New Search
.~:~~~ <br /> ®ATE: ~ 1 C~~ <br />CONTRACT FEE SECTION INBTIALS: <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 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: Cit oy f Eu ene - E~ineering AGENCY #: 1336 <br />AGENCY CONTACT PERSON: Lorin Broaden PHONE: (541) 682-5238 <br />PROJECT MANAGER NAME: David Starns PHONE: (541) 682-8306 <br />MAILING ADDRESS: 244E Broadway <br />PROJECT NAME: 2008 Wastewater Rehabilitation Basins DW 21 SW 33-35 DW 44 and various locations <br />CONTRACT NAME (if part of larger project): <br />PROJECT LOCATION: Various locations in the city <br />PROJECT NUMBER: 4507 DATE AWARDED: 6/13/2008 <br />CONTRACTOR BUSINESS NAME (DBA): H & J Construction Inc. <br />CONTRACTOR CCB#: 88084 <br />CONTRACT AMOUNT: $756.992.00 AMOUNT DUE: ~ ~ ~ ~~ <br />Contract amount x .001 <br />(Please duplicate this form for future use) <br /> <br />2~~~ <br />~Cc~ 1~~. c____ <br />~` ~ WH-39 (Rev. 11/07) ~`-~ ~'~i;~ ~~~ <br />