A.
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You were or are employed on the project.
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B.
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You meet one of the following:
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1.
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Any person who submits a bid for the purpose of securing the award of a contract
for construction of the public improvement.
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2.
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Any person acting as a subcontractor of a person mentioned in (B.1.) above.
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3.
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Any bona fide organization of labor which has as members or is authorized to represent
employees of a person mentioned in (B.1. or B.2.) and which exists, in whole or
in part, for the purpose of negotiating with employers concerning the wages, hours,
or terms and conditions of employment of employees.
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4.
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Any association having as members any of the persons mentioned in (B.1. or B.2.)
of this section.
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A.
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Download or view the form, then print out a copy of the form (it is a legal
size document, 8½" by 11").
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B.
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Read all questions on the wage claim form carefully before answering. Please fill
out your claim completely, legibly, and accurately. You must sign, date, and have
it notarized.
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C.
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Provide the contractor's name, name of business, correct address, county, and telephone
number. You as the claimant are responsible for providing this information.
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D.
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To help prove your claim, please provide copies of any
documentation you have available. For example, pay stubs or a personal record of
hours worked on the project. DO NOT SEND ORIGINALS.
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E.
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Be certain that your name, address, social security number, and telephone number
are correct. If you do not have a telephone number, please supply this Division
with a telephone number where we can reach you. If your address or telephone number
changes, it is your responsibility to notify us immediately
or your claim could be closed.
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The Prevailing Wage Complaint Form (PDF) can be downloaded
here.
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