wagecompMSBA Accelerated Repair Program
RK Finn/Ryan Road and Leeds Elementary Schools
Northampton, Massachusetts
Statement of Wage Rate Compliance Form
00 56 00
SECTION 00 56 00
STATEMENT OF WAGE RATE COMPLIANCE FORM
(Required at Contract signing – NOT required with bid)
A. Statement of Compliance: The Contractor and each Subcontractor shall furnish to the
Office of the Attorney General and to the City of Northampton, within 15 days after
completion of its portion of the work, fully completed and certified
copies of this “Statement of Wage Rate Compliance” certifying compliance with wage and
benefit provisions of M.G.L. Chapter 149, Sections 26 and 27, and as amended by
Section 331 of Chapter 110 of the acts of 1993.
Date: ____________________________ , 2015
I, ___________________________________________________,
(Insert name and title of signatory party.)
do hereby state that I pay or supervise the payment of the persons employed by
______________________________________________________________
(Insert name of Contractor or Subcontractor.)
on the Project: Roof Replacement at the RK Finn/Ryan Road & Leeds Elementary Schools,
Northampton, Massachusetts
(Insert name of Project)
and that all mechanics, apprentices, teamsters, chauffeurs, and laborers employed on said
project have been in accordance with wages determined under the provisions of Section 26
and 27 of Chapter 149 of the Massachusetts General Laws.
Signature ___________________________________
Title ____________________________________
This Statement is signed under penalties of perjury as provided for under Section 27B of
Chapter 149, Massachusetts General Laws.