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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 />CERTIFICATION OF UNDERSTANDING <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 fallowing 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 £or this project: <br />IDOC$V3ROMVCMUtlFORM&MBU8944AMS. EadonMpa DOC <br />Ammida Jc-)hvlsov) <br />? oll Officer's Name <br />umaln <br />Payroll Officer's Si re <br />Econo RYACE Inc. <br />Can or/Subcontractor <br />byC�f F %° <br />Signature <br />{'clrn ayl � a �U nsclh <br />Printed Name <br />Pre s 1 dent <br />Title <br />r2ez� Ise <br />Date <br />39,)l � JL4 C- 1?) <br />Contractor/Subcontractor License No. <br />Io�oR a9B32S <br />DUNS Number — _ -- <br />23A -64 <br />
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