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(Insert) AGENCY LETTERHEAD
Pre-Construction Conference Checklist
Date:
Contract No.:
Enclosures:
___ Pre-Construction Conference/Labor
Compliance Outline
___ CEM 2501, Fringe Benefit Statement*
___ CEM 2502, Payroll*
___ CEM 2503, Statement of Compliance*
___ CEM 2505, Owner-Operator Listing*
___ CEM 2505, Owner-Operator Listing Statement of Compliance*
___ CEM 2510, Truck Owner-Operator Certification of Ownership*
___ DIR General Prevailing Wage Determinations
Posters: (Two Each - One for Job Site & One for Home Office)
___ Your Rights Under The Family and Medical Leave Act of 1993, (DLSE) (Federal)
___ PAYDAY Notice, Department of Labor Standards Enforcement, (DLSE) 8 (State)
___ EMERGENCY NUMBER LISTING (CAL/OSHA)S-500 (State)
___ EEO is THE LAW (English and Spanish) (OFFCP) (Federal)
___ Notice Federal Project (Federal aid Projects Only) (FHWA)-1022 (Federal)
___ Important Wage Rate Information (English and Spanish) (FHWA)-1495 (Federal)
___ Fraud, Waste or Abuse (FHWA) (Federal)
___ Safety and Health Protection (English and Spanish) (CAL/OSHA) (State)
___ All Employees Working on Federal or Federally Financed Construction Projects (DLSE) (Federal)
___ NOTICE Employee Polygraph Protection (English and Spanish) (DLSE) 1462 (Federal)
___ Discrimination and Harassment in Employment (English and Spanish) (DFEH)-162 (State)
___ Employee Rights on Government Constracts (DLSE) - 1313 (State)
By signature below, receipt of the Signature Form with enclosures is hereby
acknowledged.
| _____________________________________ |
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_____________________________________ |
| Prime Construction Representative (please
print) |
|
Labor Compliance Representative or Resident
Engineer |
| _____________________________________ |
|
_____________________________________ |
| Prime Contractor Representative (signature) |
|
Date |
Rev. 01/29/09
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