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