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- 1h <br />Travel Lane County <br />754 Olive St <br />PO Box 10286 <br />Eugene OR 97440 <br />Tj 541.484.5307 <br />F1 541.343.6335 <br />TravelLaneCo unty. o rg <br />Eric Jones <br />Eugene Public Works <br />101 E Broadway Ste 400 <br />Eugene OR 97401 <br />City of Eugene Bicycling Program <br />Invoice <br />Account No. 1573 <br />Invoice No. 7065 <br />Date 01/01/2011 <br />Terms Upon Receipt <br />Quantity <br />Description <br />Amount <br />1 <br />Additional Location <br />$50.00 <br />1 <br />Dues (Basic Membership - Non-profit) <br />$0.00 <br />Public Works <br />Amount <br />1 1 Dues (Basic Membership - Non-profit) 1 $150.001 <br />Invoice total $200.00 U(y lu <br />We appreciate your continued support of Travel Lane County. <br />Current <br />31 to 60 <br />61 to 90 <br />Over 90 <br />$0.00 <br />$200.00 <br />$0.00 <br />$0.00 <br />?_011 C) 16 3~+ <br />Please Return This Portion With Your Payment <br />pal' <br />41, <br />Eric Jones <br />Eugene Public Works <br />Account No. 1573 <br />Invoice No. 7065 <br />Qgto~'0I 0 ( <br />Payments Details <br />❑ Payment Enclosed $ <br />❑ Credit Card Account $ <br />Cardholder Name <br />Cardholder Number <br />CVVR (American Express) <br />Signature <br />Travel Lane County accepts Visa / MasterCard / American Express <br />Card Expiration Date <br />