{{#if_eq ApplicationType.Display 'Renewal Application' }}
Pay Type
How many workers with disabilities were paid an hourly subminimum wage during the most recently completed fiscal quarter?
What was the job or contract on which the employer employed the largest number of workers at hourly subminimum wage rates during the most recently completed fiscal quarter?
Description of Work Performed on this Job/Contract by Workers Paid Subminimum Wages
Which method did the employer use to determine the prevailing wage for the job or contract identified above?
Prevailing wage determined based on this survey
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| Basis for Conclusion Wage Rate is Not Based on Entry Level | {{ ConclusionWageRateNotBasedOnEntry }} |
Description of Work (include job classification code, if known)
Alternate data source used
Prevailing wage provided by source
Date data retrieved
Attach the applicable SCA Wage Determination
Attachments are included at the end of the PDF.
{{/if_eq}}How frequently does the employer conduct work measurements or time studies of each worker with a disability who is paid an hourly subminium wage?
Attach a work measurement or time study for ONE currently employed worker with a disability who is paid an hourly subminimum wage for the contract identified above.
Attachments are included at the end of the PDF.
How many workers with disabilities received subminimum wages and were paid piece rates during the most recently completed fiscal quarter?
What was the job or contract on which the employer employed the largest number of workers who received subminimum wages and were paid piece rates during the most recently completed fiscal quarter?
Description of Work Performed on this Job/Contract by Workers Paid Subminimum Wages
Which method did the employer use to determine the Prevailing Wage for the job or contract identified above?
Prevailing Wage Determined based on this survey
| Source Employer Name | {{ EmployerName }} |
|---|---|
| Address | {{ formatAddress Address }} |
| Telephone Number. | {{ Phone }} |
| First Name of Individual Contacted | {{ ContactFirstName }} |
| Last Name of Individual Contacted | {{ ContactLastName }} |
| Title of Individual Contacted | {{ ContactTitle }} |
| Date of Contact | {{ formatDateTime ContactDate }} |
| Brief Description of Job/Task | {{ JobDescription }} |
| Experienced Worker Wage Provided | {{ ExperiencedWorkerWageProvided }} |
| Basis for Conclusion Wage Rate is Not Based on Entry Level | {{ ConclusionWageRateNotBasedOnEntry }} |
Description of Work (include job classification code, if known)
Alternate data source used
Prevailing wage provided by source
Date data retrieved
Attach the applicable SCA Wage Determination
Attachments are included at the end of the PDF.
{{/if_eq}}Descripton of Work
Prevailing Wage Determined for This Job
Standard Productivity
Piece Rate Paid to Workers
Attach all documentation of the methods used to determine the standard productivity and the piece rate.
Attachments are included at the end of the PDF.