STATE_OF_INTENT_TO_PAY_PREVAILING_WAGES.pdf

PDF 91 KB Posted

Attached to
New Sunshine Substation Transmission Line Construction
Solicitation number
ITB-2614
Issued by
San Juan County, New Mexico

About this file

This is a Statement of Intent to Pay Prevailing Wages form issued by the State of New Mexico for use on public works projects, specifically applicable to the City of Gallup's New Sunshine Substation Transmission Line Construction project. The form must be completed and submitted to the contracting agency within three days of contract award and requires information from the general contractor, subcontractors, and any additional tier subcontractors involved in the project. The form captures essential contractor details including company name, address, contact information, estimated project start and completion dates, state wage decision number, project title, physical address, and total contract amounts for each tier of contractor participation.

The form serves as a binding certification in which contractors attest that all workers employed on the public works project will be paid no less than the prevailing wage rates established by the Department of Workforce Solutions, Labor Relations Division, as identified by the State Wage Decision Number. For the New Sunshine Substation project, the prevailing wage rates for McKinley County classifications include Lineman at $51.71 base/$21.43 fringe, Journeyman Transmission Technician at $47.58 base/$20.40 fringe, Cable Splicer at $52.98 base/$21.75 fringe, and Equipment Operator at $40.94 base/$17.73 fringe. Contractors who violate prevailing wage laws through incorrect job classification, improper payment of wages, or overtime violations are subject to debarment and required payment of back wages. The form requires separate signed documentation for each contractor tier and applies to all contractors and subcontractors working on contracts exceeding $60,000.

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Text version

(Revised 08/22/2013)

STATEMENT OF INTENT TO PAY PREVAILING WAGES

To Be Completed Before Construction Starts

All FIELDS ARE REQUIRED

FORM MUST BE SENT TO THE CONTRACTING AGENCY WITHIN 3 DAY OF THE AWARD

General Contractor Information Company Name:

Address:

City : State: Zip:

Phone: Fax: E-Mail:

Estimated Start Date: State Wage Decision Number:

Project Title:

Project Physical Address:

Total Contract Amount: Estimated Completion Date:

Print Name:

General Contractor Signature:

Sub Contractor Information Sub Contract Amount:

Start date on this project:

Company Name:

Address:

City: State: Zip:

Phone: Fax: E-Mail:

Sub Contractor Signature:

2nd, 3rd, etc. Tier Sub-Contractor Information Contract Amount:

Start date on this project:

Company Name:

Address:

City: State: Zip:

Phone: Fax: E-Mail:

Tier Signature:

I hereby certify that the above information is correct and that all workers I employ on this public works project will be paid no less than the Prevailing Wage Rate(s) as determined by the Department of Workforce Solutions, Labor Relations Division for this project as identified by the State Wage Decision Number. I understand that contractors who violate Prevailing Wage Laws (i.e., incorrect job classification, improper payment of prevailing wages, and/or overtime, etc.), are subject to debarment procedures and shall be required to pay any back wages due to workers. (Ref. Labor Relations Division, Public Works Minimum Wage Act Policy Manual (11.1.2 NMAC) & Public Works Minimum Wage Act (13-4-11 through 13-4-18, NMSA 1978).

Contractor’s Signature Date

(Revised 08/22/2013)

INSTRUCTIONS FOR COMPLETING STATEMENT OF INTENT TO PAY PREVAILING WAGES

GENERAL CONTRACTOR

1. Enter general contractor information and provide signature.

2. Enter State Wage Decision Number as listed in bid documents. (Example: BE-13-0123 B)

3. Enter project title - listed in bid documents.

4. Enter project physical address - exact location of project (job site).

5. Enter estimated start & completion dates of project.

6. Enter general contractor’s contract amount.

7. All Statements must be sent to the Contracting Agency.

SUB CONTRACTOR

1. Enter general contractor information, but general contractor signature is not needed.

2. Enter sub contractor information as indicated and provide signature.

3. Enter sub contractor contract amount.

NOTE: A separate signed form is needed for each contractor.

2ND TIER SUB CONTRACTOR

1. Enter general contractor information, but general contractor signature is not needed.

2. Enter sub contractor information; subcontractor signature not needed.

3. Enter 2nd tier sub information and provide signature.

4. Enter 2nd tier contractors contract amount.

3RD TIER AND HIGHER CONTRACTOR

1. Attach a copy of this completed form & list the 3rd tier contractor information under the 2nd tier

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