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• <br />Purchase Order <br />PO Number: 101613 <br />41 <br />47 v ~i f ; <br />VENDOR NOTICE: If you accept this P.O., you must agree to all terms and con tions on <br />front and back of P.O. This is a TAX EXEMPT district for EDUCA/rIALPUrp <br />ses only. <br />Vendor: 10103 <br />DEPARTMENT OF STATE LANDS 775 SUMMER ST NE ST <br />E 100 SALEM OR 97301-1279 <br />United States of America <br />Contact: <br />Phone: 503 378-3805 <br />Fay: n <br />Freight Terms: PREPAID ~C <br />Shipping Terms: <br />Ship Via: <br />i <br />Ship to: <br />ORIGINAL <br />Date: 3/31/2008 <br />Page: 1 <br />Capital Improvement Program <br />715 West 4th Avenue. ; <br />Eugene OR 97402 <br />BILL TO. <br />Capital Improvement Program <br />Facilities Management <br />715 West 4th Avenue <br />Eugene, Oregon 97402 <br />Contact: Kathi Hernandez <br />Phone: (541) 687-3259 <br />Line No. Item Number / Description Quantity Units Unit Price I Extended Amount <br />Deliver on March 31, 2008 unless specified by line <br />1 JOINT PERMIT APPLICATION FOR 1.0000 EA 1,220.00000 <br />1650 FILLMORE STREET <br />Purchase Order Summary <br />Goods Total: <br />Order Total: <br />CONSENT TO ALLOW CORPS OR DEPT <br />OF STATE LANDS STAFF TO ENTER INTO <br />THE PROPERTY TO INSPECT THE PROJECT <br />LOCATION AND DETERMINE COMPLIANCE. <br />LOCATION IS AREA IMMEDIATELY SOUTH <br />OF ARTS AND TECHNOLOGY ACADEMY ('FORMALLY JEFFERSON MIDDLE <br />SCHOOL) BUILDINGS. <br />End of Purchase order: 101613 <br />.00000 <br />.00000 <br />1,220.00 <br />1,220.00 <br />1,220.00 <br />TO-4 1.4 W. <br />AUTHORIZED BY <br />