1999-08-23_GENERAL DOCUMENTS - C1981017

• Permit No: C1981017
• IBM Index Class Name: GENERAL DOCUMENTS
• Doc Date: 8/23/1999
• Doc Name: Bid Documents ‎(IMP)‎
• Permit Index Doc Type: General Correspondence
• Media Type: D
• Archive: No

Attachment B
AML CONTRACTOR
OWNERSHIP AND CONTROL DATA CERTIFICATION
Company Name: `E 1i Phone• (I-1 o Wt
Address:
Subcontractor Name: Phone:
Address:
CERTIFICATION OF EXISTING DATA:
being duly authorized, do hereby
certify that no changes have occurred in the existing ownership and
control data (attach printouts) listed in the Federal Office of
Surface Mining, Applicant/Violator System for the contractor
company, {); - i,�; ,stir and the subcontractor company,
�/
Signature Title Date
NOTIFICATION OF OWNERSHIP AND CONTROL DATA CHANGES:
The ownership and control data currently in the Federal Office of
Surface Mining, Applicant/Violator System needs to be amended in
the following ways:
Addition of informatio related to officers, directors,
shareholders or any of er entity who owns or controls the
contractor as defuned i!n 30 R 773 .5 :
Name I Title
Address
Begin date End Date (attach documentation)