Form Wh-347 - Payroll (For Contractor'S Optional Use) Page 2
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(b) WHERE FRINGE BENEFITS ARE PAID IN CASH
I,
−
Each laborer or mechanic listed in the above referenced payroll has been paid,
(Name of Signatory Party)
(Title)
as indicated on the payroll, an amount not less than the sum of the applicable
basic hourly wage rate plus the amount of the required fringe benefits as listed
do hereby state:
in the contract, except as noted in section 4(c) below.
(1) That I pay or supervise the payment of the persons employed by
(c) EXCEPTIONS
on the
(Contractor or Subcontractor)
EXCEPTION (CRAFT)
EXPLANATION
; that during the payroll period commencing on the
(Building or Work)
day of
,
, and ending the
day of
,
,
all pers ons em ployed on s aid proj ect hav e been paid t he f ull weekly wages earned, that no rebates have
been or will be made either directly or indirectly to or on behalf of said
from the full
(Contractor or Subcontractor)
weekly wages earned by any pers on and t hat no deduc tions hav e been m ade eit her direc tly or indirec tly
from the full wages earned by any person, other than permissible deductions as defined in Regulations, Part
3 (29 C.F.R. Subtitle A), issued by the Secretary of Labor under the Copeland Act, as amended (48 Stat. 948,
63 Start. 108, 72 Stat. 967; 76 Stat. 357; 40 U.S.C. § 3145), and described below:
REMARKS:
(2) That any payrolls otherwise under this c ontract required t o be s ubmitted f or t he abov e period are
correct and complete; that the wage rates for laborers or mechanics contained therein are not less than the
applicable wage rates contained in any wage det ermination incorporated int o t he c ontract; t hat t he
classifications set forth therein for each laborer or mechanic conform with the work he performed.
(3) T hat any apprent ices em ployed in t he abov e period
are duly registered in a bona fide
apprenticeship program regis tered w ith a St ate apprent iceship agency recognized by the Bureau of
Apprenticeship and Training, United States Department of Labor, or if no such recognized agency exists in a
State, are registered with the Bureau of Apprenticeship and Training, United States Department of Labor.
(4) That:
NAME AND TITLE
SIGNATURE
(a) WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, FUNDS, OR PROGRAMS
−
in addition to the basic hourly wage rates paid to each laborer or mechanic listed in
the above referenced payroll, payments of fringe bene fits as listed in the contract
THE WILLFUL FALSIFICATION O F ANY O F T HE ABO VE ST ATEMENTS M AY SUBJ ECT T HE CO NTRACTOR O R
SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION. SEE SECTION 1001 OF TITLE 18 AND SECTION 231 OF TITLE
have been or will be
made to appropria te progra ms for the bene fit of such
31 OF THE UNITED STATES CODE.
employees, except as noted in section 4(c) below.
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