20_PW_AFFIDAVIT_OF_COMPLIANCE_-_OHIO_(2025.09.10).pdf
PDF 153 KB Posted
- Attached to
- Rockefeller Greenhouse Campus CM-R Improvements
- Solicitation number
- AR2547
- Issued by
- Cuyahoga County, Ohio
About this file
This is an Affidavit of Compliance form issued by the Ohio Bureau of Wage and Hour Administration for the Rockefeller Greenhouse Campus Construction Management at Risk improvements project in Cleveland. The form certifies that all wages paid to employees working on the project comply with prevailing wage requirements under Chapter 4115 of the Ohio Revised Code for specified project dates. The affidavit must be executed and sworn by an officer or agent of the contractor or subcontractor who supervises employee payment and submitted to the City of Cleveland (public authority) before surety release or final payment is made under the contract terms.
The form requires certification that no rebates or deductions have been or will be made from wages paid in connection with the project, except those provided by law. The affidavit must be notarized and includes fields for the signatory's name and title, company name, project name and location, project dates, and notary information. This compliance document is a mandatory submission requirement for contractors and subcontractors working on public works projects in Ohio to ensure adherence to prevailing wage standards.
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Text version
Bureau of Wage and Hour Administration
6606 Tussing Road
Reynoldsburg, OH 43068-9009
LAW1003
3/2019
An Equal Opportunity Employer and Service Provider
614-644-2239 Fax 614-728-8639
TTY/TDD 800-750-0750
com.ohio.gov
Affidavit of Compliance
Prevailing Wages
I, (Name of person signing affidavit) (Title) do hereby certify that the wages paid to all employees of
(Company Name) for all hours worked on the
(Project name and location) project, during the period from to are in (Project Dates) compliance with prevailing wage requirements of Chapter 4115 of the Ohio Revised Code. I further certify that no rebates or deductions have been or will be made, directly or indirectly, from any wages paid in connection with this project, other than those provided by law.
(Signature of Officer or Agent)
Sworn to and subscribed in my presence this _______ day of __________, 20__________.
(Notary Public)
The above affidavit must be executed and sworn to by the officer or agent of the contractor or subcontractor who supervises the payment of employees. This affidavit must be submitted to the owner (public authority) before the surety is released or final payment due under the terms of the contract is made.
| Name of person signing affidavit Title: |
| Company Name: |
| Project name and location: |
| From Date: |
| To Date: |
File details come from the government source that posted it. Updated .