PAGE 1 | PRE-CONSTRUCTION WORKFORCE AFFIDAVIT V. 11.2024 DWES
1. Project Sponsor’s Information
Name:
Department of Workplace and
Employment Standards (DWES)
250 Frank H. Ogawa Plaza, Suite 3341
Oakland, CA 94612
Email:
Address:
Telephone:
2. Property Information and Related Applications
Project Address:
Block/Lot(s):
Building Permit Application No(s):
Estimated Residential Units: Estimated SQ FT Commercial Space:
Estimated Height/Number of Floors: Estimated Construction Cost:
Anticipated Construction Start Date:
3. Construction Workforce Information
YES NO
A. Will the anticipated employee compensation by trade be consistent with area Prevailing Wage?
B. Will the awarded contractor(s) participate in an apprenticeship program approved by the State of California’s Department of Industrial Relations? C. Will workers be provided employer-sponsored health care benefits? D. Will workers need to provide their own tools to work on the project? E. What is the estimated number of City of Oakland residents to be hired?
PRE-CONSTRUCTION
Affidavit for
Construction Workforce
Required for all newly constructed buildings having at least one hundred (100) residential dwelling units or one hundred thousand (100,000) square feet of new non-residential floor area.
Submit with Building Permit Application (OMC 15.80.030 A.B.) DRAFT
Attachment B
PAGE 2 | PRE-CONSTRUCTION WORKFORCE AFFIDAVIT V. 11.2024 DWES
4. Construction Workforce Projections
Please provide the estimated number of employees from each construction trade to be used on the project, indicating how many are entry and/or apprentice level as well as the anticipated journeyman wage for these positions.
5. Construction Contractors
Please provide the name, scope of work, address, and contract value for all the construction contractors that will be used on this project:
NAME OF CONTRACTOR SCOPE OF WORK ADDRESS ESTIMATED
CONTRACT
VALUE
TRADE/CRAFT JOURNEYMAN
WAGE
# APPRENTICE
POSITIONS
# TOTAL
POSITIONS
Abatement
Laborer
Boilermaker
Bricklayer
Carpenter
Cement
Mason
Drywaller/
Latherer
Electrician
Elevator
Constructor
Floor Coverer
Glazier
Heat & Frost
Insulator
Ironworker
TOTAL:
TRADE/CRAFT JOURNEYMAN
WAGE
# APPRENTICE
POSITIONS
# TOTAL
POSITIONS
Painter
Pile Driver
Plasterer
Plumber and
Pipefitter
Roofer/
Waterproofer
Sheet Metal
Worker
Sprinkler
Fitter
Taper
Tile Layer/
Finisher
Other:
TOTAL:
Other:
Other:
Laborer
Operating
Engineer
DRAFT
PAGE 3 | PRE-CONSTRUCTION WORKFORCE AFFIDAVIT V. 11.2024 DWES
DECLARATION OF SPONSOR OF PRINCIPAL PROJECT
PRINT NAMEAND TITLE OF AUTHORIZED REPRESENTATIVE EMAIL PHONE NUMBER I HEREBY DECLARE UNDER PENALTY OF PERJURY THAT THE INFORMATION PROVIDED HEREIN IS ACCURATE TO THE BEST OF MY KNOWLEDGE . I ACKNOWLEDGE THAT THIS PROJECT MAY BE
REQUIRED TO SUBMIT ONGOING MONTHLY
PAYROLL RECORDS, BENEFITS REPORTS, AND A POST -CONSTRUCTION/POST-PROJECT COMPLETION REPORT VERIFYING WORKER AND BUSINESS UTILIZATION ON THE PROJECT. I ALSO ACKNOWLEDGE THAT THE PROJECT SPONSOR MAY BE SUBJECT TO A CIVIL PENALTY FOR 1) EACH MONTH FOR WHICH COMPLETE REPORTIN G IS NOT PROVIDED,
IN THE AMOUNT
OF TEN PRECENT OF THE DOLLAR VALUE OF CONSTRUCTION WORK PERFORMED ON THE PROJECT IN THE MONTH IN QUESTION , BUT NOT TO EXCEED TEN THOUSAND DOLLA RS FOR THAT MONTH, AND 2) NOT SUBMITTING A POST-CONSTRUCTION / POST-PROJECT COMPLETION REPORT WITHIN SIX MONTHS OF THE COMPLETION OF THE PROJECT, IN THE AMOUNT OF TEN THOUSAND DOLLARS. (SIGNATURE OF AUTHORIZED REPRESENTATIVE) (DATE)
FOR PLANNING DEPARTMENT STAFFONLY: PLEASE EMAIL AN ELECTRONIC COPY OF THE COMPLETED
CONSTRUCTION WORKFORCE AFFIDAVIT TO THE DEPARTMENT OF WORKPLACE AND EMPLOYMENT STANDARDS (DWES) –
FOR PLANNING DEPARTMENT STAFF ONLY: PLEASE EMAIL AN ELECTRONIC COPY OF THIS COMPLETED CONSTRUCTION WORKFORCE AFFIDAVIT TO THE DEPARTMENT OF WORKPLACE AND EMPLOYMENT STANDARDS (DWES) – [email protected]
oaklandca.gov/departments/workplace-employment-standards
NAME OF CONTRACTOR SCOPE OF WORK ADDRESS ESTIMATED
CONTRACT
VALUE
5. Construction Contractors (continued)
Please provide the name, scope of work, address, and contract value for all the construction contractors that will be used on this project:
NAME
DRAFT