Labor Compliance Program Manual - San Francisco Public Schools

Awarding Body LCP State of California Requirements as of January 21, 2009
Procedures Manual
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LABOR COMPLIANCE PROGRAM
REQUEST FOR APPROVAL OF FORFEITURE AMOUNT
Awarding body or 3 rd Party Administrator:
Name:
Date Requested: Name of Affected Public Agency:
Project Information
Project Name
Contract Number
Project Location (County)
Bid Advertisement
Estimated Completion
Date
Project Accepted/Completion Date
Date
Notice of Recordation by County Recorder Funds in Retention
Contractor Information
Name & address of General
Contractor
General description of scope of work of
the entire project
Name & address of Subcontractor or
Affected Contractor
General description of scope of work for
the Subcontractor or affected contractor
LCP Investigation and Findings
Has Final Approval been granted? Yes ( ) No ( )
Date of Notice of Withholding Contract Payments ___________________
Wages assessed $______________ Training $______________________
1775 Penalties assessed $________ 1813 Penalties $_________________
1776 Penalties assessed $________
TOTAL NOTICE OF WITHHOLDING CONTRACT PAYMENTS $____________
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SFUSD - 60 - Appendix D