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NYC-WTC_000208110

Label derived from the City's folder field. The City does not supply document titles.NYC-WTC_000208110
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69L6TO0C00 OOTOWT? ALIO NYC 9/11 Public Portal Document HARIE OF THE CONSULTING FIRM: NEW YORK CITY BOARD OF EDUCATION GENERAL FIELD VERIFICATION FORM ATC Associates Inc. SPECIFICATION NO - | SCHOOL: ee ae _ ADDRESS: ee TYPE OF SERVICES PROVIDED: (check as applicable) [_] ASBESTOS TECHNICIAN | _] PROJECT DESIGNER* {_]MISC. CONSULTING SERVICES {] AIR SAMPLING TECHNICIAN { |] PROJECT MONITOR LOCATIONS(S): — ANE BONN WORK PERFORMED: DATE TIME NAME OF THE NAME & SIGNATURE IN OUT PROFESSIONAL OF AUTHORIZED PERSONNEL CUSTODIAN/PRINCIPAL name (print) signature - name (print) .. _ Signature y \ fi y ~~ Ta Jie ||) Sax | [oe [Ke J | x acoN [Te Wue Eukyna le ‘aon 6/i3/| I en | | on La (VL Ke “nee Aun OM wanes dA Ok f we ee Hu WS a Eb Waa 4 tt Aw Qye Kj ae ; Le i 7 NOTE: Please complete the following as applicable, indicate “N/A” if not applicable. Ashestas ‘Minimum payment for Project Desiqner's services shall be four (4) times the unit price per hour. lspector's be Project Monitor's no oofs ma total no ol hours chool visits: it Misc. consulting services no. of hours: NYC-WTC_000208110

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NYC-WTC_000208110Source: 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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