Form Erd-10584 - Agent Or Subcontractor Affidavit Of Compliance With Prevailing Wage Rate Determination - 1997 Page 2

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LIST OF AGENTS OR SUBCONTRACTORS
NAME _________________________________________________
NAME _________________________________________________
ADDRESS _____________________________________________
ADDRESS _____________________________________________
CITY, STATE, ZIP ______________________________________
CITY, STATE, ZIP ______________________________________
TELEPHONE # _(______)________________________________
TELEPHONE # _(______)________________________________
NAME _________________________________________________
NAME _________________________________________________
ADDRESS _____________________________________________
ADDRESS _____________________________________________
CITY, STATE, ZIP ______________________________________
CITY, STATE, ZIP ______________________________________
TELEPHONE # _(______)________________________________
TELEPHONE # _(______)________________________________
NAME _________________________________________________
NAME _________________________________________________
ADDRESS _____________________________________________
ADDRESS _____________________________________________
CITY, STATE, ZIP ______________________________________
CITY, STATE, ZIP ______________________________________
TELEPHONE # _(______)________________________________
TELEPHONE # _(______)________________________________
NAME _________________________________________________
NAME _________________________________________________
ADDRESS _____________________________________________
ADDRESS _____________________________________________
CITY, STATE, ZIP ______________________________________
CITY, STATE, ZIP ______________________________________
TELEPHONE # _(______)________________________________
TELEPHONE # _(______)________________________________
NAME _________________________________________________
NAME _________________________________________________
ADDRESS _____________________________________________
ADDRESS _____________________________________________
CITY, STATE, ZIP ______________________________________
CITY, STATE, ZIP ______________________________________
TELEPHONE # _(______)_________________________________
TELEPHONE # _(______)________________________________
NAME _________________________________________________
NAME _________________________________________________
ADDRESS _____________________________________________
ADDRESS _____________________________________________
CITY, STATE, ZIP ______________________________________
CITY, STATE, ZIP ______________________________________
TELEPHONE # _(______)________________________________
TELEPHONE # _(______)________________________________

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