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Request for Determination of Prevailing Wage Rates
Date of Request:
mm/dd/yyyy
Name of Inquirer:
Company Name:
Mailing Address:
City:
State:
Zip:
Telephone:
example: (XXX) XXX-XXXX
Fax:
example: (XXX) XXX-XXXX
Email:
U.S. Decision No.
(If applicable):
Title of Project:
Location of Project:
(city)
(county)
(state)
Estimated Value of Contract:
Project Fund Source:
Public Body Awarding Contract:
Contact Person:
Address:
City:
State:
Zip:
Telephone:
Projected Bid Date:
Job Classification Required:
(check only one)
General Building Construction Trades
General Heavy or Utility Construction Trades
Both Building and Heavy Trades
Brief Description of Work to Be Performed:
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