Free Rev - Connecticut

Rev. 3/1/07

CONNECTICUT DEPARTMENT OF LABOR
PREVAILING WAGE RATES REQUEST FORM CONTRACTING AGENCY/POLITICAL SUBDIVISION OR THEIR AGENT REQUESTING RATES

Project Name and Number (If Applicable):

Location of Project: Project Description:

Total Cost of Project: Estimated Duration of the Project: Start Date: Date Advertised to Bid:
CHECK THE TYPE OF SCHEDULE(S) NEEDED: 1) BUILDING

End Date:

2) HEAVY/HIGHWAY 3) RESIDENTIAL 4) SPANISH RATES (available in Building Only upon request) MAIL PICK-UP OR E-MAIL (provide email address)

Please fax or mail to: Connecticut Department of Labor Wage & Workplace Standards Division Attention: Holly Carter 200 Folly Brook Blvd. Wethersfield, CT 06109 Fax Number (860)263-6541 Telephone Number (860)263-6549 Come visit us on our website at WWW.CT.GOV/DOL

Now you can request rates through our website at
WWW.CTDOL.STATE.CT.US/WGWKSTND/FORMS/PREVWGFM.HTM As required by law please submit requests for rates at least ten (10) days but not more than twenty (20) days prior to the date of advertisement for bid.

NAME, ADDRESS, AND TELEPHONE NUMBER OF PERSON REQUESTING RATES: