1-CDBG Procurement Paperwork Instructions to Bidders.pdf

QUAKER VALLEY COUNCIL OF GOVERNMENTS

INSTRUCTIONS TO BIDDERS

1. be submitted electronically through All proposals must https://pennbid.net

2. The communities for which bids are being requested have different specifications and instructions for construction of projects identified, bidders must submit proposals in accordance with the specifications of these communities, including using their forms for the submission of proposals as well as completing any required ACED or QVCOG forms.

3. If the specifications provide for the submission of alternate bids, the bid must clearly indicate whether an alternate bid is included. Each alternate bid must be clearly and separately set forth.

4. Proposals must be accompanied by a certified check, cashier's check or bid bond in the amount of ten (10%) percent of the bid, made payable to QVCOG.

5. The bids will remain firm for a period of ninety (90) days.

6. The successful bidder must furnish a Surety Company Performance Bond in the amount of one hundred (100%) percent of the contract price. The successful bidder must also furnish a Surety Company Labor and Materials Bond in the amount of one hundred (100%) percent of the contract price. Upon completion of the project a TWO (2) year maintenance bond must be provided, dated as of the day of acceptance by the appropriate municipal engineer, in the amount and terms specified in the bid material for that project. In the event no provision for maintenance bond is set forth, the amount shall be fifty (50%) of the contract price for the stipulated two (2) year period.

7. The successful bidder shall furnish certificates of insurance evidencing the following coverage as follows:

• Automobile Liability Insurance $1,000,000

Aggregate Bodily Injury and Property Damage

• Comprehensive General Liability Insurance $1,000,000 Aggregate Bodily injury and Property Damage

• Workers Compensation Insurance $500,000

The above listed coverages are minimums. If higher limits are stipulated in the detailed specifications, those higher limits shall prevail and shall be met by the successful bidder.

8. If the bidder is a Corporation, the proposal must be signed by the President or Vice President and attested to by the Secretary. Alternate signatures must be accompanied by a corporate resolution certifying and authorizing those individuals to submit and sign the proposal. If the bidder is a Sole Proprietor or Partnership, the proposal must be signed by the sole proprietor or a partner. Alternate signatures must be accompanied by a Power of Attorney certifying and authorizing those individuals to submit and sign the proposal.

9. No bid may be withdrawn after the bid opening. (In submitting this bid the bidder specifically waives the provisions of 73 P.S. Section 1601 et seq. Pertaining to Public Contracts and withdrawal of Bids.) All bids will then remain firm for a period of ninety (90) days.

10. Compliance is required with the Davis-Bacon Act (Demolitions are excluded from the Davis-Bacon Act wage requirements) and other Federal and local labor and minority standards. The bidder is cautioned to examine all pertinent bid materials and submit all required bid documents.

FAILURE TO SUBMIT ALL REQUIRED FORMS MAY INVALIDATE THE

BID.

11. This project is being funded, in part, through the U.S. Department of Housing and Urban Development (HUD). The successful bidder must be prepared to comply with all Federal statutes regarding the use of Federal Funds. This includes the submission of weekly payroll forms and other reports as required by HUD, the Department of Labor and the Allegheny County Department of Economic Development.

12. Award of the bid is contingent upon the release of funds by HUD.

13. QVCOG reserves the right to waive any informality or to reject any or all proposals.

14. Unique Entity Identification and CAGE Numbers: In accordance with HUD regulations, organizations receiving Federal funding are required to register via the System for Award Management (SAM) to obtain a Unique Entity Identification Number & CAGE Number. In order to get a CAGE number, you must first obtain a UEID number. To obtain this unique identification number go to the following website:

SAM.gov or call 1-866-606-8220 for further information. The UEID number must be renewed on a yearly basis. Proof of registration is mandatory, to be considered for funding.

