Asbestos Report - OGPe-Cert_AC-915579-HWY-203 205.pdf
PDF 1 MB Posted
- Attached to
- Landslide Repairs in Ciales, Puerto Rico
- Solicitation number
- 693C73-24-B-000008
About this file
This document is a Certification of No Asbestos Presence in Structures to be Demolished. It certifies that the structure located on PR-144 Km 6.3 - 18.2, Jayuya to Ciales, Puerto Rico is free of asbestos. The certification is signed by a registered professional or asbestos inspector.
The related federal contract opportunity is for Landslide Repairs in Ciales, Puerto Rico, Solicitation Number 693C73-24-B-000008. The project consists of repairing landslides caused by Hurricanes Irma and Maria on various Puerto Rico highways, including PR-144, PR-146, and PR-149. The work includes utility relocation, embankment reconstruction, landslide stabilizations, drainage systems, retaining walls, milling and overlay, pavement reconstruction, guardrail replacement, sediment and erosion control, and traffic maintenance. The project is expected to be in the $5,000,000 to $10,000,000 price range, and sealed bids from certified Small Business Concerns only will be accepted. Bid documents are scheduled to be issued on or about April 1, 2024, and the bid due date and location will be specified in the solicitation. Interested vendors must register at www.sam.gov to receive email notifications and be included on the Interested Vendors List.
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Text version
Forma P GC-009
GOBIERNO DE PUERTO RICO
OFICINA DEL GOBERNADOR
JUNTA DE CALIDAD AMBIENTAL
Área de Calidad de Agua
CERTIFICACION DE NO PRESENCIA DE ASBESTO
EN ESTRUCTURAS A DEMOLERSE
(Deberá completarse en letra de molde o impresa)
PGC-_____________________
PARA USO OFICIAL
(Nombre) (Estado Civil) (Municipio)
Dirección Postal__________________________________ _________________________________________________ demolición se encuentra libre de asbesto.
2. La información antes indicada es cierta y correcta.
3. Afirmo y reconozco las consecuencias de incluir y someter información falsa en este documento.
(Municipio)
Firma y Sello del Profesional o
Firma del Inspector de Asbesto registrado por la JCA (Original)
Nota: Ingenieros o Arquitectos deberán someter evidencia de que se encuentra al día en el pago de sus cuotas de colegiación e Inspectores de Asbesto deberán someter evidencia de la tarjeta de registro provista por la JCA.
Dirección Física: Ave. Ponce de León 1308, Carr. Estatal 8838, Sector el Cinco, Río Piedras, PR 00926
Dirección Postal: Apartado 11488, Santurce, PR 00910-
Elme Rivera Casado Yo, ______________________________, mayor de edad,______________, y vecino de__ _______________________ Vega Baja
Vega Baja Lakes Calle 11 L31 00693 (Pueblo) (Zip Code)
Vega Baja
787 724 5788
969 1311 787 722 0220
4. Para que así conste, firmo la presente certificación en ___________________ __________________ de Puerto Rico,
* Esta certificacion es exclusivamente para las areas muestreadas.
Tel. (787) 767-8181 • Fax (787) 767-1962 hoy día ____ de ____________________ de ________
Teléfonos: Residencial (______) ______- ________ Oficina (______) ______- ________ Ext.________ Fax (______) ______- ________
Certifico que:
1. La estructura localizada en__________________________________________________, la cual será objeto de una
San Juan
8 enero 2019 amarin Typewritten text Road PR-144 Km 6.3 - 18.2, Jayuya to Ciales, PR
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