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: (Tn Rr- SIIAMITr n WITu semi ,, ., e — — — ~•- • ~^ us:rAR M I Ur UESIGN AND CONSTRUCTION OF ~qq~~ ADDRESS NAME OFCOASBESTOSSREMOVALCSR 4-20 129TH STREET PHONE No. PAYROLL No. COLLEGE POINT NY 11356 ( ) - 3 CONTRACT REG No. JOB CODE WEEK ENDING - DATE PROJECT NAME AND LOCATION TAX I.D. No. 20766 07/28/02 125 CEDAR 120 L 3) 11-2869540 1) LIST TRADE & 4) DAY AND DATE 5) 6 SUPPLEMENTAL BENEFITS 11) 12) 13) gASE 7) EMPLOYEE'S NAME, CIRCLE WORK T MON TUE WED THU FRI SAT SUN 8) 9) 10 CLASSIF: I TOTAL RATE TOTAL ADDRESS, OF PAID TO SOCIAL SECURITY No. JOURNEYPERSON M 722 723 724 725 726 72 72 HOURS PAY TOTAL RATE (local t TOTAL GROSS TAX AND APPRENTICE PER BASE PER if Union PAID OTHER NET E PAY PoY DEDUCTION HELPER HOUR is check) PAY HOUR WOMOCZYL, IREUEUSZ._. JOURNEYMAN T 8.0 8.0 28.15 UEO PII AB-SUPERVIS o 5.0 5.0 42.22 514.98 U 80 514.98 458.32 -.-.-.-.-.-.... T 56.66 R UEO T

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I hereby certify th FALSIFICATION OF STATEMENT IS A PUNISHABLE OFFENSE at-the-.ebo a inforJr atjon represents wages and supplemental F7062.ELX benefits paid to all nR.Icnne em,,In,..A i Y ...., ••••• s ._ YV,N.,u •••i •••• ____._.__.:__ worn upon the e per wn. un ers and that the Agency relies upon the information as being c IIVR -------------------•

undersigns . mplete and accurate in making payments to the

SIG C 4 NAME (Print) TITLE ATE

NYC-WTC 000108086