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SUBCONTRACTOR/EMPLOYEE MASTER LIST

(RSA 21-I:81-a and 21-I:81-b)

Revision Date: 5/4/16

Project Name: DHHS Skylight State of NH

Project Number: 80635-D

General Contractor: Martini Northern, LLC

299 Hanover Street

Portsmouth, NH 03801

NAME OF GENERAL CONTRACTOR, SUBCONTRACTOR, OR INDEPENDENT / EMPLOYEES EXPECTED
TO WORK ON
THE JOBSITE / ENTITY WITH WHOM SUBCONTRACTOR
OR INDEPENDENT IS CONTRACTED / ENTITY PROVIDING WORKERS COMPENSATION COVERAGE / OSHA-10
CERT.
ON FILE (Y/N) / NAME & ADDRESS
OF INSURANCE CARRIER
General Contractor (GC) / -- / n/a / General Contractor / -- / Name & Address
Martini Northern, LLC / 2 / State of NH, Dept. of Transportation. / Martini Northern / n / USI New England
299 Hanover Street / 5 Bedford Farm Dr.
Portsmouth, NH 03801 / Bedford, NH 03110
Subcontractor/Independent
Address / -- / GC or Subcontractor/Indep name / GC or Subcontractor/Indep name / -- / Name & Address
Bri-Weld / 4 / Martini Northern, LLC / Bri-Weld / SigmaOne, PO Box 1387,
Paul Archambault / Yes / Concord NH 03302
Brian Potter / Yes
Joseph Chase / Yes
Jeffrey Ely / Yes
Nicholas Breen / Yes
Avery Hastings / Yes
10 / Martini Northern, LLC / North Ridge Contracting, Inc. / Travelers
North Ridge Contracting, Inc. / Rob Cookson / Yes
Tom Tilton / Yes
Jakob Grover / Yes
Thomas Fortier / Yes
Jeremy Rockwell / Yes
Vinny Porcella / Yes
Joseph Ayoub / Yes
Nick Porcella / Yes
Bob Harrington / Yes
Ralph Mayes / Yes
Dividers Plus / 2 / Martini Northern, LLC / Dividers Plus Inc
Dustin Moss / Yes / NH Employers
Nicholas Oltsch / No / Insurance Company
54 Third Ave
Burlington, MA 01803
NH Glass / 3 / Martini Northern LLC / New Hampshire Glass / Rowley
Dave Dickson / Yes
Seth Crisp / Yes
Andrew Lane / Yes