New Search
I <br /> OF 0 <br /> ~ ~ ~ <br /> ~ <br /> * * ~ Bureau of Labor and Industries <br /> <br /> F+« «o <br /> ~ * ~ ~ ` ~ * Brad Avakian <br /> * <br /> Commissioner - <br /> ra59 <br /> E <br /> October 14, 2005 <br /> CITY OF EUGENE <br /> ENGINEERING DIVISION 1 BROGDEN <br /> 244 E BROADWAY <br /> EUGENE OR 97401 ~ <br /> FEE <br /> PAYMENT RECEIPT FAR PUBLIC ~VURKS <br /> ~~RS X39-0~~-Q~IU} <br /> Name of Proj ect: TONAWANDA PUMP STATION #59922 <br /> This certiflcate is proof the CITY OF EUGENE, ENGINEERING DIVISION I BROGDEN <br /> made a fee payment of $250 for the public Works project named above, based on the contract <br /> awarded to H & J CONSTRUCTION INC ~CCB#:85054} on 12-SEPw05, leaving a balance of ~ <br /> $0 for this contract. <br /> As required by ORS 2790.825 and OAR 839-025-4210, the agency shall, upon completion of <br /> the contract, determine the final contract price, including change orders and adjustments to the <br /> contract. If the final contract price varies by $100,000 or mare, the agency shall submit any <br /> additional payment ar request for refund of fees, using form WH-40, to the bureau within 30 <br /> days of final payment to the contractor by the agency. <br /> I <br /> DCT~ ~ <br /> Z~~B <br /> PORTLAND EUGENE BEND MEDFORD <br /> $00 NE Oregon St. Suite 1045 1400 Execufiive Parkway, Suite 200 Worksaurce Bend 119 N Oakdale Ave. <br /> Portland, 0R 97232-2x80 Eugene, OR 97401-2158 1645 NE Forbes Rd, Ste 10b Medford, OR 97501-Zd29 <br /> (971} 673-0763 X541}bbd-7623 Bend, OR 97701-4990 X541} 776-4270 <br /> Fax X971} 673-0762 FAX X541} b8b-79$0 (541} 322-2435 FAX X541}776-6284 <br /> TTY (971} 673-07bb FAX X541} 389-8245 <br /> SALEM PENDLETON <br /> 3845 Wolverine St. NE; E-1 1327 SE 3'~ St. <br /> Salem OR 97305-1248 Pendleton, OR 97801-4101 <br /> X503} 378-3292 www oregon.gov/boli (541} 276-7884 <br /> FAx X503} 373-7b36 ~ EQUAL OPPORTUNITY EMPLOYER FAx (541) 276-5767 <br /> <br />