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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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ITUXHIBI'T 17 <br />CER`I "IFICATION OF UNDERSTANDING <br />AND AUTHORIZATION <br />Project Name: PACIFIC ELECTRIC PARK <br />Project Number; 14.7513 <br />This is to cortify that the principals cud the authorized payroll officer, below, have read and understand the labor <br />standards clauses portaining to the subject project. <br />The following persou(s) is desigunted as the payroll officer for the undersigned mad is authorized to sign the <br />Statement of Compliance, which will accompany our weekly certified payroll reports for this project: <br />VCS <br />Payroll Officer's Nana <br />ollOfficeN•'s rguahure <br />�Z, 7Z. %ae-,e ,dt rea? (9*, <br />Contraotor /Sub ontm far <br />by <br />Signature <br />Printedd Name <br />Title <br />!7 ,7-0,/ tw <br />Date <br />Coaatradtor /Subcontractor License No. <br />0q Zq P-01 1 <br />DUNS Number <br />FIWQCSNR015vCSW VOFORMS1h16e5�4hM9 'SeClian9Speq.dee <br />23A -63 <br />
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