Wh 38 Form PDF Details

The WH-38 form serves as a critical tool in the construction industry, ensuring compliance with wage and hour regulations. Crafted by the Bureau of Labor and Industries, it's part of the machinery that upholds the integrity of employment standards within Oregon's public sector construction. Designed to accommodate both prime contractors and subcontractors, this certified statement form collects extensive data ranging from payroll numbers to project-specific details such as the business name, Construction Contractors Board (CCB) registration number, project name, and location. It meticulously records the period of work, classifies labor, and tallies hours worked along with gross wages and any applicable deductions. Beyond serving as a payroll record, the form acts as a declaration, with the signatory asserting that all workers have received their rightful wages, free of unauthorized deductions or rebates. Moreover, it confirms that wage rates meet or exceed set minimums and that, where applicable, benefits are properly disbursed. Not officially sanctioned by the U.S. Department of Labor but created to align with both state and federal guidelines - including the Davis-Bacon Act - the WH-38 form embodies a cornerstone of regulatory compliance and fairness in labor for Oregon's construction endeavors.

QuestionAnswer
Form NameWh 38 Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other nameswh38, WWW, BOLI, PWR

Form Preview Example

BUREAU OF LABOR AND INDUSTRIES

 

 

 

PAYROLL/CERTIFIED STATEMENT FORM WH-38

WAGE AND HOUR DIVISION

 

 

 

FOR USE IN COMPLYING WITH ORS 279C.845*

PRIME CONTRACTOR

SUBCONTRACTOR

PAYROLL NO.________________________

 

Business Name (DBA):

 

Phone: (

)

CCB Registration Number:

Project Name:

 

Project Number:

Type of Work:

 

Street Address:

 

 

Project Location:

 

Mailing Address:

Project County:

Date Pay Period Began:

 

 

Date Pay Period Ended:

 

 

 

 

 

 

 

 

 

 

 

THIS SECTION FOR PRIME CONTRACTORS ONLY

 

 

 

THIS SECTION FOR SUBCONTRACTORS ONLY

 

Public Contracting Agency Name:

 

 

 

 

 

 

 

Subcontract Amount:

 

 

 

 

 

 

 

 

 

 

 

 

 

Prime Contractor Business Name (DBA):

 

 

 

 

Phone: (

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Prime Contractor Phone: (

)

 

 

 

 

 

Date Contract Specifications First Advertised for Bid:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Prime Contractor’s CCB Registration Number:

 

 

 

 

Contract Amount:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date You Began Work on the Project:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(1)

 

(2)

 

 

 

(3) DAY AND DATE

(4)

(5)

(6)

(7)

(8)

 

(9)

(10)

 

(11)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOURLY

 

 

 

 

 

 

 

 

 

TRADE,

 

 

 

 

 

 

 

 

 

 

BASE

FRINGE

 

ITEMIZED

 

NET

HOURLY FRINGE

 

 

 

 

CLASSIFICATION

 

 

 

 

 

 

 

 

 

 

BENEFIT

GROSS

 

WAGES

BENEFITS PAID TO

 

NAME OF BENEFIT

NAME AND ADDRESS

 

 

 

 

 

 

 

 

 

TOTAL

HOURLY

DEDUCTIONS

 

 

(INCLUDE GROUP # AND

 

 

 

 

 

 

 

 

 

AMOUNTS

AMOUNT

 

PAID

BENEFIT PARTY,

 

PARTY, PLAN, FUND, OR

OF EMPLOYEE

 

 

 

 

 

 

 

 

 

HOURS

RATE

FICA, FED, STATE,

 

 

APPRENTICESHIP STEP

 

 

 

 

 

 

 

 

 

PAID AS

EARNED

 

FOR

PLAN, FUND, OR

 

PROGRAM

 

 

 

 

 

 

 

 

 

 

 

 

OF PAY

ETC.

