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� � . Exhibit B <br /> Ill�nois�Department <br /> � of Transportation Engineering Payment Report <br /> Prime Consultant <br /> Name URS Corporation <br /> Address 345 East Ash Av., Suite B, Decatur, IL 62526 <br /> Telephone _�217)875-4800 <br /> TIN Number 94-1716908 <br /> Project Information <br /> Local Agency City of Decatur, Illinois <br /> Section Number 06-00625-00-SW <br /> Project Number TE-OOD7(29) <br /> Job Number P-97-027-07 <br /> This form is to verify the amount paid to the Sub-consultant on the above captioned contract. Under penalty of law for <br /> perjury or falsification, the undersigned certifies that work was executed by the Sub-consultant for the amount listed below. <br /> Sub-Consultant Name TIN Number Actual Payment <br /> from Prime <br /> Sub-Consultant Total: <br /> Prime Consultant Total: <br /> Total for all Work <br /> Com leted: <br /> Signature and title of Prime Consultant Date <br /> Note: The Department of Transportation is requesting disclosure of information that is necessary to accomplish the statutory <br /> purpose as outlined under state and federal law. Disclosure of this information is REQUIRED and shall be deemed as <br /> concurring with the payment amount specified above. <br /> Page 7 of 10 BLR 05610(Rev.9/06) <br /> Printed on 5/12/2008 3:40:51 PM <br />