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NYC-WTC_000202695

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NYC 9/11 Public Portal Document

NEW YORK CITY BOARD OF EDUCATION GENERAL FIELD VERiFICATION FORM

AME OF Tl IE CONSUL riNG FIRM; ATC Associates Inc. SPECIFICATION NO.:

/PEOF SERVICES PROVIDED: oulicabic)

□ ASBESTOS TECHNICIAN □ PROJECT DESIGNER* □ mISC. consulting SERVICES □ AIR SAMPLING TECHNICIAN □ PROJECT MONITOR

□CATIQNS(S). 9 0 '/d I~\'/ 7 7 - WORK PERFORMED- 7 7

ATE TIME NAME OF THE . NAME & SIGNATURE IN V OUT 5 PROFESSIONAL OF AUTHORISED PERSONNEL CUSTODIAN/PRIN<3IPAL' name (print) signature y . name (print) signalize

^3 0 777^ 72W I >5^ Wv ^7 (7 (7

o OTE: Please complete the following as applicable, indicate "N/A" if not applicable. H H Hj Asbeslos Inspeclor’s no. of school visits: I hO

s o Air Sampling Technician's no. of school visits: ‘Minimum payment for Project Designer's services shall be four (4) times ttie unit price per hour. o o I Project Monitor's total no. of hours: o o co to Mise, consulting services no. of hours: (JI (JI

(71

NYC-WTC_000202695

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NYC-WTC_000202695Source: NYC Law Department, mirrored locally

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Form verifying on-site asbestos technician and air sampling services performed by ATC Associates Inc. at a New York City Board of Education school.

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Form verifying on-site asbestos technician and air sampling services performed by ATC Associates Inc. at a New York City Board of Education school.

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