1995-04-17_GENERAL DOCUMENTS - C1981048

• Permit No: C1981048
• IBM Index Class Name: GENERAL DOCUMENTS
• Doc Date: 4/17/1995
• Doc Name: PKA-9-440
• Permit Index Doc Type: Reclamation Projects
• Media Type: D
• Archive: No

Attachment A
AML CONTRACTOR
OWNERSHIP AND CONTROL
INFORMATION PACKAGE
1 . Contract No.
2 . Contract Type:
Inspection Engineering Reclamation _
GENERAL INFORMATION
3 . Contractor Name KtSSL FR IZ F_r L #M/+T, phone 2/ 9- 7F i' —y,20 7
Mailing Address R. 0, ff to x ' /
City -R 0 L){J 14 L, � StaC-D Zip K /02 5j L/
SSN _ EIN
4. Sub-contractor Name Phone
Mailing Address
City State Zip
SSN EIN
All sub-contractors who will receive 10% or greater of the
total AML Contract award must be identified, with the
exception of contracts awarded for inspection services or
include inspection duties. All subcontractors on inspection
contracts or who are carrying out inspection duties MUST be
identified. If there is more than one subcontractor, list
above information on a supplemental page.
OWNERSHIP AND CONTROL
5. a) Contractor' s Legal Structure:
()o Sole Proprietorship ( ) Partnership
( ) Corporation ( ) Other
If Contractor is a sole proprietorship, list:
Owner Name _P14,1 L J� FSS ,L r R Phone 2 ) 2- 7�"% Y,3 0 7
Mailing Address T . 0 , S 0 X _
City State `_1 U _ Zip /-D 9
SSN 0 - R' ,V y & EIN
Beginning date as owner of sole proprietorship I !?go
b) Sub-contractor' s Legal Structure:
( ) Sole Prop r etorship ( ) Partnership
( ) Corporation ( ) Other
it