SPECIAL NOTICE TO BIDDERS

Although QVCOG is the official signatory to the contract with the successful bidder (contractor), QVCOG is acting as agent for the municipality in soliciting this proposal, awarding the contract and monitoring contract performance. All work must be performed to the satisfaction of the subject municipality. Any construction problems or disputes must be resolved by the contractor and the municipality. All requests for payment must be processed through the municipality. No payments will be made unless first approved by the municipality. Although all payments will be made through the QVCOG office, QVCOG will be directly responsible only for that share of the project being paid from Community Development Funds. Any and all portions of the project payable by the municipality cannot and will not be paid until those funds are received from the municipality. Payment from Allegheny County Economic Development Funds will take 4 to 8 weeks from the time it is processed from the QVCOG office. When submitting payment requests, the contractor should, therefore, anticipate the approval time required by the municipality and the processing time required by the County.

QUAKER VALLEY COUNCIL OF GOVERNMENTS

Compliance Paperwork and Instructions for Contractors

1. All signatures must be signed in BLUE INK.

2. Complete all forms as necessary.

3. Submit completed forms with bid.

INCLUDE IN BID

SPECIFICATIONS

Project Name:

Project Number:

Grantee:

Project Manager:

Project Location:

Allegheny County Economic Development

Federally-Funded Projects

Procurement Compliance Package Checklist

PROCUREMENT DOCUMENTS TO BE SUBMITTED BY THE PRIME CONTRACTOR/SUBCONTRACTOR/SUPPLIER

The documents listed on this checklist must be included in your bid submission, unless otherwise noted below. These documents are to be submitted to the Agency by all contractors and forwarded to the ACED Project Manager for final approval. The documents pertaining to Subcontractors must be provided within 10 days of the project award letter, if not included with the Prime Contractor’s original bid proposal.

INITIAL TO INDICATE THE DOCUMENTS HAVE BEEN PROVIDED

Grantee / Project Manager

Notice to Prime Contractors/Subcontractors This document must be included in the bid package and completed by the Prime Contractor/Subcontractor as part of the original bid proposal.

Affirmative Action / MWBE Certification This document must be included in the bid package and completed by the Prime Contractor/Subcontractor as part of the original bid proposal.

M/W/DBE/VOSB Solicitation & Commitment Statement This document must be included in the bid package and completed by the Prime Contractor/Subcontractor as part of the original bid proposal.

Award Verification for Prime/ Subcontractors (Form-PL3/PL4) This document must be included in the bid package and completed by the Agency/Prime Contractor/Subcontractor as part of the original bid proposal.

Schedule of Subcontractors This document must be included in the bid package and submitted no more than 10 days after contract is awarded.

Agency Prime Contractor/Subcontractor Verification This document must be included in the bid package and submitted no more than 10 days after contract is awarded.

Fringe Benefit Letter This document must be included in the bid package and completed by the Prime Contractor/Subcontractor as part of the original bid proposal.

U.S. Department of Labor Certified Payrolls/ Apprentice Registrations Upon being awarded the contract, all contractors must submit a weekly certified payroll sheet to the Project Manager. This document is two (2) pages; include deduction explanations. Provide valid apprenticeship program documents for all apprentices.

Construction Stoppage Statement This document is provided to the Project Manager if the project requires a delay of work for six weeks or more.

Section 3 - Contractor’s Compliance Certification (see separate Section 3 Packet) For housing construction, rehabilitation, or other public construction: Agencies that receive assistance that exceeds $200,000 and contractors/ subcontractors that receive contracts in excess of $100,000 are required to comply with Section 3 requirements.

Section 3 Monthly Employment and Business Utilization Reports (Due Monthly)

Award Verification for Suppliers / Professional Services -PL5 This document is to be submitted for all suppliers or professional services receiving $1,000 or more.

Agency/Prime Contractor/SubcontractorSupplier / Professional Services Verification This document must be included in the bid package and submitted no more than 10 days after contract is awarded.

Revised April 2024

Allegheny County Economic Development Federally-Funded Projects

Procurement Compliance / Bid Package Documents

NOTICE TO PRIME CONTRACTORS/SUBCONTRACTORS

PROJECT NAME__________________________________________ Project #_______________________

INCLUDE IN BID

SPECIFICATIONS

PROJECT LOCATION_____________________________________________________________________

Agency_______________________________________________________________________________

All contractors for the above-named project understand that any payment requests for the project will not be processed by Allegheny County Economic Development until all requirements are met. It is the responsibility of the Agency to make sure that all the paperwork is submitted by everyone on the project before request for payments are submitted.

