ASITE USER ACCESS / TRAINING REQUEST FORM

USER INFORMATION

Date: 8/15/23 NYCT/MTA BSC# Contractor Info: Birth MM/DD: 04/01 C Account:
Last Name: ANTIC First Name: MARKO

Company Name: HIRANI GROUP Work Address : 120 W John St, Hicksville Zip Code: 11801
Work Phone Number: (516) 248-1010 Company Assigned Email: mantic@hiranigroup.com
PROJECT(S) REQUESTED:

Do You Require Training? Check One: Yes ☐ No ☐

If Yes, Please Select One:
☐
■ CM/CCM/CMO/RE/FE ☐ GENERAL CONTRACTOR ☐ DM / DESIGN TEAM / DESIGN CONSULTANT ☐ READ ONLY / OVERSIGHT

Primary Job Assignment Description: Mandatory, Must Select at least one

☐ 01 CCM
☐ 02 CMO / Construction Manager
☐ 03 Resident Engineer
☐ 04 Design Team
☐ 05 Design Manager
☐ 06 Program Officer
☐ 07 Oversight, Audit IG
☐ 08 GEC Consultant (MTACC)
☐ 09 Contractor
☐ 09 Design Build Contractor
☐ 10 Sub – Contractor
☐ 11 View Only (Internal)
☐ 12 View Only (External Guest) ☐ 18 OCIP
☐ 13 Stakeholder (User Dept.) ☐ 19 Scheduling
☐ 14 Amtrak Reviewer (MTACC) ☐ 20 Estimating
☐ 15 Environmental Consultant ☐ 21 Commissioning, Quality, Safety
☐ 16 Program Support
☐ 17 Construction Inspector (Field Engr.)

Secondary Job Assignment Description: Select one or multiple

☐ ADA ☐ Department of Buses ☐ Primary Responders ☐ Systems Engineering
☐ AFC ☐ Dept. of Diversity & Civil Rights ☐ Program Area ☐ Systems Integration
☐ Architecture ☐ Diversion and Work Trains ☐ Project Coordination ☐ TA Labor
☐ CADD Support ☐ DOT Coordination ☐ Quality ☐ Tools & Simulators
☐ Capital Planning and Budget ☐ Electrical ☐ Safety ☐ Track
☐ Car Equipment ☐ Environmental ☐ SCADA ☐ Traction Power
☐ Civil ☐ Fiber Optics ☐ Scheduling ☐ Utilities
☐ Code Compliance ☐ Field Administrator ☐ SDS Review ☐ Waste Management
☐ Commissioning ☐ Field Contractor ☐ Signage ☐ Zone Controller
☐ Commissioning - Elevators ☐ Field Engineer ☐ Signals
☐ Commission - HVAC ☐ Field Inspector ☐ Specification Review
☐ Communications ☐ Fire Alarm ☐ Stakeholder
☐ Consultant – Architecture ☐ Gov. & Community Relations ☐ Station Clearing House
☐ Consultant – Civil ☐ Historic Preservation ☐ Stations Environment
☐ Consultant – Communications ☐ Instrumentation & Controls ☐ Structural
☐ Consultant – Electrical ☐ Mechanical – Elevators ☐ Structure CPM
☐ Consultant – Mech. – Elevators ☐ Mech. - HVAC & Plumbing ☐ Subways -MOW Electrical
☐ Consult. Mech. HVAC & Plumbing ☐ MTA Oversight ☐ Subways–MOW Elevator & Escalators
☐ Consultant – Structure ☐ OCIP ☐ Subways -MOW EMD
☐ Consultant – Utility ☐ Office of System Safety (OSS) ☐ Subways -MOW Engineering
☐ Cost Controls ☐ On-Call Group ☐ Subways -MOW Infrastructure
☐ Cost Estimating ☐ Operation Planning ☐ Subways - Stations Environment
☐ Data Communications Systems ☐ Power ☐ Subways - Stations Program

Signature Block:
Program Manager (print name): Program Manager Signature: Date:
CM/DM (print name): CM/DM Signature: Date:

ADMINISTRATION SECTION: DO NOT FILL IN THIS SECTION:

Added By: Date: Role Assigned: User ID: ☐ NEW ☐ REACTIVATE

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