23_PW_CERTIFIED_PAYROLL_REPORT_-_OHIO_(2024.12.27).pdf
PDF 55 KB Posted
- Attached to
- Rockefeller Greenhouse Campus CM-R Improvements
- Solicitation number
- AR2547
- Issued by
- Cuyahoga County, Ohio
About this file
This is a Prevailing Wage Certified Payroll Report for the State of Ohio, specifically related to the Rockefeller Greenhouse Campus CM-R Improvements project managed by the City of Cleveland through the Mayor's Office of Capital Projects. The report documents labor costs and prevailing wage compliance for workers employed on the construction project, which encompasses three distinct components: a Traditional Design-Build for the Rockefeller Greenhouse Admin Building, Forestry Garage, and Historic Brick Garage; a Traditional Design-Build for the Rockefeller Main Greenhouse General Improvements; and a Progressive Design Build project for the Rockefeller Main Greenhouse solar glazing. The certified payroll report serves as evidence of compliance with prevailing wage requirements mandated for public works projects in Ohio, detailing worker classifications, hours worked, and wage rates paid to ensure adherence to state labor standards.
The payroll documentation includes detailed records of compensation provided to construction workers on the project, verifying that all employees received wages meeting or exceeding the established prevailing wage rates for their respective job classifications. This certified payroll report is a critical compliance document for public works projects in Ohio, ensuring that contractors meet statutory wage requirements and that taxpayer funds are being appropriately directed to worker compensation. The report maintains records necessary for audit purposes and demonstrates the contractor's commitment to fair labor practices while executing the City of Cleveland's capital improvement initiative for the historic Rockefeller Greenhouse Campus.
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Text version
F330-03Av0612 1If Subcontractor, provide Contractor name in space provided. 2Attach additional pages as necessary. 3Text will wrap. 4Text will fit to cell.
My signature on this form signifies that I pay, or supervise the payment of the employees shown above. I am certifying: 1) That during the pay period reported on this form, all hours worked on this Project have been paid at the appropriate prevailing wage rate for the class of work done. 2) That the fringe benefits have been paid as indicated above. 3) That no rebates or deductions have been or will be made, directly or indirectly from the total wages earned, other than permissable deductions as defined in Ohio Revised Code Chapter 4115. 4) That apprentices are registered with the U.S. Department of Labor, Bureau of Apprenticeship and Training. I understand that the willful falsification of any of the above statements may subject the Contractor or Subcontractor to civil or criminal prosecution. In addition, I have submitted the full Name, Social Security Number, and Address of each Worker on a separate sheet (Part B) to form the entire Certified Payroll Report required by Applicable Law.
Signature: Date:Type or Print Name and Title:
ST
OT
OT
ST
ST
OT
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ST
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OT
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9. TTL
HRS
ALL
JOBS
7.
PROJ
GROSS
WAGES
W TH F
PAYROLL NUMBER
S of
Certified Payroll Report - Part A 330 Construction Contractor Payment State of Ohio Standard Forms for Public Facility Construction
11.
TAXES
WITH-
HELD
12.
OTHER
DEDUC-
TIONS
13.
NET
WAGES
PAID
APP OTHER
CASH8. FRINGES:
APPROVED PLANS
CASH AND APPROVED PLANS
PENS
M T
VAC
S
4. HOURS WORKED - DAY AND DATE
1. NAME AND INDIVIDUAL
IDENTIFYING NUMBER (e.g., LAST
FOUR DIGITS OF SOCIAL SECURITY
NUMBER) OF WORKER
2. WORK
CLASS-
IFICA-
TION
3.
RACE
AND
SEX
H&W
OT
ST
10. TOTAL
GROSS
ALL JOBS
5.
TOTAL
PROJ
HRS
6.
BASE
WAGE
RATE
PAGE2
EMPLOYER NAME AND ADDRESS NAME OF GENERAL / PRIME CONTRACTOR PROJECT NAME AND LOCATION (COUNTY) CONTRACTING AUTHORITY (OR OWNER)
PROJECT / CONTRACT NUMBERWEEK ENDING CHECK IF SUBCONTRACTOR1
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F330-03Bv0612 1If Subcontractor, provide Contractor name in space provided. 2Attach additional pages as necessary. 3For Public Records Requests, redact Social Security Numbers.
FULL NAME OF WORKER SOCIAL SECURITY NUMBER3 STREET ADDRESS CITY, STATE AND ZIP CODE of
CHECK IF SUBCONTRACTOR1 WEEK ENDING PAYROLL NUMBER PAGE2 PROJECT / CONTRACT NUMBER
Certified Payroll Report - Part B 330 Construction Contractor Payment State of Ohio Standard Forms for Public Facility Construction EMPLOYER NAME AND ADDRESS NAME OF GENERAL / PRIME CONTRACTOR PROJECT NAME AND LOCATION (COUNTY) CONTRACTING AUTHORITY (OR OWNER)
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