It is further understood that the Prime Contractor is responsible for collecting all paperwork for each

Subcontractor hired and must submit it to the Agency, along with a signed agreement between the

Prime and Subcontractor(s. Both Prime and Subcontractors are required to retain copies of all paperwork for this Federally-funded project for a period of three (3) years after completion of the project.

By signing this form, you have acknowledged that you did receive a copy of the U.S. Department of

Housing and Urban Development’s Federal Labor Standards Provision and that you understand all the requirements.

The Prime Contractor was given: U.S. Department of Labor publication WH 1321, “Notice to All

Employees”; U.S. Occupational Safety and Health Administration publication 3165, “Job Safety & Health

Protection Poster”; and U.S. Department of Housing and Urban Development publication 901, “Equal

Employment Opportunity.” These posters, along with a copy of the issued U.S. Department of Labor

Wage Decision, are to be displayed in a prominent place at the work site.

The contractor understands that no basic wage can be lower than the wage issued: if fringe benefits are not paid into a special fund, the fringe benefits listed for any particular trade in the wage decision is added to, and becomes part of, the basic hourly wage for the employee performing the work.

All payrolls must be forwarded within seven days after the pay period. Payrolls must be certified on the reverse side and the signatures must be hand written in blue ink. No stamped, initialed or photo copied signatures are accepted.

Acknowledgement by Prime Contractor____ Subcontractor____

Company Name_________________________________________________________________________

Authorized Official:______________________________________________________________________

Signature:__________________________________________________________Date:______________ This form must be signed by the Prime Contractor or Subcontractor

AFFIRMATIVE ACTION / MWBE CERTIFICATION

PRIME / SUBCONTRACTOR AFFIRMATIVE ACTION CERTIFICATION

INCLUDE IN BID

SPECIFICATIONS

PRIME/SUBCONTRACTOR — Agrees to comply with the U.S. Department of Labor Model Affirmative Action Plan

(41-CFR-60-1.4).

MINORITY BUSINESS AND FEMALE UTILIZATION CERTIFICATION

Company Name____________________________________________, Contractor, will abide by and initiate all of my subcontracts to the greatest extent feasible, the requirements of Executive Order 11625 and Executive Order 12138 regarding utilization of Minority and Female Business on this project.

On this project, I plan to use__________% MBE, _________% WBE, ________% DBE, _________% VOSB

SIGNATURE_____________________________________________________DATE _________________

NAME___________________________________________TITLE________________________________

CONTRACTOR’S FEDERAL ID NUMBER_____________________________PHONE#____________________

PROJECT NAME________________________________________________________________________

LOCATION________________________________________ PROJECT #____________________________

INCLUDE IN BID

SPECIFICATIONS

Allegheny County Economic Development

M/W/DBE/VOSB Solicitation and Commitment Statement A good faith effort must be made to meet the ACED M/W/DBE/VOSB contract goals of 13% MBE, 2% WBE, and 5% VOSB PARTICIPATION.

ALL COLUMNS MUST BE COMPLETELY FILLED IN FOR ALL MWDBE/VOSB SUBCONTRACTORS AND SUPPLIERS

SOLICITATION AND COMMITMENT

MINORITY, WOMEN AND DISADVANTAGED BUSINESS ENTERPRISES and VETERAN-OWNED SMALL BUSINESSES

PROJECT

NUMBER

NAME OF FIRM ADDRESS PHONE NUMBER

List below ALL M/W/DBE/VOSB solicited - whether or not commitment was obtained - Copy this form as necessary

MBE_ WBE DBE_ VOSB_ TYPE(S) OF SUBCONTRACT WORK

OR MATERIALS

DATE SOLICITED COMMITMENT MADE GIVE REASON(S) IF NO

COMMITMENT MADE CERTIFIED BY: YES(IF YES GIVE DATE)

