(HUD-11) Record of Employee Interview.pdf
PDF 74 KB Posted
- Attached to
- Tub Surround Installation - Phyllis Circle
- Solicitation number
- B23001
- Issued by
- Yellowstone County, Montana
About this file
The HUD-11 Record of Employee Interview is an official form from the U.S. Department of Housing and Urban Development's Office of Davis-Bacon and Labor Standards, designed for conducting on-site interviews with construction workers on federally funded projects. The form is used to verify wage compliance, interview individual workers privately, and collect detailed information about their employment, job duties, pay rates, and working conditions. The specific context for this form is related to a tub surround installation project at 355, 2742, and 2757 Phyllis Circle in Billings, Montana, involving work in 30 apartments that includes removing existing tubs and tile shower walls and installing walk-in shower inserts on the first floor and tub surrounds on the second floor.
The document provides comprehensive instructions for HUD staff, fee construction inspectors, and local agency labor standards monitors on how to complete the interview form. Key compliance aspects include verifying employee identification, documenting job classifications, specific duties performed, tools used, and comparing the interview information against certified payroll reports. The form emphasizes confidentiality, voluntary employee participation, and the importance of detailed, specific observations to potentially identify labor standards violations. While the form does not specify exact financial details, it is part of the federal government's process to ensure proper wage payment and working conditions on federally assisted construction projects.
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Text version
Record of Employee Interview Instructions
U.S. Department of Housing and Urban Development Office of Davis-Bacon and Labor Standards
OMB Approval No. 2501-0009 (exp. 12/31/2024)
Previous editions are obsolete Form HUD-11 (05/2021)
Instructions
General:
This form is to be used by HUD and local agency staff for recording information gathered during on-site interviews with laborers and mechanics employed on projects subject to Federal prevailing wage requirements. Typically, the staff that will conduct on-site interviews and use this form are HUD staff and fee construction inspectors, HUD Labor Standards staff, and local agency labor standards contract monitors.
Information recorded on the form HUD-11 is evaluated for general compliance and compared to certified payroll reports submitted by the respective employer. The comparison tests the veracity of the payroll reports and may be critical to the successful conclusion of enforcement actions in the event of labor standards violations. The thoroughness and accuracy of the information gathered during interviews is crucial.
Note that the interview itself and the information collected on the form HUD-11 are considered confidential. Interviews should be conducted individually and privately. All laborers and mechanics employed on the job site must be made available for interview at the interviewer’s request. The employee’s participation, however, is voluntary. Interviews shall be conducted in a manner and place that are conducive to the purposes of the interview and that cause the least inconvenience to the employer(s) and the employee(s).
Completing the form HUD-11:
Items 1a - 1c: Self-explanatory
Items 2a – 2d: Enter the employee’s full name, a telephone number where the employee can be reached, and the employee’s home address. Many construction workers use a temporary address in the locality of the project and have a more permanent address elsewhere from which mail may be forwarded to them. Obtain a more permanent address, if available. Ask the employee for a form of identification (e.g., driver’s license) to verify their name.
Items 3a – 4c: Enter the employee’s responses. Ask the employee whether they have a pay stub with them; if so, determine whether the pay stub is consistent with the information provided by the employee.
Items 5 – 7: Be certain that the employee’s responses are specific. For example, job classification (#5) must identify the trade involved (e.g., Carpenter, Electrician, Plumber) – responses such as “journeyman” or “mechanic” are not helpful for our purposes.
Items 8 – 12b: Self-explanatory
Items 13 – 15c: These items represent some of the most important information that can be gathered while conducting on-site interviews. Please be specific about the duties you observed the employee performing. It may be easiest to make these observations before initiating the interview. Please record any comments or remarks that may be helpful. For example, if the employee interviewed was working with a crew, how many workers were in the crew? Was the employee evasive?
The level of specificity that is warranted is directly related to the extent to which interview(s) or other observations indicate that there may be violations present. If interviews indicate that there may be underpayments involving a particular trade(s), the interviewer is encouraged to interview as many workers in that trade(s) that are available.
Items 16 – 17b: The information on the form HUD-11 may be reviewed for general compliance, initially. For example, are the job classification and wage rate stated by the employee compatible with the classifications and wage rates on the applicable wage decision? Are the duties observed by the interviewer consistent with the job classification?
Item 18: Please place here any additional information you may want to document or continuing information from other lines that do not fit in their block space.
Once the corresponding certified payroll reports are received, the information on the HUD-11 shall be compared to the payroll reports. Any discrepancies noted between the HUD-11 information and that on the payroll report shall be noted in Item 16, Remarks. If discrepancies are noted, follow-up actions to resolve the discrepancies must be taken.
