Statement_of_Intent_To_Pay_Prevailing_Wages.pdf
PDF 91 KB Posted
- Attached to
- G-80 Well POD-1 and POD-2 Drilling and Testing
- Solicitation number
- 2025-ITB-005
- Issued by
- Quay County, New Mexico
About this file
The document is a New Mexico Department of Workforce Solutions Labor Relations Division Statement of Intent to Pay Prevailing Wages form, revised on 08/22/2013, designed to ensure contractors on public works projects comply with state wage regulations. The form is required to be completed and submitted to the contracting agency within three days of contract award, and it covers multiple tiers of contractors (general, sub, and subsequent tier contractors) who will be working on a specific project. For this particular instance, the form relates to the G-80 Well POD-1 and POD-2 Drilling and Testing project located in McKinley County, New Mexico, involving groundwater supply well drilling and related technical services.
The form mandates that all contractors certify they will pay workers no less than the prevailing wage rates determined by the Department of Workforce Solutions for the specific project. Contractors who violate prevailing wage laws are subject to debarment procedures and must pay any back wages owed to workers. The document provides detailed instructions for completing the form, including requirements for entering contractor information, project details, contract amounts, and signatures. Each tier of contractor must complete a separate form, with specific signature requirements varying by contractor level. The form serves as a legal commitment to comply with the Public Works Minimum Wage Act (13-4-11 through 13-4-18, NMSA 1978) and helps ensure fair compensation for workers on public construction projects.
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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 .