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20B - AA - STREET REPAIR
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11/19/2019
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20B - AA - STREET REPAIR
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Last modified
11/14/2019 7:26:22 PM
Creation date
11/12/2019 2:21:44 PM
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
20B
Date
11/19/2019
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EXHIBIT 17 <br />CERTIFICATION OF UNDERSTANDING <br />AND AUTHORIZATION <br />Proj ect Name: <br />Project Number: 11— ~%S�2 <br />This is to certify that the principals and the authorized payroll officer, below, have read and understand the labor <br />standards clauses pertaining to the subject project. <br />The following person(s) is designated as the payroll officer for the undersigned and is authorized to sign the <br />Statement of Compliance, which will accompany our weekly certified payroll reports for this project: <br />&P4. 544MR210 aR DEfir7on/n 11AA/L�E`�,r <br />Payroll lice's Name <br />Pa •ol f er's Signature <br />-0gA 1-2 <br />Contract be ttr ctor <br />by <br />Signature/ <br />Vl91-1' &AiiAN22 <br />Printed Name <br />lI(G� FSIDkn/� <br />Title <br />Date <br />3�Mo <br />Contractor/Subcontractor License No, <br />DUNS Number <br />F%DOCSTROPSVCS%HUDFORMSIMBU5Bo4AMB - Secbon3Specs. DOC <br />
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