MONTH DAY YR

NO

COMPANY NAME

SOLICITATION METHOD

ADDRESS AMOUNT COMMITTED

QUOTE RECEIVED

$ AMOUNT

% OF TOTAL BID

CONTACT PERSON / PHONE # YES NO

MBE_ WBE DBE_ VOSB_ TYPE(S) OF SUBCONTRACT WORK

OR MATERIALS

DATE SOLICITED COMMITMENT MADE GIVE REASON(S) IF NO

COMMITMENT MADE CERTIFIED BY: YES(IF YES GIVE DATE)

MONTH DAY YR

NO

COMPANY NAME

SOLICITATION METHOD

ADDRESS AMOUNT COMMITTED

QUOTE RECEIVED

$ AMOUNT

% OF TOTAL BID

CONTACT PERSON / PHONE # YES NO

MBE_ WBE DBE_ VOSB_ TYPE(S) OF SUBCONTRACT WORK

OR MATERIALS

DATE SOLICITED COMMITMENT MADE GIVE REASON(S) IF NO

COMMITMENT MADE CERTIFIED BY: YES(IF YES GIVE DATE)

MONTH DAY YR

NO

COMPANY NAME

SOLICITATION METHOD

ADDRESS AMOUNT COMMITTED

QUOTE RECEIVED

$ AMOUNT

% OF TOTAL BID

CONTACT PERSON / PHONE # YES NO

Prepared by: Signature: Title:_ Date:

Project #

Project Name:

Date Contract Awarded to Contractor Above:

Agency Signature

Print Name

INCLUDE IN BID

SPECIFICATIONS

Is Company: MBE: Yes No WBE: Yes No DBE: Yes No VOSB: Yes No

If your company is a MBE/ WBE/ DBE/ VOSB Company? Is it certified with Allegheny County’s Office of Minority & Women Business? Yes No_ Certification #_ Expiration Date

Are you certified under the PAUCP? (PA Unified Certification Program) Yes No If yes, Certification #_

Expiration Date Other Certification? (type, #, expiration date)

RACIAL / ETHNIC CODES:

1. White American 2. Black American 3. Native American 4. Hispanic American

5. Asian/Pacific American 6. Hasidic Jews

Date:Company Signature:

Title:

THIS PORTION IS TO BE COMPLETED BY OPERATING AGENCY ONLY:

Total Project Contract Award Amount $

Project Location:

Date

Title

Revised April 2024

State City

Email IRS ID # )

Zip Code

Company Name

Address

Telephone Number (

DUNS # CAGE # CAGE Expiration

Print Name:

Allegheny County Economic Development Federally-Funded Projects Procurement Compliance / Bid Package Documents

Above Contractor Contract Amount: $

Above Contractor CDBG Contract Amount $___________________

Above Contractor HOME Contract Amount $___________________

Above Contractor ESG Contract Amount $___________________

AWARD VERIFICATION FOR PRIME/ SUBCONTRACTORS- PL3/PL4

THIS FORM MUST BE COMPLETED, SIGNED, AND SUBMITTED FOR ALL CONTRACTORS USED ON THE JOB.

ALL INFORMATION MUST BE FILLED IN COMPLETELY OR FORM MUST BE RESUBMITTED.

(Check One)

PL3- Award Notice for Prime Contractor PL4- Award Notice for Subcontractor

To be filled out by Prime/ Subcontractor:

SCHEDULE OF SUBCONTRACTORS

PRIME CONTRACTORS: This form must be submitted to the GRANTEE no more than ten days after you have received a bid award letter notifying you that you have been awarded the contract. Failure to submit this form could disqualify your bid.

