ATT 17 - Davis-Bacon Weekly Certified Payroll.pdf
PDF 221 KB Posted
- Attached to
- FLETC Artesia Construction IDIQ Contract Federal contract opportunity
- Solicitation number
- 70LART25RPFB00001
About this file
The Davis-Bacon Weekly Certified Payroll form is a standardized U.S. Department of Labor document used to report weekly wage information for workers on federal or federally-assisted construction contracts. The form requires contractors to document detailed payroll information for each worker, including name, labor classification, hours worked, wage rates, fringe benefits, and total earnings. Contractors must certify the accuracy of the payroll information, confirming that workers have been paid prevailing wages and that any apprentices are properly registered.
The form is part of compliance requirements for the Davis-Bacon and Related Acts, which mandate specific wage and record-keeping standards for construction workers on government-funded projects. Key sections include spaces to record project details, individual worker information, daily and weekly hours, wage rates for straight time and overtime, fringe benefits, and deductions. The document includes a certification section where a company official must verify the payroll information's completeness and accuracy, with potential civil or criminal penalties for willful falsification of information.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 70LART25RPFB00001 Amend 0001.pdf | ||
| ATT 16 - Statement and Acknowledgement.pdf | ||
| ATT 7 - Pre-Proposal Inquiry (PPI).xlsx | XLSX spreadsheet | |
| ATT 6 - WD Residential NM20250005 01-03-2025.pdf | ||
| 70LART25RPFB00001.pdf | ||
| ATT 13 - Security Orientation Training Acknowledgement.pdf | ||
| ATT 12 - Contractor Fitness Security Screening Request.pdf | ||
| ATT 8 - Past Performance Questionnaire (PPQ).docx | DOCX document | |
| ATT 15 - Employment Eligibility Verification.pdf | ||
| ATT 14 - Declaration of Federal Employment.pdf | ||
| ATT 11 - Consumer Reports Fair Credit Reporting.pdf | ||
| ATT 10 - Non_Disclosure Agreement.pdf | ||
| ATT 9 - Visitor and Vendor Access Request.pdf | ||
| ATT 5 - WD Highway NM20250036 01-03-2025.pdf | ||
| ATT 2 - Specifications 03-20-2025.pdf | ||
| ATT 1 - Statement of Work 03-20-2025.pdf | ||
| ATT 4 - WD Heavy NM20250012 02-14-2025.pdf | ||
| ATT 3 - WD Building NM20250018 03-07-2025.pdf |
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Text version
Rev. January 2025 OMB No.: 1235-0008 Expires: 01/31/2028
U.S. Department of Labor Wage and Hour Division
Davis-Bacon and Related Acts Weekly www.dol.gov/whd/forms/wh347instr.htm) named project below.
SUBMISSION OF FINAL DBRA CERTIFIED PAYROLL FORM PRIME CONTRACTOR SUBCONTRACTOR
PROJECT NAME PROJECT NO. or CONTRACT NO. CERTIFIED PAYROLL NO. PRIME CONTRACTOR’S/SUBCONTRACTOR’S BUSINESS NAME
PROJECT LOCATION WAGE DETERMINATION NO. WEEK ENDING DATE PRIME CONTRACTOR’S/SUBCONTRACTOR’S BUSINESS ADDRESS
(1A) (1B) (1C) (1D) (1E) (2) (3) (4) (5) (6A) (6B) (6C) (7A) (7B) (8) (9)
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PROJECT NAME PROJECT NO. or CONTRACT NO. PAYROLL NO. PRIME CONTRACTOR’S/SUBCONTRACTOR’S BUSINESS NAME
PROJECT LOCATION WEEK ENDING DATE CERTIFYING OFFICIAL’s NAME AND TITLE
The payroll
APPRENTICESHIP PROGRAM NAME REGISTERED NAME OF LABOR CLASSIFICATION
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FB NAME FB NAME FB NAME FB NAME FB NAME FB NAME
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FB TYPE FB TYPE FB TYPE FB TYPE FB TYPE FB TYPE
PLAN NO. PLAN NO. PLAN NO. PLAN NO. PLAN NO. PLAN NO.
Funded Unfunded Funded Unfunded Funded Unfunded Funded Unfunded Funded Unfunded Funded Unfunded
Hourly Credit $ Hourly Credit $ Hourly Credit $ Hourly Credit $ Hourly Credit $ Hourly Credit $ $ Hourly Credit $ Hourly Credit $ Hourly Credit $ Hourly Credit $ Hourly Credit $ Hourly Credit $ $ Hourly Credit $ Hourly Credit $ Hourly Credit $ Hourly Credit $ Hourly Credit $ Hourly Credit $ $ Hourly Credit $ Hourly Credit $ Hourly Credit $ Hourly Credit $ Hourly Credit $ Hourly Credit $ $ Hourly Credit $ Hourly Credit $ Hourly Credit $ Hourly Credit $ Hourly Credit $ Hourly Credit $ $ Hourly Credit $ Hourly Credit $ Hourly Credit $ Hourly Credit $ Hourly Credit $ Hourly Credit $ $ Hourly Credit $ Hourly Credit $ Hourly Credit $ Hourly Credit $ Hourly Credit $ Hourly Credit $ $ Hourly Credit $ Hourly Credit $ Hourly Credit $ Hourly Credit $ Hourly Credit $ Hrly Credit $ $
ADDITIONAL REMARKS
SIGNATURE OF CERTIFYING OFFICIAL DATE TELEPHONE NUMBER EMAIL ADDRESS
THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEMENTS MAY SUBJECT THE CONTRACTOR OR SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION (SEE SECTION 1001 OF TITLE 18 AND SECTION 3729 OF TITLE 31 OF THE UNITED STATES CODE), AS WELL AS DEBARMENT FROM FUTURE FEDERAL AND FEDERALLY-ASSISTED CONTRACTS. INFORMATION REPORTED IN CERTIFIED PAYROLLS MAY BE SUBJECT TO DISCLOSURE IN RESPONSE TO A FREEDOM OF INFORMATION ACT REQUEST.
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