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Fillable Printable Payroll Certification

Fillable Printable Payroll Certification

Payroll Certification

Payroll Certification

GOLDEN STATE LABOR COMPLIANCE,
LLC
LABOR COMPLIANCE PROGRAM
PRE-CONSTRUCTION MEETING HANDOUT
38733 9
TH
Street East, Suite W
Palmdale, CA 93550
Telephone: 661-267-0940
Fax: 661-267-0981
GOLDEN STATE LC
CONTRACTOR’S ACKNOWLEDGEMENT OF LCP
Documentation and Certification of Compliance with Prevailing Wage Laws
Awarding Body:
Project Name:
Contractor: Phone: License #:
Contractor Address: City: Zip:
I / we the above named contractor herein acknowledges, I HAVE BEEN INFORMED THAT PRIOR TO RELEASE OF ANY
PAYMENT(S) for the project, the following documents “MUST” be submitted and verified by Golden State Labor Compliance.
REQUIRED DO CUME NT S:
Submitted One Time, Prior to 1
st
Day on the Project:
1) Fringe Benefit Statement (We t Signature).
2) Golden State Labor Compliance Co ntractor’s Acknowl edgement (Wet Signature).
3) DAS-140 (Copy of form su bmitted to Applicable Apprenticeship Committee).
Submitted at Regular Intervals as Published in the Awarding Body’s LCP:
1) Weekly Certified Payroll Reports. (Attach correct Payroll Ce rtification)
2) Payroll Certification will
only be accepted with corre ct verbia ge (Labor Code 1776. (a), (2)) (Wet Signat ure ).
3) Apprenticeship Training Payments: A paid-to-date letter from the JATC or a copy of CAC-2 accompanied with copy
of check payable to the CAC, paid to the 15
th
of the previous month.
Submitted as Requested by the Awarding Body’s LCP:
1) Time cards, front & back copies of cancelled checks, daily logs, employee sign-in - sheets and/or any other record
maintained for the purposes of reporting payroll may be requested by the LCP at any time and shall be provide d
within 10 Days of request.
I / WE HAVE BEEN ADVISED THAT THE PAYROLL DOCUMENTS CAN TAKE 2 WEEKS TO VERIFY AFTER RECEIPT BY GOLDEN
ST ATE LC. (Documents will be date stamped upon rec eip t by Golden State LC).
I ACKNOWLEDGE AND AFFIRM THAT THE FOLLOWING LABOR COMPLIANCE PROGRAM PROVISIONS WERE EXPLAINED IN
DETAIL:
1. Our Firm’s duty to pay prevailing wages under La bor Code
Section 1770 et seq.
2. Our Firm has a duty to employ registere d apprentices on the
Public works project un der Labor Code Section 1777.5.
3. Our firm is aware of the penalties for fail ure to pay prevailing
wages and emplo y apprentices under Labor Code Sectio ns
1775 and 1777.7.
4. Our Firm is required to keep and submit copies upon request of
certified payroll records and are aware of the penalties for failure to
do so under La bor Code Section 1776 et seq . All contractors who
perform work, even if their portion of work is less than one h alf of one
percent, are to submit Certifie d Payroll Records.
5. Our Firm is aware of the prohi bition against employment
discrimination under Labor C ode Sections 1735 and 1777.6.
6. There is a prohibition against accepting or extracting Kickbacks
from employee wages under Lab or Code Section 1778.
7. There is a prohibition again s t accepting fe es for registering any
person for publ ic work under Labor Code S ection 1779; or fo r filling
work orders on public works under Labor Code Section 1780.
8. Our Company has listed all subcontractors pursuant to the Pub lic
Contract Code Section 4100 et seq.
9. Our Company is properly licensed by the State of California a nd
will ensure that all of our subc ontractors are properly licensed by the
State of California.
10. The prohib ition against unfair competition under Business and
Professions Code Sectio n 17200-1720 8.
11. Our company is properl y insure d for Workers Compensation
under Labor Code Section 18 61.
12. Our company and its empl oyees will abide by the Occupational,
Safety and Health laws and regulatio ns that app ly to the particular
construction project.
13. There is a F ederal Prohibition against hiring undocumented
workers and the requirement to secure proof of elig ibility/citizenship
from all workers.
14. The require ment to provide itemized wage statements to
employees und er Labor Code Section 226.
