Statement_of_Intent_To_Pay_Prevailing_Wages.pdf
PDF 91 KB Posted
- Attached to
- Turnkey-Engineering, Procurement and Construction (EPC) for New Carbon Coal Electrical Substation
- Solicitation number
- 2026/2027/03
- Issued by
- Quay 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 related to the City of Gallup's turnkey Engineering, Procurement and Construction (EPC) contract for a new 115 kV to 13.2 kV, 30 MVA electrical substation in the Carbon Coal Road area. The form must be completed and submitted to the contracting agency within three days of contract award and prior to construction commencement. The document requires general contractor information including company details, contact information, estimated project start and completion dates, project title and physical address, total contract amount, and the applicable State Wage Decision Number identifying the prevailing wage rates for the project.
The form establishes a certification mechanism whereby the contractor attests that all workers employed on the public works project will be paid no less than the prevailing wage rates as determined by the New Mexico Department of Workforce Solutions, Labor Relations Division. The document accommodates multiple tiers of subcontractors, with separate signed forms required for each contractor tier involved in project delivery. Contractors who violate prevailing wage laws—including incorrect job classification, improper wage payment, or overtime violations—are subject to debarment procedures and are required to pay back wages to affected workers, in accordance with the Public Works Minimum Wage Act (NMSA 1978, 13-4-11 through 13-4-18) and implementing regulations (11.1.2 NMAC).
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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 .