Statement_of_Intent_To_Pay_Prevailing_Wages.pdf
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- Solicitation number
- ITB-2617
- Issued by
- Mckinley County, New Mexico
About this file
This is a Statement of Intent to Pay Prevailing Wages form issued by the New Mexico Department of Workforce Solutions, Labor Relations Division, in coordination with the City of Gallup for the AWOS III P/T installation project at Gallup Municipal Airport (NMDOT Project No. GUP-24-03). The form serves as a mandatory certification that must be completed and submitted to the contracting agency within three days of contract award. The document requires general contractors, subcontractors, and tiered subcontractors to provide company information, contact details, project identification, contract amounts, estimated start and completion dates, and the applicable State Wage Decision Number. Contractors must commit to paying all workers prevailing wage rates as determined by the Department of Workforce Solutions, Labor Relations Division, with the project bid proposals due electronically by March 31, 2026, at 2:00 PM and a thirty-day completion timeline required from Notice to Proceed.
The Statement of Intent to Pay Prevailing Wages is a compliance document that binds all contractors working on this public works project to adhere to prevailing wage standards established under the Public Works Minimum Wage Act (13-4-11 through 13-4-18, NMSA 1978) and the Davis-Bacon Act. Contractors acknowledge that violations including incorrect job classification, improper payment of prevailing wages, or overtime infractions may result in debarment and requirement to pay back wages to affected workers. The form accommodates multiple tiers of subcontractors, with each level requiring separate signed documentation and submission of contract amounts. Contractors must maintain compliance throughout the project duration, with this certification serving as the primary mechanism for ensuring federal and state prevailing wage requirements are met on the airport infrastructure installation contract.
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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 .