New Search
• <br />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 />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, 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 $7,500.00. Without the following completed information, the <br />bureau may be unable to properly credit you for payment received. <br />PUBLIC AGENCY: Eugene School District 4J AGENCY 639 <br />AGENCY CONTACT PERSON: Ben Brantley PHONE: (541) 687-3259 <br />PROJECT MANAGER NAME: Ben Brantley PHONE:.__ 687-3259 <br />MAILING ADDRESS: 715 W 4th Ave., Eugene, Q 97402 <br />PROJECT NAME: <br />CONTRACT NAME (if part of larger project): <br />PROJECT LOCATION: S4ACe,'5wite ; Soo 6. 43'Sl <br />T <br />PROJECT NUMBER: ~ld • CD$a . `I ~o iJ DATE AWARDED: ' i <br />CONTRACTOR BUSINESS NAME (DBA):^~ <br />CONTRACTOR CCB#: %koncl <br />CONTRACT AMOUNT: AMOUNT DUE: Z 2. ~256 v-11. <br />(Please duplicate this form for future use) <br />Co ract amount x .00I <br />u ro~~-1 U1';-0013 3E~ Ci -1(00 <br />WH-39 (Rev. 11/07) <br />