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PREVIOUS CONTRACT NO. H-9-03-242-81
WO NO. K-z.25.376.B1
TTA ENT "G"
RQYyAR COUNTY
LIVING WAGEEMPLOYER CERTIFICATION
This certification must be provided at the request of the purcnasing went before award of the contra
Employer: \NclKSgy Ashes{- 1 Yi yC I Date:
Address: 10701 siii 1;
tPaa„b rot:_ r , 33332 •
Phone Number: (95AI 680-20CIS
local Contact 1 ii[ Week le Yy
Bid/ContractNumber: �Z.05'376$
Address::�Ul } ,rt►brot'.� ViretiNt,
Contract Amount: t. 4g. Z2 Qp -3_ oo
Phone Number. t 6-fSOOS-
ISepartment Served:
Brief Description of Service Provided:
Please check one:
are provided health benefits valued at
are not provided health benefits.
By signing below t hereby certify that the employees listed below:
A. Receive a minimum pay of $ per hour and
$ per hour.
/
B. 1/ Receive a minimum pay of $ //, '8 per hour and
Please check one:
for the above referenced contract:
period:
Names / A or B
-c.edr-r lc.. ,5oe.174
-,-------~ Names of employees to be providing covered services
Names of employees that provided service for this invoice
�Names A or B
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I, j f ,- ! 6 . Aleiiq A' SY rig n.)-- , hereby certify that A,ietokbi J_,(_J�%%- Z rt Is committed
Name Title ontractor
to pay all employees working on this contract/project. and therefore covered by the Broward County Living Wage
Ordinance 2002-45. in accordance with wage rates and provisions of the Living Wage Ordinance. I further certify that
all of alion provided above Is true, complete and correct.
By DANIEL D. WEEKLEY, PRESIDENT
Sig atone Print/Type Name and Trtle
33335'
GRMMc-P612-21:105
2/16/06
Pays 7r of 8+t
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