114 LIBERTY 1 OF 2

NYC 9/11 Public Portal Document

CLEANING REQUEST FORM

As the authorized representative of 114 Liberty condominium, i hereby request that the New York City Department of Environmental Protection (DEP) perform the cleaning and monitoring work specified in the attached scopes of work for the cleaning and monitoring contractors (the "Cleaning work") at 114 Liberty street, Manhattan (the "Building"). To facilitate the performance of the cleaning work, it is agreed that: 1. Employees, authorized representatives, and contractors of DEP shall have access to all common areas of the Building, including the heating, ventilation and air conditioning (HVAC) system, for as long as necessary to perform the cleaning work. 2. The cleaning work is to be performed in accordance with DEP's role under the Federal Response Plan and pursuant to the authority of the Robert T. Stafford Disaster Relief and Emergency Assistance Act. The united states Environmental Protection Agency (EPA) will act in an oversight capacity with regard to said work. 3. DEP will be informed as to any applicable building rules which would affect the Cleaning work, including, for example, time restrictions, appropriate entrances to the Building, and elevator usage. 4. The cleaning work will be performed by contractors retained by DEP. Said contractors are required to maintain, at all times during the cleaning work, insurance coverage for commercial general liability, workers compensation, environmental impairment liability, and employee dishonesty related to the cleaning work. 5. The cleaning work will require use of the Building's electricity and water. 6. Insurance payments or any other form of compensation received by the Building owner which have been or will be received for activities covered by the cleaning work and which have not been spent for such purposes will be paid to DEP. 7. A copy of the air monitoring results will be provided to the Condominium within 96 hours of the conclusion of the cleaning work.

SIGNATURE

Authorized Representative, Date 114 Liberty Condominium

Name and Title (Print)

NYC-WTC 000155157