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s <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 />For. Office. Use Only.: <br />Project ,P13 <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 />burdau may be unable to properly credit you for payment received. <br />PUBLIC AGENCY: City of Eugene - Engineering AGENCY 1336 <br />AGENCY CONTACT PERSON: Lynn Brogden PHONE:.(541) 682-5238 <br />PROJECT MANAGER NAME: Scott Milovich PHONE: (541) 682-6086 <br />MAILING ADDRESS: 244 E. Broadway, Eugene, OR 97401 <br />PROJECT NAME: Delta Ponds Riparian Planting ' <br />CONTRACT NAME (if part of larger project): <br />PROJECT LOCATION: Delta Ponds off of Goodpasture Road <br />PROJECT NUMBER: Job #4572 DATE AWARDED: 11/21/2008 <br />CONTRACTOR BUSINESS NAME (DBA): Second Growth, Inc. <br />CONTRACTOR, CCB#: 75643 <br />CONTRACT AMOUNT: 110,025.00 AMOUNT DUE:.-~ <br />Contract amount x .001 <br />(Please duplicate this form for future use) <br />`NCO C6 S1+ I <br />WH-39 (Rev. 11/07) --kA 5. G yo <br />4V <br /> <br />