HomeMy WebLinkAboutReceipt PLANNER 6/27/2007
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
DRC2007-00027
DRC2007-00027
Payments:
Type of Payment
Check
cRcccinll
RECEIPT #:
:~RA:~;ji
AIIra- "
~.".
;r-"'y of Springfield Official Receipt
~cvelopment Services Department
Public Works Department
3200700000000000433
Date: 06/2712007
II :06: lOAM
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
tj 0 I 0340 In Person
Amount Due
382.20
19.11
$401.31
Description
CTY 10% Final Site Dev Agnnnt
+ 5% Technology Fee
Paid By
PACIFICSOURCE HEALTH
PLANS
Amount Paid
$401.31
Payment Total:
$401.31
Date Received:
~G;)1! 2007
Original submittal
Page I of I
6/27/2007