DWSRF_1445_Labor_Standards_Interview_Form.pdf
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- Solicitation number
- 25/26-62
- Issued by
- Hartford County, Connecticut
About this file
This document is the Labor Standards Interview Form (Standard Form 1445), a compliance tool prescribed by the General Services Administration for use in federal and federally-funded construction projects, including the Town of Manchester, Connecticut's Parking Lot Reconstruction project at Salters Pool. The form is designed to conduct interviews with employees working on prevailing wage projects to verify proper labor standards compliance. The form captures employee information including name, address, work classification, and wage rate, along with the prime contractor and employer details. Key compliance questions address whether employees work over 8 hours per day or 40 hours per week, receive required overtime compensation at time and a half, and receive cash payments for fringe benefits mandated by wage determinations. The form also documents deductions from pay, hours worked on the last work day, project start date, and tools used. The document includes sections for employee signature certification and interviewer assessment of proper classification and compensation, as well as verification that wage rates and required posters are displayed at the project site.
The form includes a payroll checker section to cross-reference interview information against actual payroll records to ensure accuracy and compliance. All responses are tracked with yes/no checkboxes, and the document provided shows a blank template with zero responses recorded across all compliance questions. The form requires signatures from both the employee and interviewer, with dates recorded in YYMMDD format. This Labor Standards Interview Form is a mandatory compliance document for prevailing wage projects funded through federal programs such as the Drinking Water State Revolving Fund (DWSRF), ensuring that contractors and employers on public works projects maintain required labor standards and properly compensate workers according to federal wage determinations.
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Text version
LABOR STANDARDS INTERVIEW
CONTRACT NUMBER EMPLOYEE INFORMATION
LAST NAME FIRST NAME MI
STREET ADDRESS
CITY STATE ZIP CODE
WORK CLASSIFICATION WAGE RATE
NAME OF PRIME CONTRACTOR
NAME OF EMPLOYER
SUPERVISOR'S NAME
LAST NAME FIRST NAME MI
ACTION CHECK BELOW
YES NO
Do you work over 8 hours per day?
Do you work over 40 hours per week?
Are you paid at least time and a half for overtime hours?
Are you receiving any cash payments for fringe benefits required by the posted wage determination decision?
WHAT DEDUCTIONS OTHER THAN TAXES AND SOCIAL SECURITY ARE MADE FROM YOUR PAY?
HOW MANY HOURS DID YOU WORK ON YOUR LAST WORK DAY BEFORE
THIS INTERVIEW?
DATE OF LAST WORK DAY BEFORE INTERVIEW (YYMMDD)
DATE YOU BEGAN WORK ON THIS PROJECT (YYMMDD)
TOOLS YOU USE
THE ABOVE IS CORRECT TO THE BEST OF MY KNOWLEDGE
EMPLOYEE'S SIGNATURE DATE (YYMMDD)
INTERVIEWER
SIGNATURE TYPED OR PRINTED NAME DATE (YYMMDD)
INTERVIEWER'S COMMENTS
ACTION (If explanation is needed, use comments section) YES NOWORK EMPLOYEE WAS DOING WHEN INTERVIEWED
IS EMPLOYEE PROPERLY CLASSIFIED AND PAID?
ARE WAGE RATES AND POSTERS DISPLAYED?
FOR USE BY PAYROLL CHECKER
IS ABOVE INFORMATION IN AGREEMENT WITH PAYROLL DATA?
YES NO
COMMENTS
CHECKER
LAST NAME FIRST NAME MI JOB TITLE
DATE (YYMMDD)SIGNATURE
AUTHORIZED FOR LOCAL REPRODUCTION
Previous edition not usable
STANDARD FORM 1445 (REV. 12-96)
Prescribed by GSA - FAR (48 CFR) 53.222(g)
C:\PERFORM\FORMS\S1445.FRP
Barbara Williams
LABOR STANDARDS INTERVIEW
CONTRACT NUMBER
EMPLOYEE INFORMATION
LAST NAME
FIRST NAME
MI
STREET ADDRESS
CITY
STATE
ZIP CODE
WORK CLASSIFICATION
WAGE RATE
NAME OF PRIME CONTRACTOR
NAME OF EMPLOYER
SUPERVISOR'S NAME
LAST NAME
FIRST NAME
MI
ACTION
CHECK BELOW
YES
NO
Do you work over 8 hours per day?
Do you work over 40 hours per week?
Are you paid at least time and a half for overtime hours?
Are you receiving any cash payments for fringe benefits required by the posted wage determination decision?
WHAT DEDUCTIONS OTHER THAN TAXES AND SOCIAL SECURITY ARE MADE FROM YOUR PAY?
