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Last modified
4/25/2022 9:08:17 AM
Creation date
12/20/2021 10:08:48 AM
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Contracts
Company Name
NOBEST INCORPORATED
Contract #
P 22-7537
Agency
Public Works
Council Approval Date
12/7/2021
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EXHIBIT 13 <br />U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT <br />Los Angeles Area Office, Region IX <br />1615 West Olympic Boulevard <br />Los Angles, California 90015-3801 <br />CERTIFICATION FOR APPLLICABLE FRINGE BENEFIT PAYMENTS <br />Project Name:_ G(/CaI Stleet (,pwh Re V ;�ih a <br />Project Number: 2 " % 9-7 <br />Classificatlnu/Frlugelienefits Provided <br />1} <br />Health and Welfare $ <br />Pension $ <br />Vacation $ <br />A renticeship /Training $ <br />2) <br />Health and Welfare $ <br />Pension $ <br />Vacation $ <br />Apprenticeship / Trainina $ <br />3) <br />Health and Welfare $ <br />Pension $ <br />Vacation $ <br />Apprennceahip /Training $ <br />4) <br />Health and Welfare $ <br />Pension $ <br />Vacation $ <br />Apprenticeship / Trainina $ <br />OR: (CI-IECK IF APPLICABLE) <br />Name, Address and Telephone Number of Plan/Fund Program <br />— I certify that I do not make payments to approved fringe benefit plans, funds, or programs. <br />Contractor/Subcontractor <br />Date <br />Signature <br />Tide <br />F,'MGS%PROPSVCSWUOFeRMMMBUOBU4AMB. SeoBonUBpooaeee <br />
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