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WORKSHEET FOR PROPERTY PURCHASE <br /> Date Check Needed: March 9.2006 <br /> Mail Check ? ,Hand Carry Check ?x <br /> General. Descri tion: R/W Ac uisitions for Rive <br /> p r Avenue <br /> q Im rov <br /> p ement ro'ect. <br /> p 1 <br /> Dept. Contact: _Engineering -Russ Royer ext. 5264 <br /> Vendor Name: Charles N. Shepard <br /> Address: PO Box 8516, please do not mail direct <br /> City/State Coburg, OR Zip 97408 <br /> Phone: 484-6595 Tax I D for 1099: 399-50-0580 <br /> Prepay ?x Emergency ?x Separate Check ?x Route to: Russ -Royer <br /> Line Amount 8 000.00 <br /> Line Description: This is an acquisition for the River Avenue Improvement project - ~"JN <br /> 3693. The tax lot numbers are 1700, 1800, & 1900 on map 17-04-13-22. ' <br /> Date: 2/28/06 Requested by: _Russ Rover <br /> Commodity # - ORDER # - <br /> Line Account Codes )0000( <br /> XJWCX <br /> ~2~ <br /> ~w ~~u <br /> Notes <br /> ~ <br /> <br /> PWA-LRE c:\user\fo?ms\propetty.frm 4/13/95 <br /> _ <br /> <br />