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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 <br />For Office Use Only: <br />Project DB #: <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 />bureau may be unable to properly credit you for payment received. <br />PUBLIC AGENCY: City of Eugene - En ing Bering AGENCY #: 1336 <br />AGENCY CONTACT PERSON: Lynn Brogden PHONE: (541) 682-5238 <br />PROJECT MANAGER NAME: Jenifer Willer PHONE: (541) 682-5364 <br />MAILING ADDRESS: 244E Broadway, Eugene OR 974701 <br />PROJECT NAME: North Game Farm Road from Old Coburg Road to I-5 Federal Project #STP-2385 (057) <br />CONTRACT NAME (if part of larger project): <br />PROJECT LOCATION: North Game Farm Road <br />PROJECT NUMBER: 4376 DATE AWARDED: 9/5/2008 <br />CONTRACTOR BUSINESS NAME (DBA): Babb Construction Co. dba Delta Const. Co. dba Delta Concrete <br />CONTRACTOR CCB#: 62971 C~ ~-- <br />CONTRACT AMOUNT: $438,951.08 AMOUNT DUE: ~ ~ 3 ~ ~ 1 ~ ) <br />y ~ Contract amount x .001 <br />~~v (Please duplicate this form for future use) <br />WH-39 (Rev. 11/07) ~ ~ ~~ ~~? <br />~.~~ <br />. a~ <br />