AG 2018 06 18 - Laserfiche WebLink

Home Browse Search

Rear Brake Overhaul (Both Sides) es No Minor EVAC and Recharge R134 AC System es No Alignment Yes No Battery Replacement Yes No Fuel Injection Flush Yes No Alternator Yes No Fuel Pump Module Yes No Window Motors Yes No Shock Absorbers Yes No Transmission / Engine Oil Cooler Lines Yes No Tires Yes No Towing Services i Yes No Accident Repair / Body Work Yes No This information is true and accurate to the best ofmyknowledge and ability. Typed Name of Person Completing /this Foos: /r/kr�- T' RBr� ff Title.: 111ra A'l ir/11.� L Signature: Date: 5`'//J -.'U/f Contractors and consultants will need to provide the required information for their own workforce as well as the workforce of all subcontractors that were active on their ARRA funded project(s) for the reporting month. These reports are required monthly until the contract is completed or September 2012 whichever occurs first. The Contractor hereby agrees to comply with the Contract Provisions and Reporting Requirements as indicated in the American Recovery and Reinvestment Act of 2009 and any amendments thereto. The Contractor also agrees to comply with any additional reporting requirements that may be requested by NC Department of Transportation, FTA, J. S. Department of Transportation, the Inspector General (IG), the Government Accountability Office (GAO), or other entities, for example Congressional committees or individual members of Congress. The Contractor hereby agrees to inspections or audits that may occur at any time from the any of the above referenced federal or state agencies. Contractors are requested to provide a copy of any such reports to NC Department of Transportation on any responses to such requests for information or as a result of an inspection or audit. By the submission of this proposal or bid, the Contractor hereby certifies and affirms to the truthfulness and accuracy of each of the above statements of this certification. 54 Atl chmenl number 1 In F-3 Page 172