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HomeMy WebLinkAbout31Jcb #037008
M)LIL TO. Statement of
f INDUSTRIAL STATISTICIAN INTENT TO PAY
DePartment of Labor & Industries PREVAILING WAGES
EIMPIGYment Standards Section (Public Works Contract)
General Administration Building
Olympia. WA 98504-0631 9
(206) 753-4019
Contract Awarding Public Agency
rit-y caf R-t—
Address
Phone
Contract/BPW Number
Date Bid Was Due lZ7/87
Date Contract Awarded 1/7/87
County in Which Work Performed King
Prime Contractor.- CORAL CONST CO
Your Contractor's Registration Certificate Nc.22�J=QJ=JJL-JLL-VL"* 74JD
Do You Intend To Use Subcontractors? Yes 01 No R
In compliance with RCW 39.12.040 1, the undersigned, being a duly authorized representative of
LAKESIDE INDUSTRIES P. 0. Box 1379; Bellevue, WA 98009
(c_�, - suix;�� iAdd—)
do hereby certify that the following rates of hourly wage and hourly fringe benefits will be paid to all
laborers, workers and mechanics employed by me upon the public works project described above and that
no laborer, worker or mechanic will be paid less than the "prevailing rate of wage" as determined by the
Industrial Statistician of the Department of Labor and Industries.
PLEASE NOTE, If apprentices are to be used they must be registered with the State Ap-
prenticeship Council within 60 days of hiring or they must be paid prevailing journeyman
wages for the time preceding the date of registration.
CRAFT ESTIMATED NUMBER RATE OF RATE OF HOURLY
OF WORKERS HOURLY PAY FRINGE BEN
NOTE: Attach Additional Sheets as Needed.
Subscribed and _��w"71_�.before me
y
this d.
N.tartv PUA4,ofand for the State of Washington, resid-
S in WahirWton,
SEE ATTACHED
LAKESIDE INDUSTRIES
I For L & I Use Only
APPROVED
Department of Labor & Industries
Industrial Statistician
�M_ -41, Erifice"M a . I . & .
BEFORE FINAL SETTLEMENT can be made on any public works project, the prime contractor and each
and every subcontractor must submit form LI-700-7 (F700-007-000) "Affidavit of Wages Paid" to the officer
charged with the disbursement of public funds. EACH AFFIDAVIT OF WAGES PAID MUST BE CERTI-
FIED BY THE INDUSTRIAL STATISTICIAN OF THE DEPARTMENT OF LABOR AND INDUS-
TRIES BEFORE IT IS SUBMIT -FED TO SAID OFFICER.
PROGRESS PAYMENTS: Each voucher claim submitted to an owner by a contractor for payment on a
project estimate shall state that prevailing wages have been paid in accordance with the prefiled statement
or statements of intent to pay prevailing wages on file with the public agency.
COMPLETE AN. MAIL ENTIRE SET FOR APPROVAL TO:
Employment Standards Section, Department of Labor and Industries.
-,i\-,J E L)
Olympia, Washington 98504-0631
R8, DISTRIBUTE APPROVED STATEMENTS AS FOLLOWS:
[=-,�-.-z ORIGINAL CONTRACT -AWARDING AGENCY r
�GREEN COPY) DUPLICATE -INDUSTRIAL STATISTICIAN (Retained by Deptirtnient)
BLUE COPY) TRIPLICATE -PRIME CONTRAC-MR
(YELLOW COPY) QUADRUPLICATE-SUBCONTRACTUR
1- 11 � - -.1, Q� � 7�
IM
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