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Date (b)WHERE FRINGE BENEFITS ARE PAID IN CASH <br /> 1, ❑ — Each laborer or mechanic listed in the above referenced payroll has been paid, <br /> (Name of Signatory Party) (Title) as indicated on the payroll,an amount not less than the sum of the applicable <br /> do hereby state: basic hourly wage rate plus the amount of the required fringe benefits as listed <br /> in the contract,except as noted in section 4(c)below. <br /> (1)That I pay or supervise the payment of the persons employed by (c)EXCEPTIONS <br /> on the <br /> (Contractor or Subcontractor) EXCEPTION(CRAFT) EXPLANATION <br /> ;that during the payroll period commencing on the <br /> (Building or Work) <br /> day of and ending the day of <br /> all persons employed on said project have been paid the full weekly wages earned,that no rebates have <br /> been or will be made either directly or indirectly to or on behalf of said <br /> from the full <br /> (Contractor or Subcontractor) <br /> weekly wages earned by any person and that no deductions have been made either directly or indirectly <br /> from the full wages earned by any person,other than permissible deductions as defined in Regulations,Part <br /> 3(29 C.F.R.Subtitle A),Issued by the Secretary of Labor under the Copeland Act,as amended(48 Stat.948, <br /> 63 Start.108,72 Stat.967;76 Stat.357;40 U.S.C.§3145),and described below. <br /> REMARKS: <br /> (2)That any payrolls otherwise under this contract required to be submitted for the above period are <br /> correct and complete;that the wage rates for laborers or mechanics contained therein are not less than the <br /> applicable wage rates contained in any wage determination incorporated into the contract; that the <br /> classifications set forth therein for each laborer or mechanic conform with the work he performed. <br /> (3) That any apprentices employed in the above period are duly registered in a bona fide <br /> apprenticeship program registered With a State apprenticeship agency recognized by the Bureau of <br /> Apprenticeship and Training,United States Department of Labor,or if no such recognized agency exists in a <br /> State,are registered With the Bureau of Apprenticeship and Training,United States Department of Labor. <br /> (4)That: <br /> (a)WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS,FUNDS,OR PROGRAMS NAME AND TITLE SIGNATURE <br /> ❑ — in addition to the basic hourly wage rates paid to each laborer or mechanic listed in <br /> the above referenced payroll, payments of fringe benefits as listed in the contract THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEMENTS MAY SUBJECT THE CONTRACTOR OR <br /> have been or Will be made to appropriate programs for the benefit of such SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION.SEE SECTION 1001 OF TITLE 18 AND SECTION 231 OF TITLE <br /> employees,except as noted In section 4(c)below. 31 OF THE UNITED STATES CODE. <br />