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OF O <br /> <br /> ' re('~on Bureau of Labor and Industries <br /> H' :c V <br /> <br /> ~ 5 Brad Avakian <br /> s 5e Commissioner <br /> September 26, 2008 <br /> CITY OF EUGENE <br /> ENGINEERING DIVISION / BROGDEN <br /> 244 E BROADWAY <br /> EUGENE, OR 97401 <br /> PAYMENT RECEIPT FUR PUBLIC WORKS FEE <br /> {ORS 839-025-0210) <br /> Name of Project: PINE CANYON DR STORMWATER IMPROVEMENT(STREAM RESTR <br /> #60019. <br /> This certificate is proof the CITY OF EUGENE, ENGINEERING DIVISION / BROGDEN ' <br /> made a fee payment of $250 for thepublic works project named above, based on the contract <br /> awarded to DELTA CONSTRUCTION OR CONRETE (CCB#: 62971) on 09-SEP-08, leaving a <br /> balance of $0 for this contract. <br /> As required by ORS 279C.825 and OAR 839-025-0210, 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 more, the agency shall submit any <br /> additional payment or 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 /> PORTLAND EUGENE" BEND MEDFORD <br /> 800 NE Oregon St. Suite 1045 1400 Executive Farkway, Suite 200 Worksource Bend 119 N Oakdale Ave. <br /> Portland, OR 97232-2180 Eugene, OR 97401-2158 1645 NE Forbes Rd, Ste 106 Medford, OR 97501-2629 <br /> ' (971) fi73-0763 (541) 686-7623 Bend, OR 97701-4990 (541) T76~6270 <br /> Fax (971) 673-0762 FAX (541) 686-7980 (541) 322-2435 FAX (541) 776-6284 <br /> TTY (971) 673-0766 FAX (541) 389-8265 <br /> SALEM PENDLETON <br /> ' 3865 Wolverine St. NE; E-1 1327 SE 3'~ St. <br /> Salem, OR 97305-1268 Pendleton, OR 97801-4101 .~X <br /> (503) 378-3292 www Oregon. ov/boli (541) 276-7884 ~r+ qq~'p'pp <br /> FAX (503) 373-7636 AN EQUAL, QPPCIR~.'I~~VITY EMPI..GYER FAX (541) 276-5767 Di, T ~ 2 G~Op <br /> <br />