Finance Committee - Agenda - 11/6/2019 - P102

(b) WHERE FRINGE BENEFITS ARE PAID IN CASH

Cc — Each laborer or mechanic listed in the above referenced payroll has been paid,
as indicated on the payroll, an amount not fess than the sum of the applicable
basic hourly wage rate plus the amount of the required fringe benefits as listed
in the contract, except as noted in section 4(c) below.

(c) EXCEPTIONS

EXCEPTION (CRAFT) EXPLANATION

REMARKS:

NAME AND TITLE SIGNATURE

THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEMENTS MAY SUBJECT THE CONTRACTOR OR
SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION, SEE SECTION 1001 OF TITLE 18 AND SECTION 231 OF TITLE

34_OF THE UNITED STATES CODE,