SUB CONTRACTORS: This form must be completed and submitted to the prime contractor

PROJECT NAME

PROJECT LOCATION PROJECT #

CONTRACTOR’S NAME

IRS ID#_ DATE

COMPANY NAME

ADDRESS

CITY STATE

IRS ID# TELEPHONE#

Is Subcontractor a MBE? Yes Is Subcontractor a WBE? Yes Is Subcontractor a DBE? Yes Is Subcontractor a VOSB? Yes

Type of Work

COMPANY NAME

ADDRESS

CITY ZIP

IRS ID#

No No No

No

TELEPHONE#

Is Subcontractor a MBE? Yes Is Subcontractor a WBE? Yes Is Subcontractor a DBE? Yes Is Subcontractor a VOSB? Yes

Type of Work

COMPANY NAME

ADDRESS

CITY ZIP

IRS ID#

No No No No

TELEPHONE#

Is Subcontractor a MBE? Yes Is Subcontractor a WBE? Yes Is Subcontractor a DBE? Yes Is Subcontractor a VOSB? Yes

Type of Work

COMPANY NAME

ADDRESS

CITY ZIP

IRS ID#

No No No

No

TELEPHONE#

Is Subcontractor a MBE? Yes Is Subcontractor a WBE? Yes Is Subcontractor a DBE? Yes Is Subcontractor a VOSB? Yes

Type of Work

INCLUDE IN BID

SPECIFICATIONS

Revised April 2024

ZIP

No No No No

Check here if no sub contractors will be utilized by the above contractor

STATE

STATE STATE

AGENCY > PRIME CONTRACTOR / SUBCONTRACTOR VERIFICATION

(Agency/Prime/Subcontractor Legal Name) has an agreement with

(Prime/Subcontractor Legal Name) to work on the

(Project Name)_ located in the area of , PA.

If awarded the contract, the above Agency/Prime Contractor/Subcontractor intends to have a written, binding contract with the above Prime Contractor or Subcontractor to perform the following work:

(Provide Brief Description of the Type of Work Agreed Upon)

Agency’s Authorized Signature:_____________________________________________ Date:

Agency’s Printed Name:___________________________________________________ Title:

Prime Contractor’s Authorized Signature:_____________________________________ Date:

Prime Contractor’s Printed Name: __________________________________________ Title:

Subcontractor’s Authorized Signature:_______________________________________ Date:

Subcontractor’s Printed Name: _____________________________________________ Title

INCLUDE IN BID

SPECIFICATIONS

Revised April 2024

The contract dollar amount as specified in the written agreement is $

The portion of the above to be reimbursed/paid with Federal funds is $

THIS FORM MUST BE SUBMITTED FOR EVERY PRIME / SUBCONTRACTOR HIRED FOR THIS FEDERALLY-FUNDED PROJECT AND SUBMITTED TO THE AGENCY. THIS FORM IS TO BE SUBMITTED 10 DAYS AFTER CONTRACT IS AWARDED.

Project #:

FRINGE BENEFIT LETTER

Wage Decision Serial #

IRS ID#

City State

Project Name_

Project #

Contract Amount $

Prime/Subcontractor Company Name (Circle One)_

Address:

FRINGE BENEFITS:

All Fringe Benefits will be paid as follows:

_Fringes will be included in the basic hourly wage rates.

_Fringes will be paid into the following Benefit Plans: (List Hourly Fringe Benefit Rate)

Name of Plan:

Address:

City:

Classification: Hourly Fringe Benefit Rate

Name of Plan:

Address:

City:

Classification: Hourly Fringe Benefit Rate

Name of Plan:

Address:

City:

Classification: Hourly Fringe Benefit Rate

Prime/ Subcontractor’s Signature

Printed Name: Date:

INCLUDE IN BID

SPECIFICATIONS

Revised April 2024

Zip Code

State: Zip Code:

State: Zip Code:

State: Zip Code:

U.S. Department of Labor PAYROLL (For Contractor's Optional Use; See Instructions at www.dol.gov/whd/forms/wh347instr.htm) Wage and Hour Division

Persons are not required to respond to the collection of information unless it displays a currently valid OMB control number.

NAME OF CONTRACTOR OR SUBCONTRACTOR ADDRESS OMB No.:1235-0008 Expires: 04/30/2021

PAYROLL NO. FOR WEEK ENDING PROJECT AND LOCATION PROJECT OR CONTRACT NO.

(1) (2) (3) (4) DAY AND DATE (5) (6) (7) (9)

(8)

DEDUCTIONS

O

O

O

O

O

O

O

O

NAME AND INDIVIDUAL IDENTIFYING NUMBER

(e.g., LAST FOUR DIGITS OF SOCIAL SECURITY

NUMBER) OF WORKER N

O

. O F

W

IT

H H

O

LD

iN G

E

XE

M

P

TI

O N

S

WORK

CLASSIFICATION

O T.

