Prevailing_Wage_-_Contractor's_Wage_Certification_Form_(1).pdf
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- Attached to
- SLUDGE TANK REHABILITATION AT HRWPCF
- Solicitation number
- 25/26-79
- Issued by
- Hartford County, Connecticut
About this file
This is a Prevailing Wage Contractor's Wage Certification Form issued by the Connecticut Department of Labor Wage and Workplace Standards Division, applicable to the Town of Manchester Water and Sewer Department's sludge tank rehabilitation project at the Hockanum River Water Pollution Control Facility. The form serves as a certification document that must be completed and sworn by a Construction Manager at Risk, General Contractor, or Prime Contractor prior to project commencement. The certifying officer, owner, or authorized representative attests that the contractor and all of its subcontractors will pay all workers on the project in accordance with the prevailing wage rates established for the specific project, with a copy of the applicable wage rate schedule required to be attached to the certification.
The form requires completion of project identification details including the project name and number, street address, city, company information, and rate schedule issuance date. The certification must be notarized and returned to the Connecticut Department of Labor Wage & Workplace Standards Division at 200 Folly Brook Boulevard, Wethersfield, Connecticut 06109. This prevailing wage requirement is a mandatory compliance measure for the sludge tank rehabilitation and recoating project, ensuring that all labor performed on the work meets Connecticut's established prevailing wage standards for the construction classification and location.
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Text version
CONNECTICUT DEPARTMENT OF LABOR
WAGE AND WORKPLACE STANDARDS DIVISION
CONTRACTORS WAGE CERTIFICATION FORM
Construction Manager at Risk/General Contractor/Prime Contractor
I, of
Officer, Owner, Authorized Rep. Company Name do hereby certify that the
Company Name
Street
City and all of its subcontractors will pay all workers on the
Project Name and Number
Street and City the wages as listed in the schedule of prevailing rates required for such project (a copy of which is attached hereto).
Signed
Subscribed and sworn to before me this day of , .
Notary Public
Return to:
Connecticut Department of Labor
Wage & Workplace Standards Division
200 Folly Brook Blvd.
Wethersfield, CT 06109
Rate Schedule Issued (Date):
| Owner/Officer: |
| Company Name: |
| Company Name2: |
| Company Street Address: |
| Company City: |
| Project Name & Number: |
| Project Street & City: |
| Day Numbered: |
| Month: |
| Year: |
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