Att. 8 Sample DOL Wage Determination Price Adjustment Workbook.xlsx

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ACT W900KK-21-R-0049
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Text version

Sheet1

SAMPLE Price Adjustment Request Form
Contract Number:TBD
CLIN Number:0001
CLIN Description:SAMPLE LCCS
Location:Various
Applicable Wage

Determination Number/

Collective Bargaining Agreement:Various
Price Adjustment for Lot/FY2016
(a)(b)(c)(d)(e)(a1)
CBA/WD ClassificationEmployee NumberEmployee
Base RateWD/CBA
RateHourly Salary
IncreaseLabor Category DescriptionCLINApplicable Wage

Determination Number/

Collective Bargaining Agreement:Location
1$ 14.31$ 14.31$ - 0Computer Operator ITBD2005-2312 Rev 19Fort Leonard Wood
2$ 14.31$ 14.31$ - 0Computer Operator ITBD2005-2312 Rev 19Fort Leonard Wood
3$ 14.31$ 14.31$ - 0Computer Operator ITBD2005-2312 Rev 19Fort Leonard Wood
4$ - 00
5$ - 00
Health & WelfareHealth & Welfare$ 4.02$ 4.27$ 0.25AllAll - Health & Welfare
Contract Number:TBD
CLIN Number:0001
CLIN Description:SAMPLE LCCS
Location:Various
Applicable Wage

Determination Number/

Collective Bargaining Agreement:Various.
Price Adjustment for Lot/FY2016
Lot 1Lot 2Lot 3Lot 4TOTAL
7.65%
Hollenbaugh, Devin: Obtained from the Dept. of Labor website.0.00%0.00%0.00%0.00%0.00%

Hollenbaugh, Devin: FUI, SDI, SUI, WCI Vary by Company

Hollenbaugh, Devin: Obtained from the Dept. of Labor website.Employee NumberHourly Salary
IncreaseTotal Projected HoursTotal Salary IncreaseFICA (Current Rate: 7.65%)Federal Unemployment Insurance (FUI)State Disability Insurance (SDI)State Unemployment Insurance (SUI)Workmen's Compensation Insurance (WCI)OtherTotal AdjustmentTotal AdjustmentTotal AdjustmentTotal AdjustmentTOTALCLINApplicable Wage

Determination Number/

Collective Bargaining Agreement:Location
1$ - 02,080.0$ - 0$ - 0$ - 0- 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0TBD2005-2312 Rev 19Fort Leonard Wood
2$ - 02,080.0$ - 0$ - 0$ - 0- 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0TBD2005-2312 Rev 19Fort Leonard Wood
3$ - 02,080.0$ - 0$ - 0$ - 0- 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0TBD2005-2312 Rev 19Fort Leonard Wood
4
5
Health & Welfare$ 0.25$ 6,240.00$ 1,560.00$ 119.3400$ 1,679.34$ 1,679.34$ 1,679.34$ 1,679.34$ 6,717.360AllAll - Health & Welfare

$ 1,679.34 $ 1,679.34 $ 1,679.34 $ 1,679.34 $ 6,717.36

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