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U.S. DEPARTMENT OF 1.00.
LIC STATEMENT OF COMPLIANCE F� AMI—d
---R'093
Do,. a/11,
do h—b,
Pay .1 p P,rmt Of the Person, omp1,y,d'T'"
by
on
that d—ing the Payroll period c—ml.ci.g On the 7 day of
19,&. and ending the /A day of �P�CC&tVfii&Oe
all P .... n, e—Pl1yed on aid pmj.L: have been paid the fUll
I '
--it Y wages -.—ad. that .bar.. have been -1 aill be -ad. either directly -1 Indirectly - -1 On behalf of aid
-CIRR from ----Y lamed by .., I —on and that no dird—ti.n. b
b&— mad* either directly or indirectly from the full wages lamed by any Perlon, other than Permissible ded,,ti,n. as defined
in Is Part 3 (29 CPR Subtitle A), i...ad by the Secretary Of Labor
94 Under the C-Pel..d Act, -- ..ended
863 Slat 106. 72 Stat, %7; 76 Sta�/ I
-r- r &7; 40 L & C. 276c), and described below: (48 SCSI,
I e-,O 7��-A 4 - -n �x, 0-/
(2) That r-Y P-Y-11. Otherwise nd— this c.ntr." .q.i—d to be bmill.d f— 11. -b— Period a— correct and c..pl.,e;
th. t the wage rat's ill lablIer. or mechanics contained therein are no, less than the applicable at. at.. contained I. any
wage deteirrinstion incorporated into the contract; that the cl ... ili—ll— at forth therein for each I1bO-1 -1 mechanic c.n-
h th,
form wit I a work he Perf—ed
(3) That -Y -M—nti.c,-- employed in the Sh", Period am dul., —giltered in a b— fid, apprenticeship pmg,,m Cr,ilterad
with . Strit: ripp ac. I III agency recognieed by the B—. of Apprenticeship and Training.
Labor, o United States Dpl,tmen, of
I; If no ..ch -c.Lriz.d agency ..i.t. I' I St&tl, am registered with the B,reau of Apprenticeship and Training, United
811tes apartment of Labor.
(4) TU.t:
(a) WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS. FUNDS, OR PROGRAMS
In addition to the b..ic'hO—I'Y wage rates paid to each Ilb—r or m,,h,nic listed in he above _fs—n—d pay-
-11. payments of benefits a, listed I, the contract have been or will be mod, to appropriate p ma
for the benefit of — h --Pl-Y---, ---pt as noted in Slcl..,. 4(c) b,,lo—
(b) WHERE FRINGE BENEFIT'. 'RE PA;T) IN CASH
Fl1h Llbmr 11 mechanic listed L- the ob— refre ... d p,ymil has been paid 11 indicated on the paymli,
am
,:nl n.*iS I,,* ban he t,,,, 11.!h, ap.p.liciibie -age rate III— the amount of the mqlimd fringe
�..ic h—ly w
as t.d In In section 4(c) below,
(c) EXCEPTIONS
IfI � -I -If I F% / 7 /1 /Y'7— 1
L91-11. 01 — 01 T.0 ..OVE ITIT-11 1-1— '.a
C.—C SEC SECT— 1011 01 T11,C 71! 11 T—LE �I — 1.0
,.OE
WH 348 (1/68)