Record of Employee U.S. Department of Housing and Urban Development OMB Approval No. 2501-0009
Interview Office of Davis-Bacon and Labor Standards (exp. 12/31/2024)
Previous editions are obsolete Form HUD-11 (12/2021)
The public reporting burden estimate for this collection of information is 15 minutes per response on average. This includes reviewing instructions, searching existing data sources, gathering, and maintaining the data, and completing the collection of information. This information may not be collected, nor are you required to provide, the information requested unless it displays a currently valid OMB control number. The information collected ensures compliance with the Federal labor standards through recording interviews with construction workers. The information collected assists HUD in compliance monitoring of Federal labor standards. Any information collected is covered by the Privacy Act of 1974 and by 29 CFR 5.6(a)(5). Individuals and agencies collecting this information must maintain these records in a manner that protects the individuals on whom the information is maintained. The information collected herein is voluntary, and any information provided shall be kept confidential, but failure to provide the information collected may delay enforcement of any possible Federal labor standards violations if the information would have identified any. Comments concerning this burden statement, or this collection should be sent to: National Director, Office of Davis-Bacon and Labor Standards, 451 7th Street SW, Room 7108, Washington, DC 20410. When providing comments, please refer to OMB Approval 2501- 0009
Pursuant to 5 U.S.C. § 552a(e)(3), this Privacy Act Statement serves to inform you of the following concerning the collection of the information on this form.
A. AUTHORITY: Collection of the information solicited on this form is authorized by the Davis-Bacon Act as promulgated through Department of Labor Regulations under 29 CFR Part 5.
B. PURPOSE: The primary purpose for soliciting this information is to determine if the wages paid by an employer on a project covered by the Davis-Bacon Act are in compliance with federal labor standards.
C. ROUTINE USES: The information collected ensures compliance with the Federal labor standards through recording interviews with construction workers on topics related to wages paid on the project. The information is reviewed by HUD authorized personnel to ensure compliance with Federal labor standards under the Davis-Bacon Act on covered projects. If violations are found, the information collected is used to conduct enforcement actions to ensure restitution is paid to workers of covered projects are paid proper wages under the Davis-Bacon Act.
D. CONSEQUENCES OF FAILURE TO PROVIDE INFORMATION: The information collection is voluntary. Refusing to give information will not impact your status with your employer or the government. Failure to provide the information will limit the ability of HUD to determine if you were paid proper wages under the Davis-Bacon Act, and will limit the ability for HUD to seek restitution for you in the event a violation is found.
1a. Project Name 2a. Employee Name
1b. Project Number 2b. Employee Phone Number (including area code)
1c. Contractor or Subcontractor (Employer) 2c. Employee Home Address & Zip Code
2d. Verification of identification?
Yes No
3a. How long on this job?
3b. Last date on this job before today?
3c. No. of hours last day on this job?
4a. Hourly rate of pay? 4b. Fringe Benefits?
Vacation Yes No
Medical Yes No
Pension Yes No
4c. Pay stub?
Yes No
5. Your job classification(s) (list all) --- continue in block 18 if necessary
6. Your duties --- continue in block 18 if necessary
7. Tools or equipment used --- continue in block 18 if necessary
8. Are you an apprentice or trainee? Yes No 10. Are you paid at least time and ½ for all hours worked in excess of 40 in a week? Yes No
9. Are you paid for all hours worked? Yes No 11. Have you ever been threatened or coerced into giving up any part of your pay? Yes No
12a. Employee Signature 12b. Date
13. Duties observed by the Interviewer (Please be specific.)
14. Remarks --- continue in block 18 if necessary
15a. Interviewer Name (Please Print) 15b. Signature of Interviewer 15c. Date of Interview
Payroll Examination
16. Remarks --- continue in block 18 if necessary
17a. Signature of Payroll Examiner 17b. Date
Record of Employee U.S. Department of Housing and Urban Development OMB Approval No. 2501-0009
Interview Office of Davis-Bacon and Labor Standards (exp. 12/31/2024)
Previous editions are obsolete Form HUD-11 (12/2021)
18. Additional Remarks
| Instructions |
| Completing the form HUD-11: |
| 1 c Contractor or Subcontractor Employer: |
| 12a Employee Signature: |
| 12b Date: |
| 1 a Project Name: |
| 2a Employee Name: |
| lb Project Number: |
| 2b Employee Phone Number including area code: |
| 2c Employee Home Address Zip Code: |
| 18 Additional Remarks: |
| 10: |
| Yes: Off |
| No: Off |
| 11: |
| Yes: Off |
| No: Off |
| 16: |
| Remarks: |
| 3a: |
| How Long on this job: |
| 3b: |
| Last date on this job before today: |
| 3c: |
| No: |
| of hours last day on this job: |
| 4a: |
| Hourly rate of pay: |
| 5 Your job classificationsl: |
| 6: |
| Your duties: |
| 7: |
| Tools or equipment used: |
| 13: |
| Duties observed by the Interviewer: |
| 14: |
| Remarks: |
| 15b: |
| Signature of Interviewer: |
| 15a: |
| Interviewer Name Please Print: |
| 15c: |
| Date of Interview: |
| 17a: |
| Signature of Payroll Examiner: |
| 17b: |
| Date: |
| 2d: |
| Yes: Off |
| No: Off |
| 4c: |
| Yes: Off |
| No: Off |
| 4b: |
| Med Yes: Off |
| Vaca Yes: Off |
| Pen Yes: Off |
| Vaca No: Off |
| Med No: Off |
| Pen No: Off |
| 8: |
| Yes: Off |
| No: Off |
| 9: |
| Yes: Off |
| No: Off |
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