digitally signed by glen armstrong glen armstrong

Notice of Project Western University

Facilities Management Client Services 519-661-3304 (fmhelp@uwo.ca)

Project Number:

Project Name:

Asbestos Type 3 Type 2 Type 1 Contractor In House Team Other

Shutdowns/Interruptions(Approximate Schedule):Electrical Power Domestic Water Steam Hot Water Heating

Chilled Water

Elevators

Fire Alarms

Roads / Lots

ITS Other

Issued By:

Miniature Attached Date/Schedule:

Contractor:

Attached To Follow

Special Conditions ( Noise, Odors, Asbestos, Etc.)

Comments:

Date:

Date:

Date:

Date:

Date:

Date:

Date:

Date:

Date:

Date:

Date:

Date:

Areas/Rooms Affected, Alternate Route/Service:

Description/Reason for Project:

Service to be interrupted:

Building(s) Affected:

Information Sheet Sent To Client

#1

#3

#2

#4

#1 #2

#3 #4

Phone # Cell #

Client Contact: Phone #

Designer Consultant:

Emergency Phone List: (to CCPS Only)

Project Manager/ Co-ordinator:

Signature/ Stamp:

Cell #

Note:

Signature/ Stamp:

Time:

Submit by E-mail

Print Form

9M5129-2 November 16 2016 - August 2018

Three C+ New Engineering Building 24/7

Construction of a new four storey building.

519-521-0297Glen Armstrong 5196612111 x 80323

Cornerstone Architecture

Norlon Builders London Ltd, Jeremy Valeriote 519-870-7591

General construction activity,

Client is aware and fully engaged in the project.

Glen ArmstrongDigitally signed by Glen Armstrong DN: cn=Glen Armstrong, o=UWO, ou, email=garmstr2@uwo.ca, c=CA Date: 2016.11.14 12:51:27 -05'00'

New Engineering Building Emergency Contact List

Name Company Job Title Phone EmailGlen Armstrong Western Project Manager  519‐521‐0297 garmstr2@uwo.ca Mike McLean Western Manager Planning & Design 519‐808‐5702 mmclea26@uwo.ca Tony Hammoud Western Safety & Training Coordinator  519‐521‐8444 ahammoud@uwo.ca Campus Community Police. Western 519‐661‐3300Jeremy Valeriote Norlon Builders Vice President 519‐870‐7591 jvaleriote@norlon.ca Jason Wedlake Norlon Builders Project Manager  519‐857‐7590 jwedlake@norlon.caRoy Carvalho Norlon Builders Site Superintendent 519‐868‐5057 rcarvalho@norlon.caJames Fish Con‐Wall Project Manager  519‐495‐2541 jamesf@con‐wall.caMark Liberatore Con‐Wall Site Superintendent 519‐808‐1207 markl@con‐wall.caPaul Van Oirschot PV‐Ex Project Manager  519‐280‐1801 paul@pvexconstruction.com Derek PV‐Ex Site ForemanLarry Black ACL Project Manager  519‐635‐9846 lblack@aclsteel.caSteve Rasenberg JMR VP Operations 519‐619‐2146Yanli Zhang JMR Mechanical Project Manager 519‐235‐1516 yanli.zhang@jmrelectric.caScott Milburn JMR Electrical Project Manager 519‐235‐1516 scott.milburn@jmrelectric.caDennis Mcpherson JMR Plumbing Foreman 519‐636‐9465Ben Armstrong JMR Sheet Metal Foreman 519‐619‐6618Eric Royackers JMR Electrician 519‐636‐9851Dave Campbell JMR Electrician 519‐639‐6593