Invoice for roof cleanup, Asbestos Removal Corp, Aug 2002

NYC 9/11 Public Portal Document THE CITY OF NEW YORK OFFICE OF COMPTROLLER BUREAU OF LABOR LAW PAYROLL REPORT ITO BE SUBMITTED WITH REQUISITION FOR AGENCY: rvnmc ur PAYMENT' DEPARTMENT OF DESIGN AND CONSTRUCTION cUNTFACTORISUBCONTRACTOR TRIO ASBESTOS REMOVAL CO I ADDRESS 4-20 129TH STREET ONE o. PAYROLL No. CONTRACT REG COLLEGE POINT NY 11356 P No.1 JOB CODE I WEEK ENDING - DATE PROJECT NAME ) — AND LOCATION 4 .L4/02 125 CEDAR 120 L 1AX I.D. No. 1) 2) LIST TRADE & 31 °) DAY AND DATE 5) 61 11-2869540 EMPLOYEE'S NAME, CIRCLE WORK T MON TUE BASE ) zoUrrLtMENTAL BENEFITS I 12) 131 WED THU FRl SAT sUN 9' 10 ADDRESS, CLASSIF: TOTAL RATE 91 SOCIAL SECURITY No. JOURNEYPERSON 729 730 731 801 802 80 8O HOURS OF TOTAL PAID T TOTAL' APPRENTICE M RATE (Local II TOTAL TAT AND PAY BASE GROSS HELPER E H PER PER it Uc,on OTHERI NET R K P HOUR PAY HOUR is check) PAID PAY DEDUCTION PAY POZNANSKA,EWA._._._._._._. JOURNEYMAN R 5. 5.5 23.15 U E0 P11 AB-HANDLERS o T 1. 1.0 34.72 162.06 7g 162.06 142.18 6.05 39.3 1988 JOURNEYMAN R 5. uE0 T 5.S 23.15 PII AB-HANDLERS 0 2. 2.5 34.72 214.14 U 76 214.14 151.22 6.05 48.4 62.192 R T U E O

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I hereby certif he.-above FALSIFICATION OF STATEMENT IS A PUNISHABLE OFFENSE n represents wages and supplemental above pro'e durin9 the eaf benefits paid to all persons employed by my firm F7oe2.ETx undersian d. p/ Y understand that the Agency relies upon the inf for construction work upon the ormation as being complete and accurate in making payment s to the TO E? HOB n f NAME 'Print) '/~' TITLE DATE

NYC-WTC 000108065