Teamster Reimbursement Request 1002 (gd-23)

TE AM STERS

LOCA

294

AFFILIATED WIT H

1 TERNATJONA L BROTHERHOOD OF TEAMSTERS ABOR TEMP LE

890 THIRD STREE

ALBANY, N.Y. 12206

PHONES : 489 -5436 • 489·5437 • 489-5438 FA X 518-453-9251

J OHN BULGARO

KE VIN D. HUNTER

PRESIDEN T and PRINCIPAL EXECUTI VE OFFICER

SECRETARY·TREASURER

September 17,2002

Marion L. MacQueen Director of Programs Empire State Development Corp oration 6 3 T hird Avenue New York , ew York 10017 l

Re : Teamsters Local 294 Train ing School, Project #P74 8

Dear Ms . ivlacQueen: Enclosed nlease find our request for payment/reimbursement. T he package includes the fo llowing: I. ompleted Exhibit G: Payment Requisition Form 2. SUP! orting documentation and invoices, as summarized on Exhibit G-I If any further information is needed please do not hesitate to contact my office at our number(s) listed above.

Sincerely,

John Princi al Executive O ffi cer TEAMSTE RS LO CAL 294 .1Sikh

Enclosures

GOVERNMENT EXHIBIT GD-23

l c uu -t I' ) ,,,,]1 I'

11l'~l1t I~

I

I' PI

w or],

' l ilt' I "

001

h'l :

l"lll llplt- lt',II' tl\\ t' l l l

i 'J..j 11.1l111d ~

'-:, "" pl

l 'l ll l t" 1 , 1'- ..1.' 1;'"11 1\ l:m ll ll l

65 000. 00 I

9/ 1§./02;1l1.l 9/1 6/02, l U I

1,1 f.(

1\ 1,,,,( 1111:<"111

001 Jil Pu r chas in g a 2003 l rr terne t i onel Tr act or

nil s REQUf:ST I I.... !:,:,

,\ I, ill \ 11r\/{f-

1 ... 111

\ I' f' R( ,\ '!, j ,

I " \ 1\lllNS

J) TO'l·\ I

1111 " !{H.'UE ST

R H)I IES II J) TI l

[ ''-\II-

\ r

j)

H\I .I M I

Pur cha se Tractor

ror ,«,

65, 000. 00

65 000.00

(Retalna gc) :\ \ ',\ l l A BLE

Ft li\ 'Dl NG ST,·\ Tl IS 'f' ' J .\ I

ro t~ J

Ft IN! IS ( '01\ 11\11 1n 'l' F I 'N I)~

11:\1 :\

Sl'fNl

NI

l' r f 1j

(»« ,':, N .\ 1\ l l-

1 <;1)'

, n l lli! E

65, 000. 00 65, 000.0 0 0

t. [1;;1

rr, 1':\ II

' 1:

CERTI FICATIO N I hereb) w .rrr un t and rcprcsent r« the l-n. pu c

~ l a l ,- I) n l' l ll p ll1 el1 l ' u r l' lI ral ll lll ( " r: SD ( '''I II ,al

I ) To the bcst u f my kuuwl cd ue. rniorm.•II1111 :.tnd t-> e Irc(, the cvpenduures for wlu ch r caI W;l t'r ;: l. oca l 2 <j -l1 ~ <eckme p.r.mcnr .m.I " ' re uubu t sc mcm tump l: \\1111 the r cqlll rCll1t" , l -: 'il II,.. \ g r et I1l<:11 1 between I::S l l( ~ll d l".:a lll ' ICI' L" e,1I ~ '} ..j .rrc l ' h ": l b l ~ I: pt'n ," Olnd Ih :Jt the p.rvmeut J l ,d 'lll rvu nluu sc ru c n t " I e\ IWll d ll ll rcs tor wluch tl 15 SC C~ l l1g pa yl1lcl1l and "1 rellTlI,ur'.t'IlICI1 I Ir' 'Il l [ ~. [H J Ot'S 1I0t dl lpliC;11l' rl'I IlIl'lIr 5e 1l1l'1 11 [II dr,I' III ' Cllk'1I1 o J cl1,.;I ' .rnd/o r expen ses tr oru all~ u lher sou rce

.!l 1 have Ib,'

.1I11 lh ll ll y 10

su '"111, 111 <;

II nO llt'

"II

be i.rl:

pI

re a lll~kr '

I lIe.tI

~ ') -I

The

I , I 'J.. ~

k'H' been

l'l ll TlI 'le led III

ll, t:

.) \I, lilin J 1I11bl' t\ ~ r e " n H' 1I 1

X Wud, I'IO1I ~ ln vo rccv reCLlp T'; I II: !I ib lc h xpc n sc !!t 1l',( , " ' I\l Cc'S received

Il l. pa , peTlr ,d \\ 1111

I ~ a tl 1I1 Sunuu .u y l i ·... hil lll l-..~ 1

(lIb"

" I 'f

utur-:

1'11 11 1 ' un c

11,llt

Septembe

18 , 2002

I 11 '111 l I t 1

EX H I BIT G -l : Pa y men t l{l'qIJisitio/l Ba r k -up Sumrn ary

IN \ () w! ·

!{ Fl-!::I<. I::Nl T Ii ,\ 1 ~ (

) ()N

, ~ I il( ~,

IN \lll l l; 1

RH)\ I " I I I ) 1 ' [, I . :\ 1\'1( II I , r I

65 , 000.00

9/ 16/0 2

9/ 16/ 02

( '0 tv] iV!I~ NT

65, 000. 00

TO'rr'\ L Req ues t in Category :

(Transfer to Exhibit G)

Budget Catego ry :

It

'OICE

R.EFER E le E # 11\1 :\ RK

RFO I II ~ .

1\ 1 ..( 1 IN IN\'ulCl ' j

T ED ESDC

Ai'l ) 1[NT

TOTAL Req uest in Categor y :

CO 'I IVI ENT

(Trans fer (0 Exhibi t G )

l3ud gel Catcgory:

I N \ '( .lIe )

REf-T RI.:1\iC E ;; \ ~ I " "'" ."I

'o() I I

I

HTI)1

I r-. \.illl ,-)

"I ,,; IT P

F,

\J\ l! ) I IN!

PC

( '( )tv! 1\'1E n

-- I U'[ AL Request III

('aLc gt.lI~' :

CE F; I

-

( Irunsfcr III

J - xlul» : ( J )

,-" aill Disbursement Agreement - Pa!JP i' ;-'