As an authorized representative for the above named contractor I have been informed of and am aware of the foregoing
requirem ents and have been provided with a copy of the Awarding Body’s Lab or Complian ce Docume nt Package.
Dated:
Contractor(s) Labor Co mpliance Attendee:
Print Name and Title
Signature
GSLC #9 (1/09)
GOLDEN STATE LC
CONTRACTOR’S ACKNOWLEDGEMENT OF LCP
Documentation and Certification of Compliance with Prevailing Wage Laws
Awarding Body: ABC UNIFIED SCHOOL DISTRICT
Project Name:
HAPPY DAZE ELEMENTARY SCHOOL
Contractor:
ATLAS CON S TRUCTION Phone: 555-555-5555 License #:123456
Contractor Address:
12345 MAIN STREET, SUITE A City: ANYWHERE Zip:99999
I / we the above named contractor he rein acknowledges, I HAVE BEEN INFORMED THAT PRIOR TO RELEASE OF A NY
PAYMENT(S) for the project, the following documents “MUST” be submitted and verified by Golden State Labo r Compliance.
REQUIRED DO CUME NT S:
Submitted One Time, Prior to 1
st
Day on the Project:
1) Fringe Benefit Statement (Wet Signature).
2) Golden State Labor Compl iance Contractor’s Acknowledgement (Wet Signature).
3) DAS-140 (Copy of form submitted to Applicable Ap prenticeship Committee).
Submitted at Regular Intervals as Published in the Aw arding Body’s LCP:
1) Weekly Certified Payroll Reports. (Attach correct Payroll Certification)
2) Payroll Certification will
only be accepted with correct verbiage (Labor Code 1776. (a), (2)) (Wet Signature).
3) Apprenticeship T raining Payments: A paid-to-date letter from the JATC or a copy of CAC-2 accompanied with copy of check
payable to the CAC, paid to the 15
th
of the previous month.
Submitted as Requested by the Awarding Body’s LCP:
1) Time cards, front and back of cancelled checks, daily logs, employee sign-in-sh eets, and/or any other re cord maintained for the
purposes of reporting pa yroll ma y be requested by the LCP at any time and shall be provided within 10 Days of request.
I / WE HAVE BEEN ADVISED TH AT THE PAY ROLL DOCUMENTS C AN TAKE 2 WEEKS TO VERIFY AFTER RECEIPT BY GOLDEN
ST ATE LC. (Documents will be date stamped upon rec eipt by Golden State LC).
I ACKNOWLEDGE AND AFFIRM THAT THE FOLLOWING LABOR COMPLIANCE PROGRAM PROVISIONS WERE EXPLAI NED IN
DETAIL:
1. Our Firm’s duty to pay prevailing wages under Labor Code
Section 1770 et seq.
2. Our Firm has a duty to employ registered apprentices on the pu blic
works project under Lab or Co de Section 1777.5.
3. Our firm is aware of the penalties for fail ure to pay prev ailing
wages and employ apprentices under Lab or Cod e Sections
1775 and 1777.7.
4. Our Firm is required to keep and submit copies upon request of
certified payroll records and are aware of the penalties for failure to
do so under La bor Code Section 1776 et seq . All contractors who
perform work, even if their portion of work is less than one half of one
percent, are to submit Certifie d Payroll Records.
5. Our Firm is aware of the prohibition against employment
discrimination under Labor Code Sections 1735 a nd 1777.6.
6. There is a prohibition against accepting or extracting Kickbacks
from employee wages under Lab or Code Section 1778.
7. There is a prohibition agains t accepting fees for registering any
person for publ ic work under Labor Code S ection 1779; or fo r filling
work orders on public works under Labor Code Section 1780.
8. Our Company has listed al l subcontractors pursuant to the Pub lic
Contract Code Section 4100 et seq.
9. Our Company is properl y licensed by the State of California and
will ensure that all of our subc ontractors are properly licensed by the
State of California.
10. The prohibition against unfair competition under Busin ess and
Professions Code Section 17200-1720 8.
11. Our company is properl y insure d for Workers Compensation
under Labor C ode Section 1861.
12. Our company and its empl oyees will abide by the Occupational,
Safety and Health laws and regulations that apply to the particular
construction project.
