Form WH-347: Davis-Bacon and Related Acts Weekly Certified Payroll Form

Mark the box for Prime Contractor or Subcontractor.

Unless otherwise noted, the information requested is specific to the named project.

Enter the Project Name, Project No. or Contract No., Certified Payroll No. and Prime Contractor's/Subcontractor's Business Name.

Enter the Project Location, Wage Determination No., Week Ending Date and Prime Contractor's/Subcontractor's Business Address.

Enter the Worker Entry No., Worker Last Name, Worker First Name, Worker Middle Initial and Worker Identifying No.

Under (J) Journeyworker and (RA) Registered Apprentice, enter J or RA.

Enter the Labor Classification.

Enter the (top) Days of Work Week and the (bottom) Dates.

Enter the Hours Worked Each Day, with ST = Straight Time and OT = Overtime.

Enter the Total Hours Worked for Week.

Enter the Hourly Wage Rate Paid for ST and OT.

Enter the Total Fringe Benefit Credit and the Payment in Lieu of Fringe Benefits.

Enter the Gross Amt Earned and the Gross Amt Earned for All Work.

Enter the Tax Withholdings, FICA and Other (Must Specify, See Instructions), and the Total Deductions.

Enter the Net Pay to Worker for All Work.

Enter the Prime Contractor's/Subcontractor's Business Name, the Project Name, the Project No. or Contract No. and the Payroll No.

Enter the Project Location, Week Ending Date and Certifying Official's Name and Title.

The Certifying Official states: I paid or supervised the payment of the laborers or mechanics working on the project during the stated time period. By signing you certify the following:

Check the box for: The payroll information submitted with this statement is correct and complete for the project during the period, and the wage and fringe benefit rates paid to the workers, including credit taken for the reasonably anticipated costs of a bona fide fringe benefit plan, fund or program, are not less than the applicable wage and fringe benefits rates for the classification(s) of work actually performed, as specified in the wage determination(s) incorporated into the contract.

Check the box for: All regular payrolls and all other basic records that the contractor is required to maintain for this payroll period are complete and accurate and will be made available upon request from the agency or the Department of Labor.

Check the box for: The classifications reported for each laborer or mechanic are the classification(s) of work that each worker actually performed.

Check the box for: Any workers paid as apprentices during the period are duly registered in a bona fide apprenticeship program registered with the Office of Apprenticeship, Employment and Training Administration, United States Department of Labor (“OA”), or a State Apprenticeship Agency (“SAA”) recognized by Department of Labor.

I have verified the registered apprenticeship program information provided below as accurate and applicable to any apprentices identified on page 1 of this form. Enter the Apprenticeship Program Name, mark OA or SAA under Registered, and enter the Name of Labor Classification.

Check the box for: Fringe benefits have been paid in cash and/or to bona fide fringe benefit plans, funds, or programs.

Where the contractor is claiming an hourly credit for their contributions to or reasonably anticipated costs of a bona fide fringe benefit plan, fund, or program, provide plan information and the hourly credit claimed for each worker listed on the previous page of this form.

If an amount is listed in (6B) on the first page of this certified payroll form, enter the hourly credit claimed under each plan name, type and number for each worker and check whether the plan is funded or unfunded.

Enter the FB Name, FB Type and Plan No. for each plan, and the Name of Worker, the Hourly Credit for each plan and the Total Hourly Credit.

Check the box for: All workers on the project have been paid the full weekly wages earned, and no rebates or deductions have been or will be made either directly or indirectly, other than permissible deductions as defined in 29 CFR part 3.

Write the Additional Remarks.

Sign on the Signature of Certifying Official line, and enter the Date, Telephone Number and Email Address.

Willful falsification of any of the above statements may subject the contractor or subcontractor to civil or criminal prosecution (see Section 1001 of Title 18 and Section 3729 of Title 31 of the United States Code), as well as debarment from future Federal and federally-assisted contracts.

Information reported in certified payrolls may be subject to disclosure in response to a Freedom of Information Act request.

The Copeland Act (40 U.S.C. § 3145) requires contractors and subcontractors performing work on Federal or federally financed construction contracts to, on a weekly basis, “furnish a statement on the wages paid each employee during the prior week.”

U.S. Department of Labor (DOL) Regulations at 29 C.F.R. § 5.5(a)(3)(ii) require contractors and subcontractors to submit weekly certified payrolls to the appropriate Federal agency if the agency is a party to the contract (or, if the agency is not such a party, to the applicant, sponsor, owner, or other entity, as the case may be, that maintains such records, for transmission to the Federal agency).

Each certified payroll must be accompanied by a signed “Statement of Compliance” (e.g., page 2 of the WH-347 or another document with identical wording) indicating that the certified payrolls are accurate and complete, and that each laborer or mechanic has been paid not less than the required Davis-Bacon prevailing wage rate(s) (including any fringe benefits) for the work performed.