New Search
<br />CONTRACT FEE SECTION <br /> <br />PREVAILING WAGE RATE UNIT <br />BUREAU OF LABOR AND INDUSTRIES <br />800 N.E. OREGON ST., #1045 <br />PORTLAND, OR 97232-2180 <br />For Office Use Only: <br />PHONE: (971) 673-0852 <br />FAX: (971) 673-0769 <br />Project DB #:_____________ <br />PUBLIC WORKS FEE ADJUSTMENT FORM <br /> <br />THIS FORM TO BE USED FOR RECONCILIATION OF FEES UPON COMPLETION OF <br /> <br />PUBLIC WORKS PROJECTS <br /> <br />(As required by ORS 279C.825 and OAR 839-025-0210) <br /> <br /> <br />PUBLIC AGENCIES: <br /> Complete and mail this form to BOLI at the above address after completion of the public work <br />project and not less than 30 days after the final progress payment is made to the contractor. Public agencies are required to <br />determine the final contract price, including all change orders or other adjustments to the original contract price, and to <br />calculate the adjusted prevailing wage rate fee based on the revised contract price. Documentation must be included to <br />support the final contract price. Documentation of the final contract price may consist of change orders or other contract <br />documents substantiating the amount of the contract. The prevailing wage rate fee of one-tenth of one percent (.001) shall be <br />applied to the final contract price, with credit taken for fees already submitted. The public agency must submit any additional <br /> NO ADDITIONAL FEE IS <br />fee payable to BOLI, or submit any request for refund, with this adjustment form. <br />REQUIRED TO BE PAID, AND REFUNDS WILL NOT BE MADE, FOR RECONCILED AMOUNTS OF LESS <br />THAN $100.00. <br /> <br />PUBLIC AGENCY: AGENCY #: <br />City of Eugene 1336 <br /> <br />AGENCY CONTACT PERSON: PHONE: <br />Lynn Brogden 541-682-5238 <br /> <br />MAILING ADDRESS: <br />99 E. Broadway, Suite 400 <br /> <br />PROJECT NAME: <br />Delta Ponds Path - Goodpasture Island Road to Robin Hood Avenue <br /> <br />CONTRACT NAME (if part of larger project): <br /> <br /> <br />PROJECT NUMBER:PROJECT LOCATION: <br /> 4378 Goodpasture Island Road/Robin Hood Ave. <br /> <br />CONTRACTOR BUSINESS NAME (DBA): <br />MOWAT Construction Company <br /> <br />CONTRACTOR CCB#: DATE AWARDED: <br />167954 7/27/2009 <br /> <br />FINAL CONTRACT/PROJECT AMOUNT: FINAL FEE DUE: <br />3,872,637.26 3,872.64 <br />(Include all change orders and adjustments to the contract price) (Final Contract amount X .001) <br /> <br />ORIGINAL CONTRACT AMOUNT: INITIAL FEE PAID: <br />3,438,410.50 3,438.41 <br /> (Original Contract amount X .001) <br /> <br />TOTAL ADJUSTMENT: BALANCE DUE*: <br />434,226.76 $434.23 <br /> or <br /> REFUND DUE*: <br /> <br /> <br />*Final contract fee less initial fee paid <br />Sample Calculation: <br />Final Contract Amount: $400,000.00 Final Fee Due: $400.00 <br />Original Contract Amount: - 300,000.00 Initial Fee Paid: - 300.00 <br />Total Adjustment: $100,000.00 Additional Amount Due: $100.00 <br />(Please duplicate this form for future use) <br />WH-40 (Rev. 11/07) <br />