Contracting_Agency_Certification_Form_(1).pdf

This is a Contracting Agency Certification Form issued by the Connecticut Department of Labor, Wage and Workplace Standards Division, Contract Compliance Unit, required under Connecticut General Statutes Section 31-53. The form is applicable to the East Rock College Woods Improvements project in Connecticut, which involves improvements to the College Woods area of East Rock Park, including new and improved paths, plantings, and new site furnishings. The form requires the contracting agency to certify the total dollar amount of work to be performed in connection with the public works project, regardless of whether the project consists of one or more contracts. The certification must identify the contracting agency, authorized representative, project location, contractor information, approximate starting and completion dates, and the total project cost.

The form serves as a mandatory compliance document that must be completed and returned to the Connecticut Department of Labor at 200 Folly Brook Boulevard, Wethersfield, Connecticut 06109. Contracting agencies are required to report the comprehensive project cost encompassing all work associated with the public works initiative. The form includes designated fields for contractor details, including the contractor's name, address, authorized representative, and project timeline. Inquiries regarding the certification process can be directed to the Department of Labor at (860) 263-6790.