Statement_of_Intent_To_Pay_Prevailing_Wages.pdf
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- Solicitation number
- ITB-2611
- 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. The document requires general contractors, subcontractors, and tiered subcontractors to certify compliance with prevailing wage requirements prior to construction commencement. The form must be completed and submitted to the contracting agency within three days of contract award. Required information includes contractor company details, project identification, contract amounts, estimated start and completion dates, and the State Wage Decision Number applicable to the project. The form applies to the City of Gallup's G-80 Point of Diversions #8 & #13 Well Contract No. 1 project, a water infrastructure installation project with an estimated total cost of $3,522,232.35 and an approximate duration of 220 calendar days.
All contractors and subcontractors must certify that workers employed on the public works project will receive no less than the prevailing wage rates established by the New Mexico Department of Workforce Solutions, Labor Relations Division. The form serves as a binding commitment, with contractors subject to debarment procedures and liability for back wages if they violate prevailing wage laws through incorrect job classification, improper payment of wages, or overtime violations. The document references compliance requirements under the Public Works Minimum Wage Act (13-4-11 through 13-4-18, NMSA 1978) and the Labor Relations Division Public Works Minimum Wage Act Policy Manual (11.1.2 NMAC). Separate signed forms are required for each contractor tier, with instructions provided for general contractors, subcontractors, and second and third-tier subcontractors involved in the project.
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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 .