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 (TO BE SUBMITTED WITH REQUISITION FOR PAYIL AGENCY: NAME F CONTRACTOR/SUBCONTRACTgR ~~ ^^• -_- .,r vwiury ANU cuNSTRUCTION TRIO ASBESTOS REMOVAL CO S P(ONE;o. - 4-20S129TH STREET COLLEGE POINT NY 11356 PAYROLL No. CONTRACT REG No. JOB CODE WEEK ENDING - DATE 4 PROJECT NAME AND LOCATION 20786 08/04/02 TAX I_D._No_,_._._,_„ 125 CEDAR 120 L 3) PII tl LIST TRADE & 4) DAY AND DATE 5) 7) SUPPLEMENTAL BENEFITS 11) 12) 13) EMPLOYEE'S NAME, CIRCLE WORK T MON TUE WED THU FRI SAT SUN %ASE TOTAL RATE 8) 9) 10) ADDRESS, cLAssIF: TOTAL JOURNEYPERSON 729 730 731 801 802 80 HOURS pOF TOTAL TAX AND SOCIAL SECURITY No. 80 RATE (Local I TOTAL GROSS AHELPERICE E PER PAYE PER it Union PAID PAY NET HOUR HOUR is check) DEDUCTION PAY _POZNANSKAEWA JOURNEYMAN R UE O 5. 5.5 23.15 P .' AB-HANDLERS O U 162.06 142.18 1. 1.0 34.72 162.06 78 T 6.05 39.3 19.88 ST0PA, J0ZEF _ JOURNEYMAN R 5. 5.5 23.15 U E O I AB-HANDLERS T 151.22 214.14 U O P1 2. 2.5 34.72 214.14 78 T 6.05 48.41 62.92 R T UEO

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I hereby certify that- t1Te-above in1r rmatinn FALSIFICATION OF STATEMENT _'_— _ IS A PUNISHABLE OFFENSE F7062.ELX ---- •-r•~+~•••~ -- yea au n Supplemental benefits paid to all persons empl oyed by my firm for construction work upon the above proj during the pe ' own. understand that the Agency relies upon the infofmation as undersign al being complete and accurate in making payments to p the c relies i~i~ ` ~G6ir31`•rfi .

SIGNA E NAME Print TITLE /• C DATE

NYC-WTC 000108088