Performance Statement by rss27840

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									                    STATEMENT OF NON-PERFORMANCE

Payroll No.                                                 Date:
Subcontractor:



I do hereby confirm that no Persons were employed on the construction of:
Project Name:
Project Number:
during the period commencing on
the             day of                 1999 and ending
the             day of                 1999.




                                             Signed:
                                    Printed Name & Title:

								
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