Subcontractor/Employee Master List

Total Page:16

File Type:pdf, Size:1020Kb

Subcontractor/Employee Master List

Page 1 of 3

SUBCONTRACTOR/EMPLOYEE MASTER LIST (RSA 21-I:81-a and 21-I:81-b) Revision Date: July 2014

Project Name: Acute Psychiatric Services Building Project Number: 80620 General Contractor: Covenant Fire Protection, Inc. 150 Zachary Road, Suite 6, Manchester, NH 03109 CEO: Raymond Scott 46 Lindstram Court, Manchester, NH 03103 CFO: Jason Kahan 53 Ash Avenue #1, Somerville, MA 02145 LLC Principals: Frederick Roy 99 Goshen Drive, Loudon, NH 03307

NAME OF GENERAL EMPLOYEES ENTITY WITH WHOM ENTITY PROVIDING OSHA-10 NAME & ADDRESS CONTRACTOR, EXPECTED TO WORK SUBCONTRACTOR OR WORKERS COMPENSATION CERTIFICAT OF INSURANCE SUBCONTRACTOR, OR ON THE JOBSITE INDEPENDENT IS COVERAGE E ON FILE CARRIER INDEPENDENT CONTRACTED (Y/N) Covenant Fire Protection, Inc. -- n/a Covenant Fire Protection, Inc. -- Desanctis Insurance 100 Unicorn Park Drive Woburn, MA 01801

Clark Insurance 80 Canal Street Manchester, NH 03101 Raymond Scott Covenant Fire Protection, Inc. Covenant Fire Protection, Inc. Yes -- Michael Joanis Covenant Fire Protection, Inc. Covenant Fire Protection, Inc. Yes -- Employee Name -- GC or Subcontractor/Indep name -- Employee Name -- GC or Subcontractor/Indep name -- Employee Name -- GC or Subcontractor/Indep name -- Employee Name -- GC or Subcontractor/Indep name -- Page 2 of 3

Employee Name -- GC or Subcontractor/Indep name -- Subcontractor/Independent -- GC or Subcontractor/Indep GC or Subcontractor/Indep name -- Name & Address Address name Employee Name -- GC or Subcontractor/Indep name -- Employee Name -- GC or Subcontractor/Indep name -- Subcontractor/Independent -- GC or Subcontractor/Indep GC or Subcontractor/Indep name -- Name & Address Address name Employee Name -- GC or Subcontractor/Indep name -- Employee Name -- GC or Subcontractor/Indep name -- Subcontractor/Independent -- GC or Subcontractor/Indep GC or Subcontractor/Indep name -- Name & Address Address name Employee Name -- GC or Subcontractor/Indep name -- Employee Name -- GC or Subcontractor/Indep name -- Employee Name -- GC or Subcontractor/Indep name -- Subcontractor/Independent -- GC or Subcontractor/Indep GC or Subcontractor/Indep name -- Name & Address Address name Employee Name -- GC or Subcontractor/Indep name -- Employee Name -- GC or Subcontractor/Indep name -- Employee Name -- GC or Subcontractor/Indep name -- Subcontractor/Independent -- GC or Subcontractor/Indep GC or Subcontractor/Indep name -- Name & Address Address name Employee Name -- GC or Subcontractor/Indep name -- Employee Name -- GC or Subcontractor/Indep name -- Employee Name -- GC or Subcontractor/Indep name -- Subcontractor/Independent -- GC or Subcontractor/Indep GC or Subcontractor/Indep name -- Name & Address Address name Employee Name -- GC or Subcontractor/Indep name -- Employee Name -- GC or Subcontractor/Indep name -- Employee Name -- GC or Subcontractor/Indep name -- Subcontractor/Independent -- GC or Subcontractor/Indep GC or Subcontractor/Indep name -- Name & Address Address name Employee Name -- GC or Subcontractor/Indep name -- Page 3 of 3

Employee Name -- GC or Subcontractor/Indep name -- Employee Name -- GC or Subcontractor/Indep name --

Recommended publications