Contracting_Agency_Certification_Form-State.pdf
PDF 246 KB Posted
- Attached to
- Clifton Street Boat Launch
- Solicitation number
- 2026-ITB-352
- Issued by
- New Haven County, Connecticut
About this file
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 for all public works projects. The form applies to the Clifton Street Boat Launch project in Connecticut, which involves repair and construction of a non-motorized boat launch facility at the end of Clifton Street where it meets the Quinnipiac River. The project scope includes construction of a 39-foot timber pier on timber piles, a concrete abutment, procurement and installation of an ADA-compliant aluminum gangway and floating boat launch, and repair of the landside platform featuring a low-profile pre-cast concrete block retaining wall and flatwork. The project will restore public river access and enhance resilience and accessibility to the area, which has deteriorated since its initial installation in the late 1990s due to rising sea levels and storm surges.
The contracting agency must certify the total dollar amount of work to be performed in connection with the project, inclusive of all work regardless of whether the project consists of one or more contracts. The certification form requires documentation of contractor information, including the contractor name and address, authorized representative, approximate starting and completion dates, and the total project amount. The completed form must be submitted to the Connecticut Department of Labor, Wage and Workplace Standards Division, Contract Compliance Unit, located at 200 Folly Brook Blvd., Wethersfield, CT 06109. Inquiries regarding the certification requirement can be directed to (860) 263-6790.
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Text version
~NOTICE~
TO ALL CONTRACTING AGENCIES
Please be advised that Connecticut General Statutes Section 31-53, requires the contracting agency to certify to the Department of Labor, the total dollar amount of work to be done in connection with such public works project, regardless of whether such project consists of one or more contracts.
Please find the attached “Contracting Agency Certification Form” to be completed and returned to the Department of Labor, Wage and Workplace Standards Division, Public Contract Compliance Unit.
O Inquiries can be directed to (860) 263-6790.
https://www.cga.ct.gov/current/pub/chap_557.htm#sec_31-53
CONNECTICUT DEPARTMENT OF LABOR
WAGE AND WORKPLACE STANDARDS DIVISION
CONTRACT COMPLIANCE UNIT
CONTRACTING AGENCY CERTIFICATION FORM
I, , acting in my official capacity as , authorized representative title for , located at , contracting agency address do hereby certify that the total dollar amount of work to be done in connection with
, located at , project name and number address shall be $ , which includes all work, regardless of whether such project consists of one or more contracts.
CONTRACTOR INFORMATION
Name:
Address:
Authorized Representative:
Approximate Starting Date:
Approximate Completion Date:
Signature Date
Return To: Connecticut Department of Labor Wage & Workplace Standards Division Contract Compliance Unit 200 Folly Brook Blvd.
Wethersfield, CT 06109
Date Issued: ___________________________
| Title: |
| Authorized Rep: |
| Contracting Agency: |
| Agency Address: |
| Project Name/Number: |
| Project Address: |
| Project Amount: |
| Contractor Name: |
| Contractor Address: |
| Contractor Rep: |
| Start Date: |
| Complete Date: |
| Signature Date: |
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