DRAFT_B2_08.3_SF1413.pdf
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- Solicitation number
- SLAC_RFP_368509
- Issued by
-
Department of Energy Office of Science
About this file
This is Standard Form 1413 (REV. 10/2023), a federal form used to document the award of subcontracts under prime federal contracts and ensure labor compliance. The form serves as a statement by the prime contractor and acknowledgment by the subcontractor regarding the applicability of labor standards clauses to the subcontract.
Part I requires the prime contractor to provide identifying information including the prime contract number, subcontract award date, subcontract number, names and addresses of both the prime contractor and subcontractor, the name of the firm awarding the subcontract, a description of the subcontractor's work, project details, and location. The prime contractor must also indicate whether the prime contract contains the "Contract Work Hours and Safety Standards Act -- Overtime Compensation" clause. Part II requires the subcontractor to acknowledge that specific labor standards clauses from the prime contract are incorporated into the subcontract, including provisions related to contract work hours and safety standards, payroll and basic records, withholding of funds, disputes concerning labor standards, construction wage rate requirements, apprentices and trainees, Copeland Act compliance, subcontracts, contract termination and debarment, and certification of eligibility. The form includes spaces for intermediate subcontractors if applicable and requires signatures from authorized representatives of both the prime contractor and subcontractor with dates. The OMB control number is 9000-0066, with an expiration date of 5/31/2027, and the estimated burden is 0.05 hours for completion.
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Text version
Statement And Acknowledgment OMB Control Number: 9000-0066 Expiration Date: 5/31/2027
Part I - Statement Of Prime Contractor
1. Prime Contract Number 2. Date Subcontract Awarded
3. Subcontract Number
Authorized For Local Reproduction Previous Edition Is Not Usable
STANDARD FORM 1413 (REV. 10/2023)
Prescribed by GSA/FAR (48 CFR) 53.222(e)
4. Prime Contractor 5. Subcontractor
a. Name a. Name
b. Street Address b. Street Address
c. City d. State e. ZIP Code c. City d. State e. ZIP Code
6. The prime contract does, does not contain the clause entitled "Contract Work Hours and Safety Standards Act -- Overtime Compensation."
7. The prime contractor states that under the contract shown in Item 1, a subcontract was awarded on the date shown in Item 2 to the subcontractor identified in Item 5 by the following firm:
a. Name Of Awarding Firm
b. Description Of Work By Subcontractor
8. Project 9. Location
10a. Name Of Person Signing 11. By (Signature) 12. Date Signed
10b. Title Of Person Signing
Part II - Acknowledgment Of Subcontractor
13. The subcontractor acknowledges that the following clauses of the contract shown in Item 1 are included in this subcontract:
Contract Work Hours and Safety Standards Act - Overtime
Compensation (If included in prime contract see Block 6) Payrolls and Basic Records Withholding of Funds Disputes Concerning Labor Standards Compliance with Construction Wage Rate Requirements and Related Regulations
Construction Wage Rate Requirements Apprentices and Trainees Compliance with Copeland Act Requirements Subcontracts (Labor Standards) Contract Termination - Debarment Certification of Eligibility
DRAFT
Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U.S.C. §
3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB) control number.
The OMB control number for this collection is 9000-0066. We estimate that it will take .05 hours to read the instructions, gather the facts, and answer the questions. Send only comments relating to our time estimate, including suggestions for reducing this burden, or any other aspects of this collection of information to: U.S. General Services Administration, Regulatory Secretariat Division (M1V1CB), 1800
F Street, NW, Washington, DC 20405.
15b. Title Of Person Signing
15a. Name Of Person Signing 16. By (Signature) 17. Date Signed
14. Name(s) Of Any Intermediate Subcontractors, If Any
A C
DB
STANDARD FORM 1413 (REV. 10/2023) BACK
DRAFT
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