PROJECT NAME PROJECT NO.

CONTRACTOR CONTRACT NO.

SUBCONTRACTOR DATE

HOURLY LABOR RATE WORKSHEET

TRADE: CLASSIFICATION:
Rate Prevailing Wage Rate
Item Per $100 Regular Time Overtime Double Time Notes

Base Labor Rate

Benefit Benefit
Paid Provided
Fringe Benefits: (put X in appropriate box)

Pension 1
Health/Welfare 1
Training/Certification 1
Vacation/Holiday 1
Other
Fringe Benefits Subtotal

Total Hourly Rate

Benefits Paid
Total Paid Hourly Rate

Burden: Taxes & Insurance 2

Other 1
Other 1
Burden Subtotal

Contractor Liability Insurance

Small Tools

Other (warranty, record drawings,

payment bonds, performance bonds, etc.)
TOTAL HOURLY RATE (Total Hourly Rate + Burden) = Amount Contractor paid to employee

Rates certified by: Company Name:

(print name)

Signature:

Construction Mgmt.
703.33 - 04/12