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tltJ Ltl / Ltlltl 18: 7tl D41 l4YU0lJ oiicWUCn .� oa. �a <br />EXHUMT C <br />OOWMAC7OR — SLMCONTRACIOR DATA ROOR11M MW <br />This fam mist be s Lothe Oar by the mftWX9MWK= and CBM StUSIVINGtOr W lmW than tBn <br />(10) days after receiving the award In com* oft FND Davis Baodn data reporting raWmnenls and HLID <br />2516 <br />ONAISOOr Sib Wft oonsUvcft , Inc. Sub QwbacWr NOW Narne <br />Nalm Careacw PA. am 70534 Sub Contra0m NONE <br />Address ELKmM OR 97401 -0127 Addrem <br />Male <br />9&*NOrh Cunstructlon, Inc <br />Street Add Admi <br />ba a PO box may ALSO be aswod. <br />305'r Sl p PI Suite 89 <br />r OMOM 97477 <br />& 4W T= ID a <br />43- 1253582 <br />CCB Reostratlern a <br />119651 <br />Phone Ptm <br />541 744 -9204 <br />P � tom! <br />Car�r�r: Coil, Bing. MairdenariM heavy PuM Works elatP� <br />R <br />Amount of Contract <br />59.982.00 <br />Pwft tiff ft Band <br />eiflu.Uva Date: OW21/2W7 <br />Cawwfer% Inde nNiy Company of Owiifartge <br />b: The nubcovtractar Is drec k one <br />sky le <br />cNimstion <br />Other DOW or Assotilotion <br />ORMYM <br />c.. List the n804 titl and address <br />ofeadr Owner Partner or OHiaa aGadn <br />smarats sheet as <br />Name <br />TM <br />Rome Addriess <br />S. WUder <br />President <br />401 Suburban Ave. — OR 97408 <br />Leese IwL LIWe-WBder <br />Moe Preside <br />401 Suburban Ave. — Fume, OR 97408 <br />j Semlary 89099 Sarvb Lmre— OR 97905 <br />!coos B EM DNeMr <br />Tam L EM TYeasm 86094 Sarvis lane— DjWq& OR 97409 <br />d is this a VA ntaa Owned RM 7 Yes or (No) <br />a: BY6b1a�f�C® d® arawMn4mcseprsa/Cl4►alMlmlar� i (aP��) <br />1a Whfte AmerimW 2= Black Amts; 3= Plah%m Amadceru; <br />