Wage Rate Submittals

Provide the base hourly rates & the total fringe benefit rate for the respective crafts & classifications, please list if Building and/or Heavy or Highway.
 
ClassificationEffective Date IncreasesBase Hourly RateHourly Benefit Total
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Please list the geograhical areas covered (counties):
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Parties to Collective Bargaining Agreement:  Yes ( ) No ( )
If yes, Local Number: ______________________________________________________
If Yes: The actual contract must accompany this form.
Submitted By: Contractor (  ) Representative (  )  Date: _______________________
 
Print Name: ________________________  Signature: ______________________________
 
TItle: ________________________________________________________________________
 
Print Address: ________________________________________________________________
 
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Telephone: ______________________  Fax: _______________________________
 
E-mail Address: __________________________
 
Return Completed Form To:
 
Commonwealth of Pennsylvania
Department of Labor and Industry
Room 1301
651 Boas Street
Harrisburg, PA 17121
Phone: 717-705-5969
Fax: 717-787-0517
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