California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 4 - Labor Compliance Programs › Article 5 - Enforcement › Appendix C - Suggested Single Project Labor Compliance Review and Enforcement Report Form

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
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Awarding Body:
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Project Name:
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Name of Approved Labor Compliance Program:
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Bid Advertisement Date:
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Acceptance Date:
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Notice of Completion Recordation Date:
Summary of Labor Compliance Activities
1. Contract Documents Containing Prevailing Wage
						Requirements (Identify)
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2. Prejob Conference(s) -- Attach list(s) of attendees
						and dates
3. Notification to Project Workers of Labor Compliance
						Program's Contact Person. (Explain Manner of Notification for each project work
						site.)
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4. Certified Payroll Record Review
a. CPRs Received From:
Contractor/Subcontractor
For
								weeks ending ("w/e") through w/e
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b. Classifications identified in CPRs and applicable
						Prevailing Wage Determinations
Classification
Determination
								No.
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5. Further investigation or audit due to CPR review,
						information or complaint from worker or other interested person, or other
						reason:
a. Independent Confirmation of CPR Data
Contractor/Subcontractor
Worker
								Interviews (Yes/No)
Reconciled CPRs with Paychecks or Stubs
								(Yes/No)
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b. Employer Payments (Health & Welfare, Pension,
						Vacation/Holiday) Confirmation
Contractor/Subcontractor
Recipients
								of Employer Payments
Written confirmation Obtained (Yes/No)
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c. Contributions to California Apprenticeship Council or
						Other Approved Apprenticeship Program
Contractor/Subcontractor
Recipients
								of Contributions
Written confirmation Obtained (Yes/No)
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d. Additional Wage Payments or Training Fund
						Contributions Resulting from Review of CPRs
Contractor/
								Subcontractor
Additional amounts Paid to Workers
Additional
								Training Fund
Explanation
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*
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*
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*
* Use separate page(s) for explanation
6. Complaints Received Alleging Noncompliance with
						Prevailing Wage Requirements.
Name of Complainant
Date
								Received
Resolution or Current Status
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*
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*
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*
*Use separate page(s) to explain resolution or current
						status
7. Requests for Approval of Forfeiture to Labor
						Commissioner
Contractor/Subcontractor
Date of
								Request
Approved/Modified/Denied
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8. Litigation Pending Under Labor Code Section
						1742
Contractor/Subcontractor
DIR Case
								Number
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9. (Check one): ___ Final report this project ___ Annual
						report this project
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Authorized Representative for Labor Compliance
						Program