D.2 Statement of FAR 52.212-2 - Statement of DoL WD Compliance.docx

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Attached to
J071--RFQ Cancellation | Furniture Movers | Detroit VAMC Resolicit as SDVOSB Base Plus Four | Start: 3/31/26
Solicitation number
36C25026Q0253
Issued by

About this file

This is a Statement of Department of Labor Wage Determination Compliance certification form required as part of a federal contract solicitation. The document serves as a memorandum for record dated February 9, 2026, and pertains to solicitation 36C25026Q0253 for the Department of Veterans Affairs. The form requires company officials—specifically the Owner, Chief Executive Officer, and Chief Operating Officer—to certify under signature that any offer submitted is fully compliant with Department of Labor Wage Determination requirements. All employees performing services under a resulting contract must be paid at hourly rates equal to or greater than current Department of Labor Wage Determination rates as specified in the Performance Requirements Summary section of the Performance Work Statement, with rates applying to all applicable labor categories for the county in which the supported VA medical center is located.

This is a template document rather than a substantive solicitation component. It contains blank signature lines and fields for company officer names and dates, indicating it is a form to be completed and submitted by bidders as part of their quotation package. The form does not address specific products or services but rather establishes a compliance verification mechanism for prevailing wage requirements under the broader furniture repair and moving services solicitation issued by the Network Contracting Office (NCO-10).

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Other files

File Type Posted
36C25026Q0253_2.docx DOCX document
36C25026Q0253 0001 Cancellation Amendment.docx DOCX document
D.5 Statement of FAR 52.219-14 Limitations on Subcontracting Compliance.docx DOCX document
D.3 Past Performance Questionnaire.docx DOCX document
36C25026Q0253_1.docx DOCX document
36C25026Q0253.docx DOCX document
D.4 Furniture Repair Experience Questionnaire.docx DOCX document
D.1 WD 2015-4839 Rev 29 Wayne 03 Dec 2025.docx DOCX document

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Text version

D.2 52.212-2 (Addendum B) – Statement of Department of Labor Wage Determination Compliance

MEMORANDUM FOR RECORD

2/9/2026

REFERENCE: 36C25026Q0253

TO: Elizabeth Koses (Contracting Officer), NCO-10

FROM: ________

SUBJECT: Statement of Department of Labor Wage Determination Compliance I do hereby certify that the offer submitted by our company in response to the subject solicitation is fully compliant with the requirement that all employees performing services under the resultant contract (if awarded) shall be paid at an hourly rate that is equal to or greater than current Department of Labor Wage Determination (WD) as specified in the Performance Requirements Summary (PRS) section of the Performance Work Statement (PWS) for all labor categories as appropriate for the county in which the VA medical center being support for this requirement resides to include but not limited to the following:

• (WD, Labor Occupation #, Title)

Company OWNER Full Legal Name (PRINT): ________________________________ Company OWNER Signature: Date: ____________

Company CEO Full Legal Name (PRINT): ________________________________ Company CEO Signature: __________________________________ Date: ______________

Company COO Full Legal Name (PRINT): ________________________________ Company COO Signature: __________________________________ Date: ______________

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