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~e~Depa~hnent of Transpor~aAion C, ~ ~ ~ C <br /> I ~ ~O ~ ~ ~ PAGE N0. 1 <br /> 7 ~ ILLING DATE <br /> 01/06/04 19:56 <br /> (COUNT ND. <br /> <br /> ice, SEE BELOW <br /> TO ENSURE PROPER CREDIT, RETURN A COPY OF THIS FORM WITH YOUR REMITTANCE T0: <br /> OREGON DEPARTMENT OF TRANSPORTATION <br /> 355 CAPITOL STREET NE, RM434 <br /> SALEM OR 97301-3872 <br /> EUGENE, CITY OF <br /> GRANT ACCT PEGGY HAMLIN FOR INFORMATION CONCERNING <br /> 858 PEARL STREET THIS INVOICE CALL: <br /> EUGENE OR 97401 (503)986-3879 <br /> GENCV T/C CURR. DOC. DOC. DATE VENDOR N0./SUFFIX UNIT <br /> 73 350 52918 -00 9901 <br /> ACCOUNT NO . REVENUE AGENCY CUSTDMER CUSTOMER REV CUSTOMER <br /> SOURCE SOUOCE AMOUNT DUE AMOUNT REMITTED REFERENCE <br /> RVF14128-000 Ol 844010 22 886.46 14248-CON-E <br /> RVF13016-000 O1 844010 21 2,063.18 17483 - PE <br /> RVF14127-000 O1 844010 22 156.14 17483 ROW <br /> AMOUNT DUE $3.,1.05.78 <br /> 71r-3150A (17-06) <br /> <br />