Florida Wages And Payrolls Forms & Documents (Page 3 of 13) in pdf

700-010-59

CONSTRUCTION

05/06

STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION

NOTIFICATION TO CONTRACTOR AND FEDERAL HIGHWAY ADMINISTRATION

(FHWA) OF NON-COMPLIANCE WITH THE WORK HOURS ACT OF 1962 AND

OTHER RELATED ACTS, REGULATION AND CONTRACT TERMS BETWEEN THE

STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION AND CONTRACTOR

TO: Name and Address of Prime Contractor

Name and Address of Sub-Contractor

In accordance with applicable FHWA regulations, laws, and construction contract referred to above, you are hereby notified of the

following non-compliance with their provisions and respect to payment of employees in the performance of contract work on the

following State and Federal Projects(s):

Financial Project/Contract Number

Federal Project Number

The

(Prime)

(Sub) Contractor payroll listing for the week ending (week ending date) (U.S. Department of Labor Form WH-347

(1/88) or similar form) contains the following listed violations occurring during this payroll period:

Employee’s Name

Violation

Total Hours

Additional

Violation

(Last Name and Initials)

(See Reverse Side)

Improperly Paid

Gross Wages Due

Penalty

Total

Code Date(s) / Day(s)

(Code 1 Only)

(If additional space is required, attach continuation sheet) TOTALS:

$ 0.00

If a penalty has not been assessed (see above*) this is a request for additional information. A supplemental payroll must be submitted

within 20 days of the date shown below; otherwise progress payments may be withheld.

If wages and penalty have been withheld this notification of non-compliance is being transmitted to the FHWA Administrator for further

determination and review. The decision of the Division Administrator of the FHWA or his designee is final and binding on the State of

Florida Department of Transportation and Contractor alike, subject to the Contractor’s right of appeal as set forth below. Therefore the

total amount of additional wages due and penalties have been withheld from progress or final payment on this contract pending final

determination by the FHWA and/or appeal by the Contractor. Any appeal from the finding of fact and determinations of the FHWA must

be filed within 60 days from the date of the withholding of funds on this contract. The 60 days begin with the date on which this formal

notice of the withholding of funds is received by the Contractor by certified mail (return receipt requested). The aggrieved Contractor or

Sub-Contractor shall have the right of appeal to the Federal Highway Administrator, the Secretary of Labor, and/or the Court of Claims.

Such appeals must be submitted through the State of Florida Department of Transportation who will make proper distribution.

Comments:

State of Florida

Date

State of Florida

Date

Department of Transportation

Resident Compliance Specialist

Resident Engineer (or designee)

Florida Wages And Payrolls Forms & Documents Page 3

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