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For Office Use Only: <br />Prajeet DB #: <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 97Z3Z-2180 <br />PHONE: X971} 673-o85Z <br />FAQ: X971} 673-0769 <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 Z79C.804 to Z79C.870, in compliance with ORS Z79C.8Z5. Also for use by public agencies that are a <br />party to a public works project pursuant to ORS Z79C.800~6}~a}~B} or ~C}. <br />PUBLIC AGENCIES: Please complete and mail this form to B4LI at the above address, along with the public <br />works fee of one-tenth of one percent of the contract price ~eontract amount x .041}, payable to BOLT. The <br />minimum fee is $Z5o.00, the maximum fee is $7,500.00. Without the following completed information, the <br />bureau maybe unable to properly credit you for payment received. <br />PUBLIC AGENCY: Cit of Eu ene - En ineexin AGENCY #: 1336 <br />AGENCY CONTACT PERSON: L nn Bro den PHONE: X541) b82-5238 ..,._ <br />PROJECT MANAGER NAME: David Starns <br />MAILING ADDRESS: 244 E. Broadwa <br />PROJECT NAME: 2008 V~?'astewater Manhole Rehabilitation <br />CONTRACT NAME cif part of larger project}: <br />PROJECT LOCATION: The ro'ect includes several sites in various locations from the Santa Clara area south to <br />Lorane Hi hwa and from Te Street east to Patterson Street. <br />PROJECT NUMBER: 4117 <br />DATE AWARDED: 9/12/2008 <br />CONTRACTOR BUSINESS NAME ~DBA}: 2G Inc. dba ZG Construction <br />CONTRACTOR CCB#: 40559 <br />CONTRACT AMOUNT: $79,019.94 AMOUNT DUE: ~ ~~ C~ <br />Contract amount x .001 <br />(Please duplicate this form for future use) <br />WH-39 (Rev. 11/07) ~O /j ~O n/1~ , /~~~ "~ ~ \~ <br />17L Vr%' L~ l <br />~ ~~ O~~ ~Ia~ ~i <br />PHONE: X541 ~ b82-S30b <br />