Affidavit_of_Wages_Paid.pdf
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- Attached to
- Turnkey-Engineering, Procurement and Construction (EPC) for New Carbon Coal Electrical Substation
- Solicitation number
- 2026/2027/03
- Issued by
- Quay County, New Mexico
About this file
Summary
This is an Affidavit of Wages Paid form required by the City of Gallup, New Mexico, for completion after construction is finished on a public works project. The form mandates documentation from all general contractors, subcontractors, and tier subcontractors involved in the turnkey Engineering, Procurement, and Construction (EPC) delivery of a new 115 kV to 13.2 kV, 30 MVA electrical substation located in the Carbon Coal Road area. Each contractor must submit a separate signed affidavit certifying completion of work, providing company information, contact details, and the date work was completed. The form requires identification of the applicable State Wage Decision Number and project title as listed in the bid documents, along with the exact physical address of the job site.
The affidavit serves as a compliance certification that all workers employed 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, in accordance with New Mexico's Public Works Minimum Wage Act (13-4-11 through 13-4-18, NMSA 78) and the Labor Relations Division Public Works Minimum Wage Act Policy Manual (11.1.2 NMAC). Contractors who violate prevailing wage laws through incorrect job classification, improper wage or overtime payment, or other violations are subject to debarment procedures and are required to pay back wages owed to workers. All completed affidavits must be submitted to the contracting agency following project completion.
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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 .