Prevailing Wage Statement of Compliance~72.pdf
PDF 15 KB Posted
- Solicitation number
- BD-25-1025-DOCFS-9843-111147
- Issued by
- Worcester County, Massachusetts
About this file
This is a Weekly Payroll Records Report and Statement of Compliance form from the Massachusetts Department of Labor Standards (DLS), outlining requirements under Massachusetts General Law c. 149, §27B. The document mandates that contractors and subcontractors working on public works projects must submit certified weekly payroll records to the awarding authority, either by regular mail or email. These records must be submitted within 15 days after completion of work and preserved for three years from the project completion date.
The form includes a Statement of Compliance that must be executed by the contractor, subcontractor, or authorized officer supervising wage payments. This statement certifies that all mechanics, apprentices, teamsters, chauffeurs, and laborers employed on the project have been paid in accordance with wages determined under sections 26 and 27 of chapter 149 of the Massachusetts General Laws. The form requires specific details including the name of the signatory party, their title, contractor/subcontractor information, and project identification.
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Text version
05/14
WEEKLY PAYROLL RECORDS REPORT
& STATEMENT OF COMPLIANCE
In accordance with Massachusetts General Law c. 149, §27B, a true and accurate record must be kept of all persons employed on the public works project for which the enclosed rates have been provided. A Payroll Form is available from the Department of Labor Standards (DLS) at www.mass.gov/dols/pw and includes all the information required to be kept by law. Every contractor or subcontractor is required to keep these records and preserve them for a period of three years from the date of completion of the contract.
On a weekly basis, every contractor and subcontractor is required to submit a certified copy of their weekly payroll records to the awarding authority; this includes the payroll forms and the Statement of Compliance form. The certified payroll records must be submitted either by regular mail or by e-mail to the awarding authority. Once collected, the awarding authority is required to preserve those records for three years from the date of completion of the project.
Each such contractor and subcontractor shall furnish weekly and within 15 days after completion of its portion of the work, to the awarding authority directly by first-class mail or e-mail, a statement, executed by the contractor, subcontractor or by any authorized officer thereof who supervised the payment of wages, this form, accompanied by their payroll:
STATEMENT OF COMPLIANCE
_______________, 20_______
I,___________________________________,___________________________________ (Name of signatory party) (Title) do hereby state:
That I pay or supervise the payment of the persons employed by ___________________________________ on the ______________________________ (Contractor, subcontractor or public body) (Building or project) and that all mechanics and apprentices, teamsters, chauffeurs and laborers employed on said project have been paid in accordance with wages determined under the provisions of sections twenty-six and twenty-seven of chapter one hundred and forty nine of the General Laws.
Signature _________________________ Title _____________________________ http://www.mass.gov/dols/pw
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