Affidavit_of_Wages_Paid.pdf
PDF 111 KB Posted
- Attached to
- Carbon Coal Road, McKinley County Industrial Park Waterline - US Department of Commerce (EDA) 08-79-05634
- Solicitation number
- ITB-2609
- Issued by
- Quay County, New Mexico
About this file
This file is an Affidavit of Wages Paid form required by the State of New Mexico for the Carbon Coal Road, McKinley County Industrial Park Waterline project in Gallup, New Mexico. The form must be completed and submitted to the contracting agency after construction is complete. It requires certification from general contractors, subcontractors, and any additional tier subcontractors that all workers employed on the public works project were paid no less than the prevailing wage rates as determined by the Department of Workforce Solutions, Labor Relations Division. The form mandates collection of company information, contact details, project identification including the State Wage Decision Number, and completion dates for each contractor tier involved in the project.
Contractors are required to certify compliance with New Mexico's Prevailing Wage Laws under the Public Works Minimum Wage Act (13-4-11 through 13-4-18, NMSA 78) and acknowledge that violations—including incorrect job classification, improper payment of prevailing wages, and overtime violations—are subject to debarment procedures and requirements to pay back wages to affected workers. A separate signed affidavit must be submitted for each contractor involved, and all forms must be forwarded to the contracting agency. The form was last revised on August 23, 2013.
View the file
Other files
Show all 13
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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 .