SF-1413_Statement_and_Acknowledgement_Form_(Subcontracting).pdf

PDF 564 KB Posted

Attached to
Bannock Pumping Plant Rehabilitation Federal contract opportunity
Solicitation number
140A1626B0001
Issued by
Department of the Interior Bureau of Indian Affairs Central Office

About this file

Written by GovTribe AI ·

This is Standard Form 1413 (Rev. 4/2013), a federal contracting template used to document the statement and acknowledgment of labor standards clauses between prime contractors and subcontractors. The form serves as the official record that a subcontract has been awarded under a prime federal contract and that both parties acknowledge applicable labor standards requirements.

Part I of the form requires the prime contractor to provide information including the prime contract number, subcontract award date, subcontract number, names and addresses of both the prime contractor and subcontractor, the name of the firm awarding the subcontract, and a description of work to be performed by the subcontractor. The prime contractor must also indicate whether the prime contract contains the "Contract Work Hours and Safety Standards Act -- Overtime Compensation" clause. Part II requires the subcontractor to acknowledge that specified labor standards clauses are incorporated into the subcontract, including provisions related to contract work hours and safety standards, payrolls and basic records, withholding of funds, wage rate requirements, apprentices and trainees, Copeland Act compliance, subcontracts, contract termination and debarment, and certification of eligibility. The form allows for identification of any intermediate subcontractors. Both the prime contractor and subcontractor must sign and date the document. The form is authorized for local reproduction and carries OMB Control Number 9000-0014 with an estimated completion time of 0.05 hours.

View the file

Other files for this federal contract opportunity

Other files attached to Bannock Pumping Plant Rehabilitation, newest first.
File Type Posted
B08_Attachment_14_As_Constructed_Crane_Rail_Supports_0005.pdf PDF
Sol_140A1626B0001_Amd_0005.pdf PDF
Sol_140A1626B0001_Amd_0004.pdf PDF
B08_Attachment_13_Steel_Pipes_Memo_0004.pdf PDF
B08_Attachment_12_Electrical_Service_Revision_0004.pdf PDF
B08_Attachment_11_WD_ID20260072-02_05182026_0004.pdf PDF
Sol_140A1626B0001_Amd_0003.pdf PDF
Sol_140A1626B0001_Amd_0002.pdf PDF
Sol_140A1626B0001_Amd_0001.pdf PDF
Sol_140A1626B0001.pdf PDF
Geotechnical_Report.pdf PDF
Attachment_10_Pre_Bid_Site_Visit_Agenda.pdf PDF
SF-25_Performance_Bond_Form.pdf PDF
SF-25A_Payment_Bond_Form.pdf PDF
Wage_Determination_ID20260072-01_01302026.pdf PDF
IEE_Reps.pdf PDF
Drawings.pdf PDF
SF-24_Bid_Bond_Form.pdf PDF
Technical_Specifications.pdf PDF
Scope_of_Work.pdf PDF
Show all 20

On GovTribe

Work with this file on GovTribe

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file
Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

STATEMENT AND ACKNOWLEDGMENT OMB Control Number: 9000-0014 Expiration Date: 1/31/2021

PART I - STATEMENT OF PRIME CONTRACTOR

1. PRIME CONTRACT NUMBER 2. DATE SUBCONTRACT

AWARDED

3. SUBCONTRACT NUMBER

15b. TITLE OF PERSON SIGNING

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1413 (REV. 4/2013)

Prescribed by GSA/FAR (48 CFR) 53.222(e)

4. PRIME CONTRACTOR 5. SUBCONTRACTOR

a. NAME a. NAME

b. STREET ADDRESS b. STREET ADDRESS

c. CITY d. STATE e. ZIP CODE c. CITY d. STATE e. ZIP CODE

6. The prime contract does, does not contain the clause entitled "Contract Work Hours and Safety Standards Act -- Overtime Compensation."

7. The prime contractor states that under the contract shown in Item 1, a subcontract was awarded on the date shown in Item 2 to the subcontractor identified in item 5 by the following firm:

a. NAME OF AWARDING FIRM

b. DESCRIPTION OF WORK BY SUBCONTRACTOR

8. PROJECT 9. LOCATION

10a. NAME OF PERSON SIGNING 11. BY (Signature) 12. DATE SIGNED

10b. TITLE OF PERSON SIGNING

PART II - ACKNOWLEDGMENT OF SUBCONTRACTOR

13. The subcontractor acknowledges that the following clauses of the contract shown in Item 1 are included in this subcontract:

Contract Work Hours and Safety Standards Act - Overtime Compensation (If included in prime contract see Block 6) Payrolls and Basic Records Withholding of Funds Disputes Concerning Labor Standards Compliance with Construction Wage Rate Requirements and Related Regulations

Construction Wage Rate Requirements Apprentices and Trainees Compliance with Copeland Act Requirements Subcontracts (Labor Standards) Contract Termination - Debarment Certification of Eligibility

14. NAME(S) OF ANY INTERMEDIATE SUBCONTRACTORS, IF ANY

A C

B D

15a. NAME OF PERSON SIGNING 16. BY (Signature) 17. DATE SIGNED

Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB) control number.

