D.3 Statement of FAR 52.222-41 - Statement of DoL WD Compliance.docx

This file is a Statement of Department of Labor Wage Determination Compliance template (FAR 52.222-41) that contractors must complete and submit with their offers for solicitation 36C25026Q2655. The document serves as a certification memorandum in which the contractor attests that all employees performing services under the resulting contract will be paid at hourly rates equal to or greater than the current Department of Labor Wage Determination rates applicable to the county where the VA medical center being supported is located. The template requires signature attestation from the company owner, CEO, and COO, along with their printed names and dates, confirming compliance with prevailing wage requirements.

This compliance statement is required for the Non-Emergency Medical Transportation Services contract for Aleda E. Lutz VA Medical Center (Saginaw), issued by the Department of Veterans Affairs Veterans Health Administration, Veterans Integrated Service Network 10. The contract is set aside for Veteran Owned Small Businesses and is being conducted under FAR 12 Simplified Acquisition Procedures with RFQ number 36C25026Q2655. Contractors must identify the specific occupational codes and titles for positions that will perform work under the contract and confirm wage determination compliance for those roles.