13. There is a F ederal Prohibition ag ainst hiring undocumented
workers and the requirement to secure proof of eligibility/citizenship
from all workers.
14. The require ment to provide itemized wage statements to
employees und er Labor Code Section 2 26.
As an authori zed representative for the above named contractor I have been informed of and am aware of the foregoing
requirem ents and have been provided with a copy of the Awarding Body’s Lab or Compliance Do cument Package.
Dated:
January 1, 2006
Contractor(s) Labor Co mpliance Attendee: John Atlas – President .
Print Name and Title
John Atlas .
Signature
GSLC #9SAMP (1/09)
DAS-140 FORM
(Title 8, California Code of Regulations, Section 230)
SUBMIT CONTRACT AWARD INFORMATION
Contractors shall provide contract award information to the apprenticeship committee for each
applicable apprenticeable craft or trade in the area of the site of the public works project that
has approved the contractor to train apprentices. Contractors who are not already approved to
train by an apprenticeship program sponsor shall provide contract award information to all of the
applicable apprenticeship committees whose geographic area of operation includes the area of
the public works project. Submit contract award information to the apprenticeship committees
for each apprenticeable craft or trade in the area of the site of the public works project that has
approved the contractors, who are participants in an approved apprenticeship program, to train
apprentices.
This contract award information shall be in writing on a DAS Form 140, Public Works Contract
Award Information or a letter which includes the following information, required, pursuant to
California Labor Code Section 1777.5.
(1) Contractor's name, address, telephone number and state license number;
(2) The full name and address of the public work awarding agency;
(3) The exact location of the public work site;
(4) Date of the contract award;
(5) Expected start date of the work;
(6) Estimated journeyman hours;
(7) Occupation of Apprentice
(8) Approximate number of apprentices to be employed;
(9) Approximate dates apprentices will be employed.
The information shall be provided to the applicable apprenticeship committee within ten (10)
days of the date of the execution of the prime contract or subcontract, but in no event later than
the first day in which the contractor has workers employed upon the public work.
THE TOP SECTION OF THE FORM COMPLETELY FILLED OUT will provide the
information required pursuant to California Labor Code Section 1777.5:
LOWER SECTION OF THE FORM; Check an appropriate box (#1, 2 or 3) for your
status.
In addition to the “ORIGINAL(S)” mailed to all applicable Apprenticeship
Committees, a “COPY” of this information shall also be submitted to Golden
State Labor Compliance
The filing of a DAS 140 is not a request for dispatch of registered apprentices
GSLC #12INST. (1/09)
PUBLIC WORKS CONTRACT AWARD INFORMATION (DAS-140)
Contract award information must be sent to your Apprenticeship Committee if you are approved to train. If you are not approved to train, you must send
the information (which may be this form) to ALL applicable Apprenticeship Committees in your craft or trade in the area of the site of the public work.
Go to: http://www.dir.ca.gov/das/PublicWorksForms.htm for information about programs in your area and trade. You may also consult your local
Division of Apprenticeship Standards (DAS) office whose telephone number may be found in your local directory under California, State of, Industrial
Relations, Division of Apprenticeship Sta ndards.
Do not send this form to the Division of Apprenticeship Standards.
NAME OF YOUR COMPANY CONTRACTORS STATE LICENSE NO.
MAILING ADDRESS-NUMBER & STREET, CITY, ZIP CODE AREA CODE & TELEPHONE NO.
NAME AND ADDRESS OF PUBLIC WORKS PROJECT DATE YOUR CONTRACT WAS EXECUTED
DATE OF EXPECTED/ACTUAL START OF PROJECT
NAME & ADDRESS OF PUBLIC AGENCY AW ARDING CONTRACT ESTIMATE D NUMBER OF JOURNEYMAN HOURS
OCCUPATION OF APPRENTICE
THIS FORM IS BEING SENT TO: (NAME AND ADDRESS OF APP RENTICESHIP PROGRAM(S) ESTIMATED NUMBER OF APPRENTICE HOURS
APPROXIMATE/ACTUAL DATES TO BE EMPLOYED
This is not a request for dispatch of apprentices.
