c <br />Q.- <br />region <br />January 11, 2010 <br />CITY OF EUGENE <br />PUBLIC WORKS MAINTENANCE/PARKS <br />1820 ROOSEVELT BLVD <br />EUGENE, OR 97402 <br />Bureau of Labor and Industries <br />Brad Avakian <br />Commissioner <br />- - <br />PAYMENT RECEIPT FOR PUBLIC WORKS-FEE__ <br />(ORS 839-025-0210) <br />Name of Project: DELTA PONDS VEGETATION MANAGEMENT <br />Name of Contract: DELTA PONDS VEGETATION MANAGEMENT <br />Data Base 462560 <br />This certificate is proof the CITY OF EUGENE, PUBLIC WORKS MAINTENANCE/PARKS <br />made a fee payment of $250 for the public works project named above, based on the contract <br />awarded to THE WALAMA RESTORATION PROJECT (CCB#: 166803) on 14-SEP-09, <br />leaving a 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 <br />EUGENE BEND <br />800 NE.Oregon St.;Suite 1045 1400 Executive Parkway, Suite 200 Worksource Bend <br />Portland, OR 97232-2180 ` <br />Eugene'-OR 97401-2158 1645 NE Forbes Rd, Ste 106 <br />(971) 673-0761. <br />(541) 686-7623 Bend, OR 97701-4990 <br />Fax (971) 673-0762 <br />FAX (541) 686-7980 (54 b) 322-2435 <br />Oregon Relay TTY (800) 735-2900 <br />FAX (541) 389=8265 <br />SALEM <br />3865 Wolverine St. NE; E-1 <br />Salem, OR 97305-1268 <br />(503) 378-3292 <br />www.oregon.gov/boli <br />FAX (503) 373-7636 <br />AN EQUAL OPPORTUNITY EMPLOYER <br />MEDFORD <br />119 N Oakdale Ave. <br />Medford, OR 97501-2629 <br />(541) 776-6270 <br />FAX (541) 776-6284 <br />'PENDLETO,N <br />1327 SE 3',' St. <br />Pendleton, OR 97801-4101 <br />(541) 276-7884 <br />FAX (541) 276-5767 <br />lff~~ <br />