Affidavit_of_Wages_Paid.pdf
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- Solicitation number
- 2026-ITB-004
- Issued by
- Mckinley County, New Mexico
About this file
This document is an Affidavit of Wages Paid form from the New Mexico Department of Workforce Solutions, Labor Relations Division, designed to be completed after construction is finished for public works projects. The form requires detailed documentation from general contractors, sub-contractors, and subsequent tier sub-contractors, including company information, project details, and a certification that all workers were paid prevailing wage rates as determined by the state. The specific context relates to a whole block reconstruction project on Elva Drive in Gallup, New Mexico, involving street improvements, drainage enhancements, ADA-compliant sidewalks, and infrastructure upgrades.
The form mandates contractors certify compliance with the Public Works Minimum Wage Act (13-4-11 through 13-4-18, NMSA 78), with clear warnings that violations can result in debarment procedures and required back wage payments. Contractors must provide their company name, address, contact information, project completion date, and the state wage decision number. A separate signed form is required for each contractor involved in the project, and all affidavits must be sent to the contracting agency. The document was last revised on 08/23/13 and serves as a critical accountability mechanism to ensure fair wage practices in public works construction projects.
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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 .