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U.S. 0-1 ARTMENT OF LABOR F.- A——
K I C STATEMENT OF COMPLIANCE S.d..' Bu— N.. R.o
s-
Data 41?-'rz
kLIX Fif A. W�- do hereby state:
That Ln"9L
I pay 0, up,"I.:the payment of the Persons employed'., C.,
the j*JALW&,eZ Ae,p65 4!t ko-?A,z AL,. that during the p,ymll period
19-D and ending th._,6CL_d.y of .7oo.,41,ot Y , ig-" .,I p ...... e,-pl,yed on aid Project have b— paid the full
areekly aragem ..-ad, that no rebates have been or will be made either directly or indirectly to or on behalf of said
C.'e'R4 rw"
from the full weekly -.Be. earned by ..y person and that - doducti... have
b— -ad. either directly or indirectly I— the full ..Be. earned by ..y p ...... other the. permissible deduction. As defined
in Regulation.. Part 3 (29 CFR Subtitle A), I .... d by the S-1-y of L-b., under the Copeland Act. .. .deA (48 St.t�
94&63 Star. 108. 7��r;7;: W7; 40 U.S C. 276c), and d6bd below:
(2) That any payrolls othersrise under this Contra" required to be submitted for the above period am correct and complete;
the t the wage mt*. for laborem or mechanics contained therein an not I... than the applicable Og� rate. contained 1. any
Or, incorporated into the C.ntr.,U that the CIO icalions set forth themin for each loborer or mechanic con-
ge deter-inetit-
lurto with the work he P-fd
wig) T%at any apprentic- employed In the above period a- duty -gi-ened in A t fide pprenti—hip program registered
%t. ppranti-ship agency mcognized b, the Bums, of Apprenticeship and Training, United States Depert—t of
If no such m,,gL,,d agency exists I, , State. am mui*temd with the Bureau of Apprenticeship and Training, United
state. D.P.--t of Lebo,
(4) That:
(a) WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, FUNDS. OR PROGRAMS
,:I.dditi.n to the basic hourly wage mte:dpoid to each laborer or mechanic listed In the above mferenced pay -
Furl. V.y...t. of fringe, benefit. . list in the contract have been or will be made to appropriate proWams
the benefit of such employ—, except an noted in Section 4(c) below,
(b) WHERE FRINGE BENFFIT`S ARE PAID IN CASH
Each I-eb— or machanic listed in the above mfe,,ncd payroll has been paid an indicated on the payroll.
0, amount not leas the, the sum of the Eppli-ble basic hourly wage rate plus the amount I the req.fred fringe
benefits - listed in the Contract, except noted in section 4(c) below
(C) EXCEPTIONS
EXCI!PTIOH (CRAFT) EXPLANATION
A . 77T-' ii
01 ^11 11 T", IT AT111"I 1C.1 T Cil*."'IT" 11
T.-A
F.- WH-349 (1/68)
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