Affidavit_of_Wages_Paid.pdf
PDF 111 KB Posted
- Attached to
- New Sunshine Substation Construction
- Solicitation number
- 2025/2026/02
- Issued by
- Quay County, New Mexico
About this file
The document is an Affidavit of Wages Paid form from the Department of Workforce Solutions, Labor Relations Division, designed to be completed after construction is finished. The form requires detailed information from general contractors, subcontractors, and additional tier subcontractors, including company names, addresses, contact information, project details, and completion dates. The primary purpose is to certify that all workers on a public works project were paid at least the prevailing wage rates as determined by the Department of Workforce Solutions.
The form includes a certification statement where contractors affirm that workers were paid no less than the mandated prevailing wage rates, with an understanding that violations can result in debarment procedures and requirements to pay back wages. The document references specific legal guidelines, including the Labor Relations Division Public Works Minimum Wage Act Policy Manual (11.1.2 NMAC) and the Public Works Minimum Wage Act (13-4-11 through 13-4-18, NMSA 78). The form was last revised on 08/23/13 and provides specific instructions for general contractors, subcontractors, and subsequent tier subcontractors on how to complete the affidavit.
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Text version
AFFIDAVIT OF WAGES PAID
To Be Completed After Construction Is Complete
All FIELDS ARE REQUIRED
FORM MUST BE SENT TO THE CONTRACTING AGENCY
General Contractor Information Company Name:
Address:
City: State: Zip:
Phone: Fax: E-Mail:
Estimated Completion Date: State Wage Decision Number:
Project Title:
Project Physical Address:
Print Name:
General Contractor Signature:
Sub Contractor Information
Date you completed work on this project:
Company Name:
Address:
City: State: Zip:
Phone: Fax: E-Mail:
Sub Contractor Signature:
2nd, 3rd, etc. Tier Sub Contractor Information
Date you completed work on this project:
Company Name:
Address:
City: State: Zip:
Phone: Fax: E-Mail:
Tier Signature:
I hereby certify that the above information is correct and that all workers I employ on this public works project were paid no less than the Prevailing Wage Rate(s) as determined by the Department of Workforce Solutions, Labor Relations Division for this project as identified by the State Wage Decision Number. I understand that contractors who violate Prevailing Wage Laws (i.e., incorrect job classification, improper payment of prevailing wages, and/or overtime, etc.), are subject to debarment procedures and shall be required to pay any back wages due to workers. (Ref. Labor Relations Division Public Works Minimum Wage Act Policy Manual (11.1.2 NMAC) & Public Works Minimum Wage Act (13-4-11 through 13-4-18, NMSA 78)).
Contractor’s Signature Date
(Revised 08/23/13)
INSTRUCTIONS FOR COMPLETING AFFIDAVIT OF WAGES PAID
GENERAL CONTRACTOR
1. Enter general contractor information and provide signature.
2. Enter State Wage Decision Number as listed in bid documents. (Example: BE 13-0123 B)
3. Enter project title - listed in bid documents.
4. Enter project physical address - exact location of project (job site).
5. Enter completion date of project.
6. All Affidavits’ must be sent to the Contracting Agency.
SUB CONTRACTOR
1. Enter general contractor information, but general contractor signature is not needed.
2. Enter sub contractor information as indicated and provide signature.
3. Enter sub contractor completion date.
NOTE: A separate signed form is needed for each contractor.
2ND, 3rd, etc TIER SUB CONTRACTOR
1. Enter sub contractor information, subcontractor signature is not needed.
2. Enter 2nd tier sub contractor information and provide signature.
3. Enter 2nd tier contract completion date.
(Revised 8/23/13)
File details come from the government source that posted it. Updated .