O R

S T.

HOURS WORKED EACH DAY

TOTAL

HOURS

RATE

OF PAY

GROSS

AMOUNT

EARNED FICA

WITH-

HOLDING

TAX OTHER

TOTAL

DEDUCTIONS

NET

WAGES

PAID

FOR WEEK

S

S

S

S

S

S

S

S

Rev. Dec. 2008

Rev. Dec. 2008

While completion of Form WH-347 is optional, it is mandatory for covered contractors and subcontractors performing work on Federally financed or assisted construction contracts to respond to the information collection contained in 29 C.F.R. §§ 3.3, 5.5(a). The Copeland Act (40 U.S.C. § 3145) contractors and subcontractors performing work on Federally financed or assisted construction contracts to "furnish weekly a statement with respect to the wages paid each employee during the preceding week." U.S. Department of Labor (DOL) regulations at 29 C.F.R. § 5.5(a)(3)(ii) require contractors to submit weekly a copy of all payrolls to the Federal agency contracting for or financing the construction project, accompanied by a signed "Statement of Compliance" indicating that the payrolls are correct and complete and that each laborer or mechanic has been paid not less than the proper Davis-Bacon prevailing wage rate for the work performed. DOL and federal contracting agencies receiving this information review the information to determine that employees have received legally required wages and fringe benefits.

Public Burden Statement

We estimate that is will take an average of 55 minutes to complete this collection, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. If you have any comments regarding these estimates or any other aspect of this collection, including suggestions for reducing this burden, send them to the Administrator, Wage and Hour Division, U.S. Department of Labor, Room S3502, 200 Constitution Avenue, N.W.

Washington, D.C. 20210

(over) 21

Date

I, (Name of Signatory Party) (Title) do hereby state:

(1) That I pay or supervise the payment of the persons employed by on the (Contractor or Subcontractor)

; that during the payroll period commencing on the (Building or Work) day of , , and ending the day of , , all persons employed on said project have been paid the full weekly wages earned, that no rebates have been or will be made either directly or indirectly to or on behalf of said from the full (Contractor or Subcontractor) weekly wages earned by any person and that no deductions have been made either directly or indirectly from the full wages earned by any person, other than permissible deductions as defined in Regulations, Part 3 (29 C.F.R. Subtitle A), issued by the Secretary of Labor under the Copeland Act, as amended (48 Stat. 948, 63 Stat. 108, 72 Stat. 967; 76 Stat. 357; 40 U.S.C. § 3145), and described below:

(2) That any payrolls otherwise under this contract required to be submitted for the above period are correct and complete; that the wage rates for laborers or mechanics contained therein are not less than the applicable wage rates contained in any wage determination incorporated into the contract; that the classifications set forth therein for each laborer or mechanic conform with the work he performed.

(3) That any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with a State apprenticeship agency recognized by the Bureau of Apprenticeship and Training, United States Department of Labor, or if no such recognized agency exists in a State, are registered with the Bureau of Apprenticeship and Training, United States Department of Labor.

(4) That:

(a) WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, FUNDS, OR PROGRAMS

− in addition to the basic hourly wage rates paid to each laborer or mechanic listed in the above referenced payroll, payments of fringe benefits as listed in the contract have been or will be made to appropriate programs for the benefit of such employees, except as noted in section 4(c) below.

(b) WHERE FRINGE BENEFITS ARE PAID IN CASH

− Each laborer or mechanic listed in the above referenced payroll has been paid, as indicated on the payroll, an amount not less than the sum of the applicable basic hourly wage rate plus the amount of the required fringe benefits as listed in the contract, except as noted in section 4(c) below.

(c) EXCEPTIONS

REMARKS:

EXCEPTION (CRAFT) EXPLANATION

NAME AND TITLE SIGNATURE

THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEMENTS MAY SUBJECT THE CONTRACTOR OR SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION. SEE SECTION 1001 OF TITLE 18 AND SECTION 231 OF TITLE

31 OF THE UNITED STATES CODE.

ll system as long ilize

Check one of the boxes and list name of contractor or subcontractor

Fill out completely with contractor or subcontractor address

The last day of the payroll period.