*Contracto rs must make a separate request for actual dispatch, in accordance w ith Sectio n 230.1(a) California Code of Regulations*
Check One of the Boxes Below
1. We are already approved to train apprentices by the
Apprenticeship Committee. We will employ and train under their standards. (Enter name of Committee)
2. We will comply with the standards of
Apprenticeship Committee for the duration of this job only. (Enter name of Committee)
3. We will employ and train apprentices in accordance with the California Apprenticeship Council regulations, including § 230.1 (c)
which requires that apprentices employed on public projects can only be assigned to perform work of the craft or trade to which the
apprentice is registered and that the apprentices must at all times work with or under the direct supervision of journeyman/men.
Signature Date
Typed Name
Title
GSLC #12 (1/09)
PUBLIC WORKS CONTRACT AWARD INFORMATION
Contract award information must be sent to your Apprenticeship Committee if you are approved to train. If you are not approved to train, you must send
the information (which may be this form) to ALL applicable Apprenticeship Committees in your craft or trade in the area of the site of the public work.
Go to: http://www.dir.ca.gov/das/PublicWorksForms.htm for information about programs in your area and trade. You may also consult your local
Division of Apprenticeship Standards (DAS) office whose telephone number may be found in your local directory under California, State of, Industrial
Relations, Division of Apprenticeship Sta ndards.
Do not send this form to the Division of Apprenticeship Standards.
NAME OF YOUR COMPANY CONTRACTORS STATE LICENSE NO.
ATLAS CONSTRUCTION COMPANY 123456
MAILING ADDRESS-NUMBER & STREET, CITY, ZIP CODE AREA CODE & TELEPHONE NO.
12345 MAIN STREET, ANYWHERE, 99999 555-555-5555
NAME AND ADDRESS OF PUBLIC WORKS PROJECT DATE YOUR CONTRACT WAS EXECUTED
HAPPY DAZE ELEMENTARY SCHOOL 00/00/0000
789 WIDE STREET DATE OF EXPECTED/ACTUAL START OF PROJECT
ANYWHERE, CA 99999 00/00/0000
NAME & ADDRESS OF PUBLIC AGENCY AWARDING CONTRACT ESTIMATED NUMBER OF JOURNEYMAN HOURS
OUR UNIFIE D SCH OOL DISTRICT 10
987 BROAD STREET
EVERYWHERE, CA 99999 OCCUPATION OF APPRENTICE
OCCUPATION MUST BE
RECOGNIZED BY THE DIR
THIS FORM IS BEING SENT TO: (NAME AND ADDRESS OF APPRENTICESHIP PROGRAM(S) ESTIMATED NUMBER OF APPRENTICE HOURS
2
APPLICABLE APPRENTICESHIP COMMITTEE IN THE AREA
APPROXIMATE/ACTUAL DATES TO BE EMPLOYED
OF THE PUBLIC WORK SITE 00/00/0000
http://www.dir.ca.gov/das/PublicWorksForms.htm
This is not a request for dispatch of apprentices.
*Contracto rs must make a separate request for actual dispatch, in accordance w ith Sectio n 230.1(a) California Code of Regulations*
Check One of the Boxes Below
1. We are already approved to train apprentices by the ____________________________________________________________ _
Apprenticeship Committee. We will employ and train under their standards. (Enter name of Committee)
2. We will comply with the standards of _________________________________________________________________________
Apprenticeship Committee for the duration of this job only. (Enter name of Committee)
3. We will employ and train apprentices in accordance with the California Apprenticeship Council regulations, including § 230.1 (c)
which requires that apprentices employed on public projects can only be assigned to perform work of the craft or trade to which the
apprentice is registered and that the apprentices must at all times work with or under the direct supervision of journeyman/men.
JOHN ATLAS 00/00/0000
Signature Date
John Atlas President
Typed Name Title
GSLC #12SAMP (1/09)
DAS-142 FORM
(Title 8, California Code of Regulations, Section 230)
EMPLOY REGISTERED APPRENTICES on the Public Works project in a ratio of no
less than one (1) hour of apprentice work for every five (5) hours performed by a
journeyman.
ALL CONTRACTORS MUST RE QUEST DISPATCH of required apprentices from
an Apprenticeship Program (for each apprenticeable craft or trade) by giving the
Apprenticeship Program actual notice of at least 48 hours (excluding Saturdays,
Sundays and holidays) before the date on which apprentices are required. Contractors
who are not already participating in an approved program and who did not receive
sufficient number of apprentices from their initial request, must request dispatch of
apprentices from at least one other Apprenticeship Committee, if more than one exists in
the area of the public works project.
