ATT 18 - Davis-Bacon Weekly Certified Payroll.pdf
PDF 221 KB Posted
- Attached to
- FLETC Charleston Construction IDIQ Contract Federal contract opportunity
- Solicitation number
- 70LCHS26RPFB00001
About this file
This document is a Davis-Bacon and Related Acts Weekly Certified Payroll Form issued by the U.S. Department of Labor's Wage and Hour Division. The form is designed for contractors and subcontractors performing work on federal or federally assisted construction contracts to report weekly payroll information. It requires detailed documentation of worker classifications, hours worked, wage rates, and fringe benefits for each employee, with the purpose of ensuring workers are paid prevailing wages as specified in the contract's wage determination.
The form includes multiple sections for capturing comprehensive payroll data, such as worker identifying information, labor classification, hours worked (straight time and overtime), hourly wage rates, and fringe benefit details. Contractors must certify the accuracy of the information, verify apprentices are properly registered, and confirm that all workers have been paid full weekly wages without impermissible deductions. The document emphasizes legal compliance, with a warning that willful falsification may result in civil or criminal prosecution and potential debarment from future federal contracts.
View the file
Other files for this federal contract opportunity
Show all 20
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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)
W
OR
KE
R
EN
TR
Y
NO
W
OR
KE
R
LA
ST
N
AM
E
W
OR
KE
R
FI
RS
T
NA
M E
W
OR
KE
R
M
ID
DL
E
IN
IT
IA
L
W
OR
KE
R
ID
EN
TI
FY
IN
G
NO
(J)
JO
UR
NE
YW
OR
KE
R
(R A)
R
EG
IS
TE
RD
AP
PR
EN
TI
CE
LA
BO
R
CL
AS
SI
FI
CA
TI
ON
ST
S
TR
AI
GH
T
TI
M E
OT
O
VE
RT
IM
E
(TOP) DAYS OF WORK WEEK
(BOTTOM) DATES
TO
TA
L H
OU
RS
W
OR
KE
D
FO
R
W
EE
K
HO
UR
LY
W
AG
E
RA
TE
PA
ID
FO
R
ST
A
ND
O T
TO
TA
L F
RI
NG
E
BE
NE
FI
T
CR
ED
IT
PA
YM
EN
T
IN
LI
EU
O
F
FR
IN
GE
B
EN
EF
IT
S
GR
OS
S
AM
T
EA
RN
ED
GR
OS
S
AM
T
EA
RN
ED
FO
R
AL
L
DEDUCTIONS FOR ALL
NE
T
PA
Y
TO
W
OR
KE
R
FO
R
AL
L
TA
X
W
IT
H-
HO
LD
IN
GS
FI
CA
OT
HE
R (M
US
T
SP
EC
IF
Y, S
EE
IN
ST
RU
CT
IO
NS
TO
TA
L
DE
DU
CT
IO
NS
HOURS WORKED
EACH DAY
ST
OT
ST
OT
ST
OT
ST
OT
ST
OT
ST
OT
ST
OT
ST
OT
While use of Form WH- federally n
Statement of C 2 of the WH- -o determine whether inform Avenue, N.W. Washington, D.C. 20210 (over)
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
OA SAA
NAME OF WORKER
FB NAME FB NAME FB NAME FB NAME FB NAME FB NAME
TOTAL
HOURLY
CREDIT
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.
File details come from the government source that posted it. Updated .