The OMB control number for this collection is 9000-0014. We estimate that it will take .05 hours to read the instructions, gather the facts, and answer the questions. Send only comments relating to our time estimate, including suggestions for reducing this burden, or any other aspects of this collection of information to: U.S. General Services Administration, Regulatory Secretariat Division (M1V1CB), 1800 F Street, NW, Washington, DC 20405.

1.6 Presentation Agent PDFlib 3.02 (C++/Win32) D:20050617125503-04'00' D:20080212101247-05'00'

STATEMENT AND ACKNOWLEDGMENT

OMB Control Number: 9000-0014 Expiration Date: 1/31/2021

PART I - STATEMENT OF PRIME CONTRACTOR

1. PRIME CONTRACT NUMBER

2. DATE SUBCONTRACT AWARDED

3. SUBCONTRACT NUMBER

15b. TITLE OF PERSON SIGNING

AUTHORIZED FOR LOCAL REPRODUCTION PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1413 (REV. 4/2013)

Prescribed by GSA/FAR (48 CFR) 53.222(e)

4. PRIME CONTRACTOR

5. SUBCONTRACTOR

a. NAME

a. NAME

b. STREET ADDRESS

b. STREET ADDRESS

c. CITY

d. STATE

e. ZIP CODE

c. CITY

d. STATE

e. ZIP CODE

6. The prime contract does, does not contain the clause entitled "Contract Work Hours and Safety Standards Act -- Overtime Compensation."

7. The prime contractor states that under the contract shown in Item 1, a subcontract was awarded on the date shown in Item 2 to the subcontractor identified in item 5 by the following firm:

a. NAME OF AWARDING FIRM

b. DESCRIPTION OF WORK BY SUBCONTRACTOR

8. PROJECT

9. LOCATION

10a. NAME OF PERSON SIGNING

11. BY (Signature)

12. DATE SIGNED

10b. TITLE OF PERSON SIGNING

PART II - ACKNOWLEDGMENT OF SUBCONTRACTOR

13. The subcontractor acknowledges that the following clauses of the contract shown in Item 1 are included in this subcontract:

Contract Work Hours and Safety Standards Act - Overtime Compensation (If included in prime contract see Block 6) Payrolls and Basic RecordsWithholding of FundsDisputes Concerning Labor StandardsCompliance with Construction Wage Rate Requirements and Related Regulations Construction Wage Rate Requirements Apprentices and Trainees Compliance with Copeland Act Requirements Subcontracts (Labor Standards) Contract Termination - Debarment Certification of Eligibility

14. NAME(S) OF ANY INTERMEDIATE SUBCONTRACTORS, IF ANY

A C B D 15a. NAME OF PERSON SIGNING

16. BY (Signature)

17. DATE SIGNED

Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB) control number. The OMB control number for this collection is 9000-0014. We estimate that it will take .05 hours to read the instructions, gather the facts, and answer the questions. Send only comments relating to our time estimate, including suggestions for reducing this burden, or any other aspects of this collection of information to: U.S. General Services Administration, Regulatory Secretariat Division (M1V1CB), 1800 F Street, NW, Washington, DC 20405.

1. PRIME CONTRACT NUMBER:
4A. NAME:
4B. STREET ADDRESS:
4C. CITY:
7A. NAME OF AWARDING FIRM:
10A. NAME OF PERSON SIGNING:
15A. NAME OF PERSON SIGNING:
15B. TITLE OF PERSON SIGNING:
10B. TITLE OF PERSON SIGNING:
14. NAME(S) OF ANY INTERMEDIATE SUBCONTRACTORS, IF ANY. Line A.:
14. NAME(S) OF ANY INTERMEDIATE SUBCONTRACTORS, IF ANY. Line D.:
14. NAME(S) OF ANY INTERMEDIATE SUBCONTRACTORS, IF ANY. Line C.:
14. NAME(S) OF ANY INTERMEDIATE SUBCONTRACTORS, IF ANY. Line B.:
8. PROJECT:
9. LOCATION:
7B. DESCRIPTION OF WORK BY SUBCONTRACTOR:
5C. CITY:
4E. ZIP CODE:
5E. ZIP CODE:
4D. STATE:
5D. STATE:
3. SUBCONTRACT NUMBER:
5A. NAME:
5B. STREET ADDRESS:
2. DATE SUBCONTRACT AWARDED. Enter 2 digit month, 2 digit day and 4 digit year.:
12. DATE SIGNED. Enter 2 digit month, 2 digit day and 4 digit year.:
17. DATE SIGNED. Enter 2 digit month, 2 digit day and 4 digit year.:
6. The prime contract does contain the clause entitled "Contract Work Hours and Safety Standards Act -- Overtime Compensation.": 0
6. The prime contract does not contain the clause entitled "Contract Work Hours and Safety Standards Act -- Overtime Compensation.": 0
11. BY. SIGNATURE. This is a protected field.:
16. BY. SIGNATURE. This is a protected field.:

File details come from the government source that posted it. Updated .