2 years ago

Bid Book - Dublin City, Ohio

Bid Book - Dublin City, Ohio

Each laborer or mechanic

Each laborer or mechanic listed in the above‐referenced payroll has been paid as indicated on thepayroll, and amount not less than the sum of the applicable basic hourly wage rate plus the amountof the required fringe benefits as listed in the Agreement, except as noted in Section 4 below.c. Exceptions:Exception (Craft):Explanation:____________________________ ________________________________________________________________________________ ________________________________________________________________________________ _______________________________________________________________________________ ____________________________________________________Remarks:________________________________________________________________________________________________________________________________________________________________________________________________________(Signature)______________________________________(Print Name and Title)The willful falsification of any of the above statements may subject the Contractor or Subcontractorto fines as described in Section 4115.99 of the O.R.C.8513‐006.0‐CIP

B. FINAL AFFIDAVIT OF COMPLIANCE WITH PREVAILING WAGESPROJECT: 2013 STORM STRUCTURE MAINTENANCE PROJECTSTATE OF ______________________COUNTY OF _____________________, SS:I,________________________________________,(Name of person signing the affidavit)____________________ (Title) do hereby certify that the wages paid to all employees of____________________________________________ (Company Name) for all hoursworked on project the CITY OF DUBLIN 2013 STORM STRUCTURE MAINTENANCE PROJECTlocated at various locations within the City of Dublin during the period from___________________to________________ are in compliance with the Prevailing Wagerequirements of Chapter 4115 of the Ohio Revised Code. I further certify that no rebates ordeductions have been or will be made, directly or indirectly, from any wages paid inconnection with this project, other than those provided by law.___________________________(Signature of Affiant)___________________________(Print Name)Sworn to and subscribed in my presence this _____ day of _______________, 2013.___________________________Notary PublicThe above affidavit must be executed and sworn to by the officer or agent or theContractor/Subcontractor who supervised the payment of employees, before the CITY OFDUBLIN, Ohio will release the surety and/or make final payment due under the terms of theAgreement.8613‐006.0‐CIP

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