Fax transmission journal, Oct 9 2002

NYC 9/11 Public Portal Document

°*ice APPLICATION FOR CONTRACT PF.RA717 s[PetmftM+dtemsts.d Caadol PER II T NL7MC2~N~ . l nuv.e-98)PkWfr

(Isms:_ 12 4.70 o0NTRA= s:~pF - Rcwl 2 EO1WGB: H Os OQ Dx Os OMEC OffitEC OQEC DEC OREc o SPONSOpt)1G AGM=: DRB DDc ODoT OOrsURc c# PROJECT F37GnMM Oapn zs OscA Oz4rA D.& of NT AM M:~ Dix~ RI A DHo ~[ R~SHP1tal~P NAM OF E so s: c1lg) Sqc-2,111% ACTOO:t: i n Xur 21•, ,- t5 J on Con+ v `~$am ~: ('lt ) soslNEss ADDRESS:~y_8 'RAJ L, A..e — -~ 1 _. AI- 2-400 RESIDENT ENGI~ 1VM: EPHONE #: ( PROTECT DESCRIp7FT'm. ~R M CONTRACT START D2 COUTRACT TIat1 DATE. TYPE OF PAVMG NT: 1~ ~ 3c ~p2" ROADMX: TYPE OF P Ste. r CS) REQQ (Check All 011l- OR INS2nr-r:a•rOq~_ Linable 0112-RAPID SERA 0126-TEST PITS, CORES TRANSIT CONSTRUCTION OR C 0113-REPAIR sLIMR 0132-ms /SHOVEL ON SST EE27CE 0205-PZA= SEAN.W/ ~ 1 4-PEPAat SE R 0135-m L N ION on 0136-LGEp-t01JOR INsTAT.rai.Tmqs- STRUT 0115-REPAIR /SERER 0208- oRAIM PRB TRI 0116-FURL OIL LDE RATA alt 0137-DEP-FOR IDSVJZA Cus- 0211-1LJI CRT AD 0118-RESMAEPAM Ott REPLACE Q214-Py~E L T CURB SERER ON 0215-may 0119-PAVE STREET 0201-pxA M S DE T SST 0202 -CROSS 0401-REpAtlt SID~yR ~ S~' 0120-TREE PIT SIDEir!►LT( 01 21- CONSTRUCT OR ALTER 0203-PLACE G'RANE/SHOVEL 0402-OONST UCr NEW STh jp !9MoLB OF 0403- REPLACE SITIE~Lj( AND/OR CASTII~ STREET 0 204-PLACE Emp TMw VETM7LA1T4tS OT OTTER TTPE OF PERlQT:

-- -- - IVC 7b - 6 &- CosC

OCHC APPROVAL By: j'~,,~ ' 2113 PV*aT To BE QtANTID SOa3 LJ boR LOCATIONS ON REVERSE CT TO TBE F'OIS.OaING CORIDITIONS: TM APPLICANT AGREES TO OOWW NO PER2QT -WaL BE ISSUED RITE ALL IAWS AND RULES OF T8s DIL.ESS TBE APPLICANT BAS ON FILE ALLDEPART111ENT AND OTHER APPLICABZB LAWS ARID RULES. INSURANCE (BONDS). APPROVED FOR TBE cOl43LSSIONER BY: SUE T BY: N're- Z E P Ac P DATE: _

DAB: SIGNED BY: TEL # t 7iP) 55•S _372 /

NYC-WTC 000111708