Invoice for roof cleanup, 120 Liberty/125 Cedar, Aug 2002

NYC 9/11 Public Portal Document THE CITY OF NEW YORK OFFICE OF COMPTROLLER BUREAU OF LABOR LAW PAYROLL REPORT AGENCY: (TO BE SUBMITTED WITH REQUISITION FOR PAYMENT) NAME 11E CO I r'rno,e.,e DEPARTMENT OF DESIGN AND CONSTRUCTION T~tIO ASBESTOS'REM0VALyC0 ADD S PONE j o. - 4-20S129TH STREET COLLEGE POINT NY 11356 AYROLL No. CONTRACT REG No. 4 JOB CODE WEEK ENDING - DATE PROJECT NAME AND LOCATION 20766 08/04/02 125 CEDAR/120 L P11 1) L)IST TRADE & 3) 4) DAY AND DATE 5) 6) 7) SUPPLEMENTAL BENEFITS 11) 121 13) EMPLOYEE'S NAME, CIRCLE WORK T MON TUE WED THU FRI SAT SUN TOTAL RATE a) 9) 70 AOORESS, CLASSIF: I TOTALI PAID T SOCIAL SECURITY No. JOURNEYPERSON M 729 730 731 801 802 803 80 HOURS pOF TOTAL RATE Iloc& w TOTAL GROSS TAX ND APPRENTICE E BASE 0THE1 HELPER PER PAY PER it Unix PAID PAY NET HQES fl rpE Y HOUR HOUR chock) DEDUOTION PAY POZNANSKA,EWA JOURNEYMAN R 5. 5.5 23.15 UEO AB-HANDLERS O 78 162.06 142.18 P11 1. 1.0 34.72 162.06 _._._._._._._._._._._._._._._._._.. T 6.05 39.3 19488 STOPA, JOZEF JOURNEYMAN R 5 5.5 23.15 U E O PII T AB-HANDLERS D . U 214.14 151. 22 2. 2.5 34.72 214.14 78 T 6.05 48.4 62 92 R 1 T UEO

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I hereby certif bo„ e ; t. FALSIFICATION OF STATEMENT IS A PUNISHABLE OFFENSE F7062 ELX rma Ion represents wages and supplemental benefits paid to all persons employed by my firm for construction above proje during the pe ' own. understand that the Agency relies upon the work upon the undersign d information as being complete and accurate in makin g payments to the

SIGNA RE NAME (Print) ITLE DATE

NYC-WTC 000108076