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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 For Office U,se Only: <br />Project DB #c. <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 OR9`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: City of Eugene - Engineering <br />AGENCY*: 1336 <br />AGENCY CONTACT PERSON: Lynn Brogden <br />PHONE: (541) 682-5238 <br />PROJECT MANAGER NAME: Scott Milovich <br />PHONE: (541) 682-6086 <br />MAILING ADDRESS: 244 E. Broadway. Eugene. OR 97401 <br />PROJECT NAME: Delta Ponds Soil Amdendment and Seeeding <br />CONTRACT NAME (if part of larger project): Delta Ponds Riparian Planting <br />(2009-12)(Job #4572) <br />PROJECT LOCATION: Delta Ponds off of Goodpasture Road <br />PROJECT NUMBER: Job #4596- DATE AWARDED: 10/20/2008 <br />CONTRACTOR BUSINESS NAME (DBA): Elms Landscape Services. Inc. <br />CONTRACTOR CCB#: 6855 (LCB) <br />U <br />CONTRACT AMOUNT: $38.395.20 AMOUNT D <br />E: <br />Contract amount x.001 <br />(Please duplicate this form for future use) <br />WH-39 (Rev. 1.1/07) c) C) <br />a 5 To <br />f <br />c <br />