HOW MANY HOURS DID YOU WORK ON YOUR LAST WORK DAY BEFORE THIS INTERVIEW?
DATE OF LAST WORK DAY BEFORE INTERVIEW (YYMMDD)
DATE YOU BEGAN WORK ON THIS PROJECT (YYMMDD)
TOOLS YOU USE
THE ABOVE IS CORRECT TO THE BEST OF MY KNOWLEDGE
EMPLOYEE'S SIGNATURE
DATE (YYMMDD)
INTERVIEWER
SIGNATURE
TYPED OR PRINTED NAME
DATE (YYMMDD)
INTERVIEWER'S COMMENTS
ACTION (If explanation is needed, use comments section)
YES
NO
WORK EMPLOYEE WAS DOING WHEN INTERVIEWED
IS EMPLOYEE PROPERLY CLASSIFIED AND PAID?
ARE WAGE RATES AND POSTERS DISPLAYED?
FOR USE BY PAYROLL CHECKER
IS ABOVE INFORMATION IN AGREEMENT WITH PAYROLL DATA?
YES
NO
COMMENTS
CHECKER
LAST NAME
FIRST NAME
MI
JOB TITLE
DATE (YYMMDD)
SIGNATURE
AUTHORIZED FOR LOCAL REPRODUCTION Previous edition not usable STANDARD FORM 1445 (REV. 12-96) Prescribed by GSA - FAR (48 CFR) 53.222(g)
| IS EMPLOYEE PROPERLY CLASSIFIED AND PAID? YES: 0 |
| IS EMPLOYEE PROPERLY CLASSIFIED AND PAID? NO: 0 |
| ARE WAGE RATES AND POSTERS DISPLAYED? YES: 0 |
| ARE WAGE RATES AND POSTERS DISPLAYED? NO: 0 |
| Do you work over 8 hours per day? YES: 0 |
| Do you work over 8 hours per day? NO: 0 |
| Do you work over 40 hours per week? YES: 0 |
| Do you work over 40 hours per week? NO: 0 |
| Are you paid at least time and a half for overtime hours? YES: 0 |
| Are you paid at least time and a half for overtime hours? NO: 0 |
| Are you receiving any cash payments for fringe benefits required by the posted wage determination decision? YES: 0 |
| Are you receiving any cash payments for fringe benefits required by the posted wage determination decision? NO: 0 |
| IS ABOVE INFORMATION IN AGREEMENT WITH PAYROLL DATA? NO: 0 |
| IS ABOVE INFORMATION IN AGREEMENT WITH PAYROLL DATA? YES: 0 |
| CONTRACT NUMBER: |
| NAME OF PRIME CONTRACTOR: |
| NAME OF EMPLOYER: |
| LAST NAME: |
| FIRST NAME: |
| mi1: |
| LAST NAME: |
| FIRST NAME: |
| STREET ADDRESS: |
| CITY: |
| WORK CLASSIFICATION: |
| STATE: |
| WAGE RATE: |
| ZIP CODE: |
| MIDDLE INITIAL: |
| WHAT DEDUCTIONS OTHER THAN TAXES AND SOCIAL SECURITY ARE MADE FROM YOUR PAY?: |
| HOW MANY HOURS DID YOU WORK ON YOUR LAST WORK DAY BEFORE THIS INTERVIEW?: |
| TOOLS YOU USE. 1 of 6. : |
| TOOLS YOU USE. 2 of 6: |
| TOOLS YOU USE. 3 of 6: |
| TOOLS YOU USE. 4 of 6: |
| TOOLS YOU USE. 5 of 6: |
| TOOLS YOU USE. 6 of 6: |
| INTERVIEWER TYPED OR PRINTED NAME: |
| WORK EMPLOYEE WAS DOING WHEN INTERVIEWED: |
| COMMENTS: |
| LAST NAME: |
| FIRST NAME: |
| MIDDLE INITIAL: |
| JOB TITLE: |
| SIGNATURE: |
| SIGNATURE: |
| INTERVIEWER SIGNATURE: |
| INTERVIEWER SIGNATURE: |
| EMPLOYEE'S SIGNATURE: |
| EMPLOYEE'S SIGNATURE: |
| DATE OF LAST WORK DAY BEFORE INTERVIEW (YYMMDD). : |
| DATE YOU BEGAN WORK ON THIS PROJECT (YYMMDD). : |
| DATE (YYMMDD). : |
| DATE (YYMMDD). : |
| SIGNATURE DATE (YYMMDD). : |
File details come from the government source that posted it. Updated .