DOCUMENTATION OF REQUEST FOR DISPATCH
Before the end of the project, you will be required to provide documentation showing
compliance of request of dispatch. If your payroll records indicate that you have
employed the sufficient number of apprentices during the life of the project, you do not
need to provide this documentation.
However, if no apprentices or an insufficient number of apprentices are employed, you
will be asked to provide this documentation. (Documentation may be obtained from the
apprenticeship committee that you request dispatch from). At such point in time that you
receive this documentation, please forward a copy to us. Keep accurate records of any
phone, fax or e-mail communications relevant to your request for dispatch.
UTILIZING THE DAS Form 142:
You may use the DAS Form 142 to request dispatch of an apprentice from the
Apprenticeship Committee in the craft or trade in the area of the public work. Go to:
http://www.dir.ca.gov/das/PublicWorksForms.htm for information about programs in
your area and trade. You may also consult your local Division of Apprenticeship
Standards (DAS) office whose telephone number may be found in your local directory
under California, State of, Industrial Relations, Division of Apprenticeship Standards.
(1) Locate an applicable Apprenticeship Committee from the information above
(2) Enter the Committee’s name and contact information
(3) Enter your Compan y name and contact information
(4) Enter the information regarding the apprentices (number needed, craft/trade, dates to
report)
(5) Include who the apprentice should report to, where and what time
You may use the DAS Form 142, or make a verbal or written request, to ask for the dispatch of
an apprentice . Please take note of California Code of Reg ulations, Title 8, § 230.1 (a) which says
in part: if in response to a written request an Apprenticeship Committee does not dispatch a ny
apprentice to a contractor who h as agreed to employ and train apprentices in accordance with
either the Apprentice ship Committee's Standards or these regulations within 72 hours of such
request (excluding Saturdays, Sundays and holidays) the contractor shall not be considered in
violation of this section as a result of failure to employ apprentices ...
GSLC #13INST. (1/09)
REQUEST FOR DISPATCH OF AN APPRENTICE (DAS-142)
Do not send this form to DAS
You may use this form to request dispatch of an apprentice from the Apprenticeship
Committee in the craft or trade in the area of the publi c wo rk. Go to:
http://www.dir.ca.gov/das/PublicWorksForms.htm for information about programs in
your area and trade. You may also consult your local Division of Apprenticeship
Standards (DAS) office whose telepho ne number may be found in your local directory
under Califor nia, State of, Industrial Relations, Division of Apprenticeship Standards.
Date:
To Applicable Apprenticeship Committee:
Address:
Telephone: Fax:
Contractor Requesting Dispatch:
Address:
Telephone: Fax:
Person making request:
Number of Apprentice(s) Needed Craft or Trade
Date Apprentice(s) to Report: (48 hours notice required)
Name of Person to Report to:
Address to Report to:
Time to Report:
You may use this form, or make a verbal or written request, to ask for the dispatch of an
apprentice. Please take note of California Code of Re gulations, Title 8, § 230.1 (a) which
says in part: if in response to a written request an Apprenticeship Committee does not
dispatch any apprentice to a contractor who has agreed to employ and train apprentices
in accordance with either t he Apprenticeship Committee's Standards or these
regulations within 72 hours of such request (excluding Saturdays, Sundays and holidays)
the contracto r shall not be consid ered in violation of this section as a result of failure to
employ apprentices ...
GSLC #13 (1/09)
REQUEST FOR DISPATCH OF AN APPRENTICE
Do not send this form to DAS
You may use this form to request dispatch of an apprentice from the Apprenticeship
Committee in the craft or trade in the area of the publi c wo rk. Go to:
http://www.dir.ca.gov/das/PublicWorksForms.htm for information about programs in
your area and trade. You may also consult your local Division of Apprentice ship
Standards (DAS) office whose telepho ne number may be found in your local directory
under Califor nia, State of, Industrial Relations, Division of Apprenticeship Standard s.
