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~1~lTf~~T FE>1 TI <br />>~~r~i~ vl~ RATE ~JIT xti.~, ~ ~l~~E~l~ F L~1 I~ II~UTI~ <br />it - ~ E~~, IEti T.~' #1~4~ <br />Pr~~~t <br />For use b~ public a~enci~s that h~►v~ ~or~~ra~te~ ►~ith a contractor an ~ ~ubli~ ~vnrk pro~eet r~gu~ate~ b~~ <br />to 1~7,87~, in ~rnpli~n~~ ~vi~h ~R 74 l~ h public ~~encres that ~r~ a <br />hurt to ~ public works project pu~rsurrt to ICI 79.8~0~~~a~(~) ~r . <br />1~~JI~~I tsEIIE~ Pla~~ ~~t~plte and mail this farm to ~Gl at the above a~~ress, al~~~ Frith the public <br />orbs fee of any-tenth ~f percent of tl7e eontrat prise ~~~ntr~ct amount .~~I, pa}~able t~ >i~I. Thy <br />minirnu~ fee is the rn~xirnum fee is 7,~~~~~~ 1ith~ut the f~llou~in completed inf~rrt~~ti~n, the <br />bureau rna}~ be un~bl t~ pr~p~rlf credit }+ou far pa}~rner~t tei~r~~. <br />~~JBLI E it~r~f Eu~ne - Erg ink, El <br />t1El~ Il~t ~I~[~tr Hraadwa quite <br />iT~ TATS, I1~~ Eu~~~, ~ ~7~~ l <br />~►E1V~ 1VTT ~1~1~~ n n ~ro~~en I~H~Y~: {4 t - <br />I~I~JET ~V1IEI~ 1AI~ catt lilovi~l~ Pi~E: ~4 l <br />~C~JET 11V1E; felt ~~nd ip~~~an Bench anstructi~a~ <br />[~Tr~T liE cif part of l~r~~r pr~je~~: Delta fonds <br />PIJET ~TtI~1; ~~lt~ Fares <br />P1~,~~T ; ~ ~T~ Tl~1'T FIIT I~EITI~~F ~~1~~I~~9 <br />I~TE 1VTRT ~l~'V~i~~; ~~II~O fY'f RT~I t~~#: ?1 <br />~1T1T Bf11~ f~►i~ I~B Babb inst. dba Cclt~ int. ~b~ Delta ar~crete o. <br />ITT DBE X99 )~ivi~i~r~ Avenue <br />~T TTEa rl~: Eu~ene~ i ~4~4 <br />iTIT ~►LI~T: I~.O~ 1I~I![T ~[lE1I~II); "~D•x <br />~~ss t~~n 501} is it part ova l~rg~r praj~~t'' ❑~res ❑na or~tr~~t ~o~n~ ~ .~~I ~ fee due <br />{~l~as~ duplicate this ~~rm for future use} <br />~ - ~ ~ <br />H- ~lev, ~~I~ <br />