STATE ARBITRATION BOARD
AUTHORIZATION FOR SUBCONTRACTOR TO PURSUE ARBITRATION
DATE: _______________
STATE JOB NO.: _______________________________________
PRIME CONTRACTOR: _______________________________________
TO: State Arbitration Board
This will confirm that a portion of the work on the above referred job was subcontracted to:
__________________________________________The subletting of this work was authorized by the Department of Transportation.
The above mentioned subcontractor is hereby authorized to act as an agent of the prime contractor in pursuing claims arising out of the work subcontracted to him. This authorization is limited to the claim covered by our Request For Arbitration Of Claim dated ________________.
_________________________________________
4/25/00