Prevailing Wage/citizens Preference Complaint Form - Illinois Department Of Labor

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ILLINOIS DEPARTMENT OF LABOR
Prevailing Wage/Citizens Preference Complaint
#1 West Old State Capitol Plaza, Room 300
Springfield, Illinois 62701-1217
Complainant
Name_________________________________________________ Title___________________________________________
Local Union #___________________________________________ Trade__________________________________________
Address_______________________________________ City________________________ State_______ Zip_____________
Phone (______) ________________________________ Office Hours_____________________________________________
Alleged Violation: Prevailing Wage Act________________ Citizens Preference Act________________________________
Briefly describe violation: ________________________________________________________________________________
_______________________________________________________________________________________________________________________________
Project Information
Name of Company______________________________________________________________________________________
Name of Owner________________________________________________________________________________________
Address_______________________________________ City________________________ State_______ Zip____________
Phone (______) ________________________________
Nature of Project _______________________________________________________________________________________
Project/Contract Number_________________________________________________________________________________
Location of Project______________________________________________________________________________________
City____________________________________ State_______ Zip_________________
Type of work being performed_____________________________________________________________________________
Number of workers on the project on the date of your visit_______________________________________________________
Public Body Data
Public Body____________________________________________________________________________________________
Administrator___________________________________________________________________________________________
Address_______________________________________ City________________________ State_______ Zip_____________
Phone (______) ____________________________ Project Bid Date_________________ Date of Award________________
Is project federally funded? _______________ Is project state or locally funded?____________________
IDOL 001

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