1.

Owner of the work

:

2.

Employer

:

3.

Name of the work

:

4.

Place of work

:

5.

Name and surname or title of the subcontractor

:

6.

Works done by subcontractor  

:

An mount of 132,50 m2 tunneling excavations, pre entrenchments (anchorage bolts, shoring and concreteshotcreting), mat and geo-textile membrane coatings,drainage and installation of pipes, tunnel final coatingconcretes, concrete ano seam fillings (rubber filings),duct-bank concretes, path concretes, installing of newjerseybarriers, asphalt coating of roads sub foundation and foudation of material

7.

Construction Techniques Used

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8.

Date of contract between the subcontractor and contractor

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9.

Amount of contract between the contractor and subcontractor

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10.

Completion date of the works performed by the subcontractor

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11.

Amount of the Certificate

: