Prevailing_Wage_-_Contractor's_Wage_Certification_Form.pdf
PDF 149 KB Posted
- Attached to
- 2026 ON-CALL SIDEWALK SPOT REPAIR PROGRAM
- Solicitation number
- 25/26-48
- 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's 2026 On-Call Sidewalk Spot Repair Program (Bid No. 25/26-48). The form serves as a certification requirement for construction managers at risk, general contractors, and prime contractors bidding on the project. Sealed bids for this on-call sidewalk spot repair program will be accepted through the Town's eProcurement Portal until 2:00 pm on Monday, April 27, 2026, at which time bids will be publicly opened and read aloud. Any bids received after the specified deadline will not be considered.
The prevailing wage certification requires that the successful contractor and all subcontractors commit to paying all workers on the project in accordance with the schedule of prevailing wage rates established for the project. The certifying officer, owner, or authorized representative must execute the form under oath before a notary public and return it to the Connecticut Department of Labor Wage & Workplace Standards Division at 200 Folly Brook Boulevard, Wethersfield, Connecticut 06109. The form requires documentation of the rate schedule issue date and project-specific information including the project name and number, location details, and the company's street address and city.
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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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