Date: 00/00/0000
To Applicable Apprenticeship Committee:
ABC APPRENTICES
Address:
123 HELPING HAND AVE., NOWHERE, CA 99999
Telephone:
555-444-3333 Fax: 444-333-2222
Contractor Requesting Dispatch:
ATLAS CONSTRUCTION COMPANY
Address:
12345 MAIN STREET, ANYWHERE, CA 99999
Telephone:
555-555-5555 Fax: 555-555-0000
Person making request:
JOHN ATLAS
Number of Apprentice(s) Needed:
2 Craft or Trade: RECOGNIZED BY DIR
Date Apprentice(s) to Report:
00/00/0000 (48 hours notice required)
Name of Person to Report to:
JOHN ATLAS
Address to Report to: 12345 MAIN STREET, ANYWHERE, 99999
Time to Report: ON TIME
You may use this form, or make a verbal or written request, to ask for the dispatch of an
apprentice. Please take note of California Code of Re gulations, Title 8, § 230.1 (a) which
says in part: if in response to a written reque st an Apprenticeship Committee does not
dispatch any apprentice to a contractor who has agre ed to employ and train apprentices
in accordance with either t he Apprenticeship Committee's Standards or these
regulation s wi thin 72 hours of such request (excluding Saturda y s, Sundays and holidays)
the contractor shall not be considered in violation of this section as a result of failure to
employ apprentices ...
GSLC #13SAMP. (1/09)
FRINGE BENEFITS STATEMENT
As the direct representative of the Awarding Body and the Labor Compliance Program for the
Project, Golden State is the recipient of the Fringe Benefit Statement (Wet Signature Required).
Please submit monthly documentation that all Employer Fringe Benefit Payments are current.
CLASSIFICATION:
The Fringe Benefit Statement must include all Trades/Classifications of
employees that
YOUR COMPANY will dispatch to the Public Works Project, including
Apprentices.
Do not list each employee by name that you will dispatch within the Trade/Classification.
EFFECTIVE DATE: Is the date of the DIR Prevailing Wage Determina tion governing the
duration of the Public Works Project.
SUBSISTENCE OR TRAVEL:
If your company will be required to pay this fringe benefit
insert the per diem amount within this section.
EMPLOYER PAID FRINGE BENEFITS:
Next to each listed Fringe Benefit indicate the
hourly rates for fringe benefits payments made for employees by the employer on the various
classes of work. Do not include amounts that are paid directly by the employee.
PAID TO:
Insert the name and address of the Plan, Fund or Program where the benefit will be
sent, or if the benefit amount is to be paid directly to the Employee, indicate same by inserting
"Employee".
Do not list each employee by name.
All fringe benefits must be irrevocably paid to an authorized fund or to the employee. No unpaid
amounts are allowed.
A Common Misunderstanding of the Status of "Owner-Operators" Under the State
Labor Code.
There is a common misconception among many owner-operators that there is something like an
"exemption" from prevailing wage requirements for owner-operators that perform work on public
works projects. This is simply not the case, under the Labor Code; an owner-operator who
performs work in the field is a "journeyman", regardless of his or her status as an owner. The
Fringe Benefit Statement must reflect this fact. The only o wners who are exempt from prevailing
wage requirements are those that perform only supervisory or management functions, without
working with the tools or operating equipment.
Credits, For Fringe Benefit Payments
CALIFORNIA CODE OF REGULATIONS: TITLE 8, GROUP3, ARTICLE 4,
16200(i) Credit Available for Actual Payment of Fringe Benefit Costs up to the Prevailing
Amount. The contractor obligated to pay the full prevailing rate of per diem wages may take
credit for amounts up to the total of all fringe benefit amounts listed as prevailing in the
appropriate wage determination. This credit may be taken only as to amounts which are actual
payments under Employer Payments Section 16000(1)-(3). In the event the total of Employer
Payments by a contractor for the fringe benefits listed as prevailing is less than the aggregate
amount set out as prevailing in the wage determination, the contractor must pay the difference
directly to the employee. No amount of credit for payments over the aggregate amount of
GSLC #16INST. (1/09)
employer payments shall be taken nor shall any credit decrease the amount of direct payment
of hourly wages of those amounts found to be prevailing for straight time or overtime wages.
Memo from the Division of Industrial Relations dated 11-15-90.
THE RULE:
The contractor can pay amounts for individual benefits different than the state shows in the
wage reports so long as it is not less than the total amount permitted for all benefits. Any
contractor paid amount less than the total benefit requirements listed in the state wage reports
must be paid to the employee.
GSLC #16INST. (1/09)
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