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23A - PROJ - ELECTRIC PARK
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03/21/2017
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23A - PROJ - ELECTRIC PARK
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Last modified
3/16/2017 4:00:09 PM
Creation date
3/16/2017 3:49:07 PM
Metadata
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23A
Date
3/21/2017
Destruction Year
2022
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EXHIBIT 17 <br />cr,. 'rlFICATI.ON OF UNDI✓:RSTANDING <br />AND AUTHORIZATION <br />Project Name: PACIFIC ELECTRIC PARK <br />Project Number: 14 -7513 <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 authoriz4d to sign the <br />Statornent of Compliance, vvhich will accompany our weekly certified payroll reports for this project: <br />Diana Lehman <br />Payroll Officoe Mw,-6 <br />Payroll Officer's Signature <br />LEHMAN CONSTRUCTION, INC. <br />Contractor /Subcontract t'" <br />t <br />by <br />ignature <br />Diana Lehman <br />Printed Name <br />Secretary/Treasurer <br />Title <br />12 -20 -16 <br />Date <br />239570 <br />Ccutractor /Sribcontraotor License No. <br />03- 069 -2045 <br />DlTNS Numbe <br />F:I DOCS TROPSVCSHUDFORMSIMBU6SD4AMB- SeoHon3Spece.MC 23A -58 <br />
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