- Reporting Format: The format for reporting of payroll records requested pursuant to Labor Code Section 1776 shall be on a form provided by the public entity. If, however, the contractor does not comply with the provisions of Labor Code Section 1776, the Labor Commissioner may require the use of DIR's suggested format, "Public Works Payroll Reporting Form" (Form A-1-131). Copies of the forms may be procured at any office of the Division of Labor Standards Enforcement (DLSE) and/or:
Acceptance of any other format shall be conditioned upon the requirement that the alternative format contain all of the information required pursuant to Labor Code Section 1776.
Division of Labor Statistics & Research
P.O. Box 420603
San Francisco, CA 94101
Attn: Prevailing Wage Unit
- Wording for Certification: The form of certification shall be as follows:
I, (insert name), the undersigned, am (insert title of position with company) with the authority to act for and on behalf of (insert name of business and/or contractor). I certify under penalty of perjury that the records or copies thereof submitted and consisting of (insert description of documents and number of pages) are the originals or true, full and correct copies of the originals which depict the payroll record(s) of the actual disbursements by way of cash, check, or whatever form to the individual or individuals named.
A public entity may require a more strict and/or more extensive form of certification
NOTE: Authority cited: Labor Code sections 54 and 1773.5. Reference: Labor Code section 1776
- Statement of Employer Payments: Click on the following link to access Form PW 26
Past DLSE debarments (Public works contractors)
For a list of past DLSE debarments of public works contractors, please contact:
Special Assistant to the Labor Commissioner
455 Golden Gate Ave., 9th Flr.
San Francisco, CA 94102