Request for Wage Determination and Response to Request Revised 2016
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U.S. DEPARTMENT OF LABOR EMPLOYMENT STANDARDS ADMINISTRATION REQUEST FOR DETERMINATION AND RESPONSE TO REQUEST (Davis-Bacon Act as Amended and Related Statutes)
Submit Request To: Department of Housing and Community Development Community Development Block Grant (CDBG) Program 2020 West El Camino Avenue, Suite 650 Sacramento, CA 95833 Attn: Marc Firestone (Labor Standards Specialist)
Or VIA e-mail: [email protected]
Jurisdiction Name:
Response to Request Standard Agreement number Type of Work: Residential Building OR Highway Heavy PI Waiver
Requesting Officer: 10 Day Update Request? Phone: Yes No
Date of this Request: Est. Advertising Date: Est. Bid Opening Date:
Prior Decision Number (if any) Est. Contract Value Est. Award Date: $
Project Name: If Housing Address/Project Location: # of Units: City: # of Stories: County: # of Dwellings: State: California Description of Work:
Address to which wage determination should be e-mailed:
HCD USE ◀◀◀ Use area determination for: Approved: Date: Name: Marc Firestone
(916) 263-1583 Position: HCD Representative II Title: Labor Standards Specialist
Request for Wage Determination and Response to Request revised 2016