT: $ 71,422.00 FEE AMOUNT DUE/PAID :� $ 250.00 <br />If less than $50K is it part of a larger project? []yes F�no Contract amount x.001 fee due <br />(Please duplicate this form for future use.) <br />WH -39 (Rev. 03/09) <br />