Figure B-1 Contractors Staffing Declaration.xlsx
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- 47PH0221R0001
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Staffing Contractor Staffing Declaration Figure B-1 for Union and Non Union Contracts Contractor Staffing Declaration
Contractor Name: _______________________________________________________________ Current Date: ___________________
| Location: | ||||||
| Contract Number: | ||||||
| Performance Start Date: | ||||||
| Services Provided: | (Select: Full Maintenance, Operations and Maintenance, Custodial, Grounds Maintenance) | |||||
| DOL Wage Determination Number: | ||||||
| Custodial Union Name: | ||||||
| Mechanical Union Name: | ||||||
| Admin Staff Workman's Comp Rate: | ||||||
| Custodial Workman's Comp Rate: | ||||||
| Mechanical Workman's Comp Rate: | ||||||
| SUTA Thresholds: | ||||||
| SUTA % Rate: | ||||||
| Is H & W | Is Pension | |||||
| The following are examples - - | SCA-DOL | If Position is Covered by | Number of | Number of | paid | paid |
| Tailor to the needs of your contract | Occupation | Collective Bargaining Agreement | Scheduled | Employees | directly to | directly to |
| Postion | Code | Identify CBA Position Title | Hours/Week | with this Schedule | Employee? | Employee? |
| General Clerk II | 01116 | |||||
| Janitor | 11150 | |||||
| Laborer, Grounds Maintenance | 11210 | |||||
| Htg, Refg, and A/C Mechanic | 23400 | |||||
| General Maintenance Worker | 23370 |
File details come from the government source that posted it. Updated .