Work order authorization, 352 Park Avenue South, Oct 1999

NYC 9/11 Public Portal Document 10 1999 10:40 FR R.B.SAMUELS 212 213 4009 TO AHb^SADOR P.03/09 ■ adERT B. SAMUELS," INC. WORK ORDER JSi PARK avenue SOUTH yZNEW YORK, NY 10010 RBS ORD€R NO.. 28504 RBS JOB NO. 5-/4 <r Jr____ INVOICE TO; XT zS CUSTOMER JOB NO. CUSTOMER W.O. NO. CUSTOMER P.O. NO JOB LOCATION .

ATTENTION:

vou ARE HEREBY AUTHORIZED AND REQUESTED TO PERFORM THE ADDITIONAL WORK SPECIFIED BELOW UPON THE FOLIOWINS BASIS COST OF ALL material AND LABOR. INCLUDING ALL PREMIUMS ON INSURANCE ANO FRINGE BENEFITS. PLUS OVERHEAD. PROFIT AND SALES TAX WHERE applicable. TERMS NET 15 Day:; ___ . _ ... , □ SERVICE CALL 1___I CONTRACT EXTRA T& M “ r zv Cl

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□ATE authorization to proceed PLEASE PRINT NAME

TIME AND MATERIAL WORK PURSUANT TO ANO UNDER PROVISION OF ABOVE WORK ORDER. labor MON TUES WED. I thurs. FRI. SAT. i SUN GRAND DATE //a/ total Nt total Na, TeUl NO Towi No. Tok' nb Total NOt Hatai No. Total HOURS

_r - Mun Men H»S Mrs Men Mrj H'J Man H-s W<n Hrs Men Mrs

foreman ■4 o/t“

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DATE______ ACCEPTED:, yV / NAME OF company

BY- PtE*S£ PRINT gy '■ tY //?

rORf MAN _ rL6ASE “Pint AUTmOXiZED SIGNaTUOE

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NYC-WTC_000171682