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W i City of Eugene - Document Services <br />44 West 7th Avenue <br />Eugene, OR, 97401 <br />Ph: (541) 682 -6878 Fax: (541) 682 -2721 <br />Signature: <br />Print: <br />Date: <br />Date: <br />Document & Distribution Services <br />Print - Mailing Job Quality Control <br />Job #: ! Date: .� <br />Job Specifications — <br />Indicia Permit #: Service Class: <br />Endorsements: t <br />Format/Layout: t 1 .�,.AC, t V2A,,� <br />Mail List Used: <br />Prepared by: <br />Inspections — <br />Proofed by customer: ❑ Yes ❑ No, declined <br />Approved by: <br />Quality Assurance Review by: <br />Mailing Service — <br />Mailing Date: <br />Postage Cost: Zs3 8$ <br />Postage Savings: e �� <br />Job Ticket <br />12095 <br />