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Subcontractor services letter for DEP, February 2012

Machine-extracted title · confidence 95%

Letter regarding subcontractor services for a water tunnel project dated February 27, 2012.

NYC-WTC_000159316–000159346

Folder label: “Requests 2012

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Scanned page image, NYC-WTC_000159319
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NYC 9/11 Public Portal Document

CITY OF NEW YORK SUBCONTRACTOR PROFILE FORM

TO BE COMPLETED BY SUBCONTRACTOR

INSTRUCTIONS TO PRIME CONTRACTOR

A Subcontractor Profile Form must be completed by EACH subcontractor that will perform on the contract. Make additional copies of this form as needed.

PRIME CONTRACTOR NAME XEIN □ SSN Jenny/BAC Killam, A Joint Venture

DEP CONTRACT #EE-GEO-02 & EE-GEO-03 REGISTRATION #82620060020284

SUBCONTRACTOR NAME □EIN XSSN

Ian Michael Gowring Pll

SUBCONTRACTOR BUSINESS ADDRESS

8921 Memory Lane, Auburn, CA 95603

Number Street Borough/City State Zip

SUBCONTRACTOR BILLING ADDRESS (IF DIFFERENT FROM ABOVE)

Number Street Borough/City State Zip

SUBCONTRACTOR TELEPHONE (530)885-9055

SUBCONTRACTOR AMOUNT $12,000

DESCRIPTION OF SUBCONTRACT AND LOCATION

Reviewing information, travel to Technical Review Committee (TRC) meeting(s), participation in the TRC, and providing input to report prepared by others

FORM MtCxAgt. COMPLETED Name (PRINT) of Subcontractor’s Representative Title BY A n ______ Am.- U<$uAj-C-Q Signatur^Zl

MOCS Subcontractor Approval Form (Sept. 2010)

I

NYC-WTC_000159319

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NYC-WTC_000159319Source: NYC Law Department, mirrored locally

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