Att. 9 Sample DOL Wage Determination Price Adj Request Information.docx

PRICE ADJUSTMENT REQUEST INFORMATION

TO BE PROVIDED WITH REQUEST FOR PRICE ADJUSTMENTS

DUE TO REVISED WAGE DETERMINATION (WD)

Contract No:_______________________________ Modification No:___________________________ I. In accordance with the terms of the Fair Labor Standards Act and Service Contract Act - Price Adjustment clause of the contract the Contractor is required to notify the Contracting Officer of any price changes (increase or decrease) discussed in this clause.

II. The following guidance shall be followed in preparing and submitting such notification.

A. Changes required as a result of increases or decreases in WAGES.

The Contractor shall complete the attached forms for all applicable requests. Separate forms should be utilized for each different location. Pages A and B must be provided for each individual employee affected.

Completion of Page A is self explanatory.

Completion of Page B shall be done as follows:

Column Description

(a) Self explanatory.

(b) From Page A column (e).

(c) Hours affected during FY.

(d) Column (b) x column (c).

(e) thru (j) Concomitant increases/decreases in Social Security and Unemployment Taxes and Workmen’s' Compensation Insurance. Complete the rates for the following items:

FICA __________%

Federal Unemployment Insurance (FUI) __________% State Unemployment Insurance (SUI) __________% State Disability Insurance (SDI) __________% Workmen’s' Compensation Insurance (WCI) __________% Other (Specify) __________% These rates shall be applied to column (d). If adjustment is required to a rate, rates shall be apportioned to reflect the effective period of the rate (i.e. FICA rate 7.65% effective 1 January 1990). The Contractor shall identify by dollar amount the applicable portion of the salary increase utilized for each rate.

(k) Total Adjustment: Add columns (e)+(f)+(g)+(h)+(i)+(j).

B. Changes required as a result of increases or decreases in FRINGE BENEFITS.

The Contractor shall provide complete rational in a similar format to Attachment (1) to justify any change requested due to revisions in Health and Welfare, Vacation or Holiday requirements.

C. Collective Bargaining Agreements For those items where the Contractor is requesting an adjustment due to changes in a Collective Bargaining Agreement, the following information shall be provided:

1. Detailed statement as to why the adjustment is justified/ applicable under the terms of the contract.

2. Copy of applicable pages of both the Current and Previous agreements covering the item for which the adjustment is requested.

3. Detailed pricing information in accordance with the applicable requirements of paragraphs A and B, above.

III. The Contractor shall provide the total requested dollar amount for Price Adjustment by combining each area in paragraph II, above. The total requested dollar amount shall be apportioned appropriately among the directly affected CLIN/SLIN in Schedule B of the contract.

IV. The Contractor shall provide the same information required in paragraphs II and III, above for each remaining option period in the contract.

V. The Contractor is required to comply with the requirements of FAR 15.804-2 Requiring Certified Cost or Pricing Data in cases where the total dollar amount of the notification exceeds the thresholds. The applicable dollar threshold under this contract is $500,000 in lieu of $100,000. This threshold dollar amount is determined by adding together the requested adjustments for the current year and all option years.