Robertson's Haun_Holland Intersection Widening** STATEMENT OF NON-PERFORMANCE PAYROLL **
86210 4460
Payroll Report # 20170623
C'ty Of menlfe�
JUN 2 6 2017
Received
Job # CIP15-04
Company Name: ROBERTSON'S
Address: 200 S MAIN ST SUITE 200
CORONA, CA 92882
Phone Number
I do hereby state that our Company did not employ any persons on the Public Work Project listed below:
Name: HAUN - HOLLAND ROAD INTERSECTION WIDENIN
Location: NEWPORT RD & CALLE THOMAS
MENIFEE, CA
During the period from 6/12/2017 to 6/18/2017
Signature
Mark Raigosa HR Manager
Printed Name/Title
06/22/2017
Date
800-834-7557
Contact Phone Number