|This information is provided free of charge by the Department of Industrial Relations from its web site at www.dir.ca.gov. These regulations are for the convenience of the user and no representation or warranty is made that the information is current or accurate. See full disclaimer at http://www.dir.ca.gov/od_pub/disclaimer.html.|
(a) 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. Copies of the forms may be procured at any office of the Division of Labor Standards Enforcement (DLSE) throughout the state and/or:
Division of Labor Statistics & Research P.O. Box 420603 San Francisco, CA 94101
ATTENTION: Prevailing Wage Unit
Acceptance of any other format shall be conditioned upon the requirement that the alternate format contain all of the information required pursuant to Labor Code Section 1776. 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).
(b) Words of Certification. The form of certification shall be as follows: I, ________________ (Name-print) the undersigned, am ________________ (position in business) with the authority to act for and on behalf of ________________, (name of business and/or contractor) certify under penalty of perjury that the records or copies thereof submitted and consisting of ________________ (description, no. 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. Date:____________ Signature:_______________________
A public entity may require a more strict and/or more extensive form of certification.
NOTE: Authority cited: Sections 54 and 1773.5, Labor Code. Reference: Section 1776, Labor Code.
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