Affidavit_of_Wages_Paid.pdf
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- 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 Affidavit of Wages Paid form, required by the City of Gallup, New Mexico for the Carbon Coal Road, McKinley County Industrial Park Waterline Project, serves as a post-construction certification document to verify compliance with prevailing wage requirements under New Mexico's Public Works Minimum Wage Act. The form must be completed and submitted to the contracting agency after construction is finished and requires detailed information from general contractors, subcontractors, and tiered subcontractors, including company details, project identification using the State Wage Decision Number, work completion dates, and signed certifications. Separate signed forms are required for each contractor level involved in the project, with general contractors providing their signatures and all subcontractor tiers providing appropriate authorization signatures for their respective work segments.
The affidavit certifies that all workers employed on the public works project received no less than the prevailing wage rates established by the Department of Workforce Solutions, Labor Relations Division, as identified by the State Wage Decision Number provided in the bid documents. Contractors who violate prevailing wage laws—including incorrect job classification, improper wage payments, or overtime violations—are subject to debarment procedures and are required to repay any back wages owed to workers. This compliance mechanism applies to the Carbon Coal Road waterline project, which exceeded the $60,000 threshold requiring prevailing wage registration and adherence under the Public Works Minimum Wage Act (13-4-11 through 13-4-18, NMSA 78).
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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 .