Time and material schedule terms, MAXONS Restorations, 2001

NYC 9/11 Public Portal Document

WTC Visual Survey Form BN.1# 10012I Prerar,ise Address: 15 -john 5fr-(f(f+ Block: 7 Residential Commercial j J Name of Building: Lot: gy Mix Use ❑ Other ❑ # of Stories: AKA's: Building Owner/Management: Telephone Number: ( ) Name: FAX: Address: On Site Contact: Name: Telephone Number. ( ) Building Owner Management Activities Interior Survey Performed ❑ Yes ❑ No Exterior Survey Performed ❑ Yes ❑ No General Clean Up ❑ Yes ❑ No Locations: ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring ❑ Yes ❑ No Locations: Copies of All Reports and Data Requested ❑ Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer 1# to 1" []>1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer Y2 to 1" 0>1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer Y2 to 1" 0>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer Y2 to 1" 0>1" Facade Description:

Roof

Debris: o Visible /Fine Layer ❑ % to 1" ❑ > 1" Description:

Setbacks N/A ❑ Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer 0 % to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ Y to 1" ❑ > 1" Comments

Date: 9c / 12002 Inspection by: Name: AP Agency: EP Name: Agency:

NYC-WTC 000094273