D.3 Statement of FAR 52.222-41 - Statement of DoL WD Compliance.docx
FAR Clause DOCX document 15 KB Posted
- Solicitation number
- 36C25027R5412
About this file
This document is a Statement of Department of Labor Wage Determination Compliance, which serves as a certification form for contractors bidding on solicitation 36C25027R5412. The contractor must certify that all employees performing services under the resultant contract will be paid at hourly rates equal to or greater than the current Department of Labor Wage Determination rates as specified in paragraph 8 of the solicitation. The form requires signatures and printed names from the company owner, CEO, and COO, along with the date of certification. The memorandum is dated 8/26/2026 and is addressed to Robert Bolcavage, Contracting Specialist at NCO-10.
This certification applies to the Veterans Affairs solicitation V226--NEMT for Cleveland VAMC Follow-on Base 2, with a contract start date of February 1, 2027. The solicitation is issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 10. The form itself is a template that requires contractors to identify applicable occupational codes and titles for positions that will be performing work under the contract, ensuring compliance with prevailing wage requirements prior to contract award.
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Other versions and copies of FAR 52.222-41
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Who attaches FAR 52.222-41
Other files
| File | Type | Posted |
|---|---|---|
| 36C25027R5412.docx | DOCX document | |
| D.6 Statement of Start Date Confirmation updated.docx | DOCX document | |
| D.5 Past Performance Questionnaire updated 7.6.2026.docx | DOCX document | |
| D.1 Required Compliance Checklist.docx | DOCX document | |
| D.2 WD 2015-4727 Rev 31 Cleveland 22 August 2026.docx | DOCX document | |
| D.4 Statement of FAR 52.219-14 Limitations on Subcontracting Compliance.docx | DOCX document |
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Text version
D.3 52.222-41– Statement of Department of Labor Wage Determination Compliance
MEMORANDUM FOR RECORD
8/26/2026
REFERENCE: 36C25027R5412
TO: Robert Bolcavage (Contracting Specialist), NCO-10 FROM: Contractor Name Address City, State Zipcode
UEI / CAGE CODE
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 paragraph 8 "Wage Rates".
• Occupational Code (Occupational Title)
· Occupational Code (Occupational 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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