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04/18/95 09:08 AUSO-LEXINGTON 4 303 832 8106 NO.591 U04 <br /> APR 17 '95 03:45PM DI+1/MINERALS&GEOLOGY P.4/17 <br /> Attachment A <br /> AML CONTRACTOR <br /> OWNERSHIP AND CONTROL <br /> INFORMATION PACRAaE <br /> 1. Contract No. <br /> 2. Contract Type: <br /> Inspection E�igiaeeriAq Reclamation <br /> GENMRAL INFORN&TION <br /> �3 7s/oz <br /> 3. Contractor Name LFR R _ea_A_-tilt lj?hone !212- Z Y ~-y30? <br /> Mailing Address U-n it ijI <br /> City 12 0 Cxv State 7 0 zip $ ,.q:�z <br /> SSN EIN <br /> 4. Sub-contractor Name Pone <br /> MAiling Address <br /> City State Zip <br /> SSN <br /> BIN <br /> All sub-contractors who will receive 10% or greater of the <br /> total AML Contract award must be identified, with the <br /> exception of contracts awarded for inspection services or <br /> include inspection duties. All subcontractors on inspection <br /> contracts or who are carrying out inspection duties MUST be <br /> identified. If there is more than one subcontractors list <br /> above information on a supplemP.ntal page. <br /> OWNERSfl2P AND CONTROL <br /> 5. e) Contractor' s Legal Structure: <br /> O0 sole Proprietorship ( ) Partnership <br /> (. ) Corporation ( ) Other <br /> If Contractor is s. sole proprietorship, list: <br /> Omer !isms /�1 L <$S�SYo 3 Phone ��-_7 e Y 1302 <br /> Mailinq Address `f <br /> City i,Q a I� U A-L F State 0 Zip <br /> SSN , N �.5 0 R' '/ Y� _ EIN <br /> 8®ginning date as owner of sole proprietorship <br /> b) Sub-Contractor' s Legal Structure: <br /> ( ) Sole proprietorship ( ) Partnership <br /> ( ) Corporation ( ) Other <br /> i <br /> i <br />