 

 

 

 

IF APPLICABLE)

 

 

 

 

 

 

 

 

 

 

WAGES TO

 

 

WEEK

PROGRAM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOURS WORKED EACH DAY

 

 

EMPLOYEE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OT

ST

OT

ST

OT

ST

OT

ST

OT

ST

*Although this form has not been officially approved by the U.S. Department of Labor, it is designed to meet the requirements of both the state PWR law and the federal Davis-Bacon Act.

WH-38 (Rev. 01-09)

THIS FORM CONTINUED ON REVERSE

CERTIFIED STATEMENT

Date:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I,

 

 

 

 

,

 

 

 

 

 

 

 

 

(NAME OF SIGNATORY PARTY)

 

 

 

(TITLE)

 

 

do hereby state:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(1) That I pay or supervise the payment of the persons employed by:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(CONTRACTOR, SUBCONTRACTOR OR SURETY)

 

 

on the

 

 

 

 

 

 

 

 

 

 

; that during the payroll period

 

 

 

 

(BUILDING OR WORK)

 

 

 

 

 

 

commencing on the

 

 

day of

 

,

 

 

, and ending the

 

day

 

 

 

 

 

 

 

 

 

 

 

(MONTH)

 

(YEAR)

 

 

of

 

,

 

 

 

, all persons employed on said project have been paid the

 

 

(MONTH)

 

(YEAR)

 

 

 

 

 

 

full weekly wages earned, that no rebates have been or will be made either directly or indirectly to or on behalf of said

(CONTRACTOR, SUBCONTRACTOR OR SURETY)

from the full weekly wages earned by any person, and that no deductions have been made either directly or indirectly from the full wages earned by any person, other than permissible deductions as specified in ORS 652.610, and as defined in Regulations, Part 3 (29 CFR Subtitle A), issued by the Secretary of Labor under the Copeland Act, as amended (48 Stat. 948, 63 Stat. 108, 72 Stat. 967; 76 Stat. 357; 40 U.S.C. 276c), and described below:

(2)That any payrolls otherwise under this contract required to be submitted for the above period are correct and complete; that the wage rates for workers contained therein are not less than the applicable wage rates contained in any wage determination incorporated into the contract; that the classifications set forth therein for each worker conform with work performed.

(3)That any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with a state apprenticeship agency recognized by the Bureau of Apprenticeship and Training, United States Department of Labor, or if no such recognized agency exists in a state, are registered with the Bureau of Apprenticeship and Training, United States Department of Labor.

I HAVE READ THIS CERTIFIED STATEMENT, KNOW THE CONTENTS THEREOF AND IT IS TRUE TO MY KNOWLEDGE:

(NAME AND TITLE)

(SIGNATURE AND DATE)

In addition to completing sections (1) - (3), if your project is subject to the federal Davis-Bacon Act requirements, complete the following section as well:

(4) That:

(a)WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, FUNDS OR PROGRAMS

- In addition to the basic hourly wage rates paid to each laborer or mechanic listed in the above referenced payroll, payments of fringe benefits as listed in the contract have been or will be made to appropriate programs for the benefit of such employees, except as noted in Section 4(c) below.

(b) WHERE FRINGE BENEFITS ARE PAID IN CASH

- Each laborer or mechanic listed in the above referenced payroll has been paid, as indicated on the payroll, an amount not less than the sum of the applicable basic hourly wage rate plus the amount of the required fringe benefits as listed in the contract, except as noted in Section 4(c) below.

(c) EXCEPTIONS:

EXCEPTION (CRAFT)

EXPLANATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REMARKS:

NAME AND TITLE

SIGNATURE

THE 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 231 OF TITLE 31 OF THE UNITED STATES CODE.

FILE THIS FORM WITH THE CONTRACTING AGENCY

NOTE TO CONTRACTORS: YOU MUST ATTACH COPIES OF THIS FORM TO EACH OF YOUR PAYROLL SUBMISSIONS ON THIS PROJECT.

INSTRUCTIONS AND ADDITIONAL FORMS ARE AVAILABLE ON OUR WEBSITE: WWW.OREGON.GOV/BOLI.

WH-38 (Rev. 01-09)

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