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<br />c~.t.'~it 1;~ <br />~?eu~n <br />Ya-~cv <br />~CJ~ ~~ <br />C~ [~ <br />~~~ ~ <br />~~~t~v~,~1~. ' <br />~~~~~ <br />~~ <br />23. In the following chart please list the companies tttet will be used for the construction or rehabilitation associated with the <br />project. Indicate the name and address of each company; list the dollar amount of the work to be provided by each company; <br />i ndicate whether or not) 00% of the workers arc employees of that company or independent contractors; indicate whether or not <br />the company pays workers wages that meet the wage rates for each classification of laborers and mechanics published by the U.S. <br />Department of Labar; indicate whether or not the company contributes to a health plan for its employees; indicate whether ar not <br />the company contributes to a pension plan far its employees; and indicate whether or not the company maintains an affirmative <br />action plan or other similar plan to achieve racial diversity, Additional information may be requested for verification of this <br />information. (lf additional space is needed, please photocopy this page). <br />Construction Company Cost of Ail Workers Pay Contribute Contribute Maintain <br />Name and Address Work Empioyeea or Wsge to a to a Affirmative <br />or independent Rate Health Pension Action <br />enntratNnrv fv/nl Plan fv/nl Plan fv/nl PI'n fv/nl <br /> <br />M <br />t <br />i <br />__- <br />n~t++~rr1 (3t~, acs ~•(c S9G 3ofl ~~tLor hIo `~s `~ Y-~3 <br />~ S.77t Ir,/t; ~ 000 ~ r vas ~. ~ `' <br />S'Mc~~srte~~ to o~p " 1f~ •r '' ~t <br />~oss /`/I~sosay' I o6 atX~ ~ ~ ,fi ~ , ~ ~ ., <br />f}S'p'~G- ~~~':a¢.,S ?-Z8 ct~ I t tt <br />t~l o t~ r t i t <br />QV~~k4~7t1~ ~Q- ~S~FOD rr ? tr 'r rt <br />Ta, _ V,q~,,-ay v~ss 11,!.00 n ~o '~ ~, •r <br /> , <br />~~- /fit-occsTae.s 4 Ge0 1~a~ n.19 '~ ~ I~.~~o <br />L./+~nD r 6s PM ~-n~([, l 3 t o0 ~~ 1,.(0 ~ ~ ~, , r <br /> <br /> <br />~P$EU- Et.~az.tc <br />(Rev 8!11!03) <br />i ~p/t7~C r. <br /> <br />4 <br />~a <br />