How to Correctly Fill Out a WH-347 Payroll Form

The completion of the WH-347 Payroll Form is optional; contractors may utilize their own payro as it conforms to the WH-347 Payroll Form and contains all the necessary information. If you ut

WH-347 Payroll Form as a pdf, saving it electronically aids in making any needed corrections.

Check one of the boxes and list name of contractor or subcontractor

Fill out completely with contractor or subcontractor address

Payrolls must be numbered sequentially and should be based on the weeks worked under a contract.

Type the word "Final" when the last payroll is submitted for the project.

The last day of the payroll period.

The name and location of project.

The prime contractor should include the project number as listed in the loan

Indicate the days and dates of the pay period.

(should match week ending directly above)

List each worker's name.

Only laborers and mechanics performing construction work under the contract should be listed.

Please note: Business Owners need only include their name, work classification including "owner" and the daily total hours worked.

Specify the job classification located in the contract wage decision and/or the corresponding job title.

Specify the total overtime and straight time hours worked on the project.

Specify the net amount paid to the employee for the pay

Must accurately reflect

List hourly wage rate and fringes paid in cash (not those paid to plans)

List each worker's name.

Only laborers and mechanics performing construction work under the contract should be listed.

Please note: Business Owners need only include their name, work classification including "owner" and the daily total hours worked.

Specify the job classification located in the contract wage decision and/or the corresponding job title.

Specify the total overtime and straight time hours worked on the project.

Specify the net amount paid to the employee for the pay

Must accurately reflect overtime and straight time hours worked under the contract.

Specify the gross earnings for the hours worked under the contract.

List hourly wage rate and fringes paid in cash (not those paid to plans)

If part of a worker's weekly wage was earned on projects other than the project described on this payroll, enter the gross amount earned on this contract in the top half of column 7. Enter the gross amount earned during the week for all projects in the bottom half.

Alex Driver worked 29.5 hours on this contract and 12.5 hours on another contract.

The gross wages earned on this project, $1,422.84, is entered in the top half of column 7.

The gross wages earned on all projects, $2,012.46, is entered in the

If an employee performs multiple work classifications under the contract, use two or more lines to distinguish the different job classifications, hours worked, and hourly wage earned for each.

If part of a worker's weekly wage was earned on projects other than the project described on this payroll, enter the gross amount earned on this contract in the top half of column 7. Enter the gross amount earned during the week for all projects in the bottom half.

Alex Driver worked 29.5 hours on this contract and 12.5 hours on another contract.

The gross wages earned on this project, $1,422.84, is entered in the top half of column 7.

The gross wages earned on all projects, $2,012.46, is entered in the

Combine the two classifications when recording the gross amount earned for this pay period, deductions, and net wages.

A registered apprentice performing work under a contract must be reported. The payroll must include the current pay scale & provide a copy of the apprenticeship agreement.

Provide explanation of "other" deductions on signatory page.

A registered apprentice performing work under a contract must be reported. The payroll must include the current pay scale & provide a copy of the apprenticeship agreement.

Provide explanation of "other" deductions on signatory page.

Fringe benefits are not paid as cash to Bart Turner: explanation is included under "(c) exceptions" on signatory page.

Explanation of "other"

Explanation of exception to fringe benefits

Explanation of "other"

Explanation of exception to fringe benefits

CONSTRUCTION STOPPAGE STATEMENT

If there is no work performed on the project for SIX WEEKS or MORE, this form must be completed and submitted to the Grantee by the Contractor.

State Zip Code

Company Name

Company Address

City

Telephone Number

Project #

Project Name

Project Address City Zip Code

I certify that work on this project will be delayed for a period of six (6) weeks or more effective as of this date _. The work on this project will resume on (date)_ .

The payroll number which was last submitted to the GRANTEE was payroll number .

Therefore when the work resumes, the payrolls will be numbered starting with the next sequential number from the last payroll submitted.

