**STATEMENT OF NON-PERFORMANCE PAYROLL**

**STATEMENT OF NON-PERFORMANCE payroll ** payroll Report #_____ Your Job # _____ Company Name: Address: Phone: I do hereby state that our Company did not provide Tradesmen on the Public Work Project listed below: Name: Location: During the period commencing on the _____ day of _____, _____ and ending the _____ day of _____, _____. _____ _____ Signature Date _____ _____ Printed Name/Title Contact phone number GSLC #50 (1/09)

**STATEMENT OF NON-PERFORMANCE PAYROLL** Payroll Report #_____ Your Job # _____ Company Name: Address: Phone:

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  Performance, Testament, Payroll, Statement of non performance payroll

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