D.3 Statement of FAR 52.222-41 Statement of DoL WD Compliance.docx
DOCX document 15 KB Posted
- Attached to
- Moving, Storage, Inventory, and Installation Services | Base Plus 4 | VA Ann Arbor Healthcare System
- Solicitation number
- 36C25026Q0717_2
About this file
This is a Statement of Department of Labor Wage Determination Compliance certification document (FAR 52.222-41) required as part of solicitation 36C25026Q0717 for moving, storage, inventory, and installation services at the VA Ann Arbor Healthcare System. The memorandum, dated July 20, 2026, requires the offeringcompany to certify that all employees performing work under the resulting contract will be paid at hourly rates equal to or greater than the current Department of Labor Wage Determination rates specified in the Performance Requirements Summary section of the Performance Work Statement for all applicable labor categories in Washtenaw County, Michigan, where the VA medical center is located.
The certification must be signed and dated by three company representatives: the Owner, Chief Executive Officer, and Chief Operating Officer, with their full legal names printed. This compliance statement is a mandatory submission requirement for bidders on this Service-Disabled Veteran Owned Small Business (SDVOSB) set-aside procurement. The document serves as a template to be completed and submitted as part of the quotation package, alongside other required attachments including the wage determination table (WD 2015-4833 Rev 31) and the past performance questionnaire.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 36C25026Q0717_3.docx | DOCX document | |
| 36C25026Q0717 0002.docx | DOCX document | |
| D.4 Past Performance Questionnaire Updated.docx | DOCX document | |
| QUESTIONS AND RESPONSES 8.10.26.docx | DOCX document | |
| 36C25026Q0717_2.docx | DOCX document | |
| 36C25026Q0717 0001.docx | DOCX document | |
| D.2 WD 2015-4833 Rev 31 Washtenaw 20 Jul 2026.txt | TXT text file | |
| D.4 Past Performance Questionnaire.docx | DOCX document | |
| 36C25026Q0717_2.docx | DOCX document | |
| D.1 36C25026Q0717.docx | DOCX document |
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Text version
D.2 52.222-41 (Addendum B) – Statement of Department of Labor Wage Determination Compliance
MEMORANDUM FOR RECORD
07/20/2026
REFERENCE: 36C25026Q0717
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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