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o F o CONTRACT FEE SECTION <br /> ~w ,A~ PREVAILING WAGE RATE UNIT <br /> BUREAU OF LABOR AND INDUSTRIES <br /> H ~ : a 800 N.E. OREGON ST., #1045 <br /> N ~ - ~ _ PORTLAND, OR 97232-2180 <br /> PHONE: (971) 673-0852 <br /> 1869 ~ ~ FAX: (971) 673-0769 For Office ~!se Onl}~: <br /> Project DB <br /> PUBLIC WORKS FEE INFORMATION FORM <br /> i 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 Eugene -Engineering AGENCY 1336 <br /> " <br /> 1 <br /> AGENCY MAILING ADDRESS: 99 E. Broadway Suite 400 <br /> CITY, STATE, ZIP: Eugene Oregon 97401 <br /> AGENCY CONTACT PERSON: Lynn Brogden PHONE: X541) 682-5238 <br /> PROJECT MANAGER NAME: David Starns PHONE: X541) 682-8306 <br /> PROJECT NAME: 2009 Wastewater Pipe Replacement Basins DC31 DC32, DW14, and DW15 at various locations <br /> CONTRACT NAME (if part of larger project): <br /> ~ PROJECT LOCATION: 15 various locations in the City of Eugene <br /> i <br /> PROJECT NO: 4637 (Contract #2010-041_ DATE "CONTRACT FIRST ADVERTISED: 6/16/2009. <br /> DATE CONTRACT AWARDED: 07/27/2009 CONTRACTOR CCB#: 51290 <br /> CONTRACTOR BUSINESS NAME (DBA): Gelco Construction Co. <br /> <br /> f <br /> CONTRACTOR ADDRESS: P.O. Box 7716 <br /> CITY, STATE, ZIP: Salem Oregon 97303 <br /> CONTRACT AMOUNT: $356,550:25 FEE AMOUNT DUE/PAID: j~. <br /> If less than $50K, is it part of a larger project? ?yes ?no Contract amount x .001 =fee due <br /> (Please duplicate this form for future use) <br /> tai ~ <br /> WH-39 (Rev. 03/09) <br /> <br />