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
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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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