Authorized Signature: Prime Contractor_ Date

Print Name Prime Contractor

Authorized Signature: Subcontractor_ Date

Print Name Subcontractor

This form must be submitted to the GRANTEE to be forwarded to the Project Manager at Allegheny

County Economic Development.

Received by (Grantee Name)

Authorized Signature Date

Received by ACED Project Manager_

Signature Date

INCLUDE IN BID

SPECIFICATIONS

State

Project #

Project Name:

Date Contract Awarded to Company Above:

Agency Signature

Print Name

AWARD VERIFICATION FOR SUPPLIERS AND PROFESSIONAL SERVICES–PL5

THIS FORM MUST BE COMPLETED, SIGNED, AND SUBMITTED FOR SUPPLIERS ($1,000 or more) AND ALL PROFESSIONAL SERVICES USED ON THE JOB. ALL INFORMATION MUST BE FILLED IN COMPLETELY OR FORM MUST BE RESUBMITTED.

PL5—Award Notice for Suppliers and Professional Services

INCLUDE IN BID

SPECIFICATIONS

Is Company: MBE: Yes No WBE: Yes No DBE: Yes No VOSB: Yes No

If your company is a MBE/ WBE/ DBE/ VOSB Company? Is it certified with Allegheny County’s Office of Minority & Women Business? Yes No_ Certification #_ Expiration Date

Are you certified under the PAUCP? (PA Unified Certification Program) Yes No If yes, Certification #_

Expiration Date Other Certification? (type, #, expiration date)

RACIAL / ETHNIC CODES:

1. White American 2. Black American 3. Native American 4. Hispanic American

5. Asian/Pacific American 6. Hasidic Jews

Date:Company Signature:

Title:

THIS PORTION IS TO BE COMPLETED BY OPERATING AGENCY ONLY:

Total Project Contract Award Amount $

Project Location:

Date

Title

Revised April 2024

State City

Email IRS ID # )

Zip Code

Company Name

Address

Telephone Number (

DUNS # CAGE # CAGE Expiration

Print Name:

Allegheny County Economic Development Federally-Funded Projects Procurement Compliance / Bid Package Documents

This portion to be completed by Supplier / Professional Service Provider:

Above Company Contract Amount: $

Above Company CDBG Contract Amount $___________________ Above Company HOME Contract Amount $___________________ Above Company ESG Contract Amount $___________________

Allegheny County Economic Development Federally-Funded Projects Procurement Compliance / Bid Package Documents

AGENCY / PRIME CONTRACTOR / SUBCONTRACTOR > SUPPLIER/

PROFESSIONAL SERVICES VERIFICATION FORM

(Agency/Prime/Subcontractor Legal Name) has an agreement with

(Supplier/ Professional Service Legal Name/ Address) to work on the

(Project Name) _ located in the area of _, PA.

If awarded the contract, the above Agency/Prime Contractor/Subcontractor intends to have a binding contract with the above supplier or professional service to provide the following materials or services:

(Provide a Brief Description of the Supplies or Professional Services Agreed Upon)

Grantee’s Authorized Signature: ______________________________________________Date: ______________________

Grantee’s Printed Name: _____________________________________________Title: _____________________________

Prime Contractor’s Authorized Signature: ______________________________________Date: ______________________

INCLUDE IN BID

SPECIFICATIONS

Prime Contractor’s Printed Name: ______________________________________ Title: ____________________________

Subcontractor’s Authorized Signature: ________________________________________ Date: ______________________

Subcontractor’s Printed Name: _________________________________________ Title: ____________________________

Supplier / Service Authorized Signature: _______________________________________Date: ______________________

Supplier / Service Printed Name: ________________________________________Title: ____________________________

THIS FORM MUST BE SUBMITTED FOR EVERY SUPPLIER ($1,000 or more) and ALL PROFESSIONAL

SERVICES HIRED FOR THIS FEDERALLY-FUNDED PROJECT AND SUBMITTED TO THE GRANTEE.

Project #:

. . The contract dollar amount as specified in the written agreement is $

The portion of the above to be reimbursed/paid with Federal funds is $ . .