STATE OF OHIO
REQUEST FOR PREVAILING WAGE RATES

Important: If you wish to retain a copy of this form for your records, please print it prior to clicking on the "Submit" button. When you click the "Submit" button, a prompt should appear which will allow you to obtain the necessary wage rates by clicking on the "view wage rates" button. Submitting this form notifies the Bureau of Labor and Worker Safety of your project. Wage rates will not be sent to you by mail as a result of the submission, rather you should obtain them by clicking on the "view wage rates" button.

Public Authority Information
Date: 11/28/2014
This form must be filled
out completely & correctly
for us to process your
request. Forms not
completed correctly will
be returned to the sender.
Owner/Public Authority Name:
Department
Division or
Agency:
Street Address:
Address 2: ODOC Date Stamp
City, OH
ZIP:
Email:
It is required that you list your e-mail address here.
County of Public
Authority:
P.A. Phone:
Project Information
Project Name: ODOC Date Stamp (BId Tab)
Site Address:
City, OH
ZIP:
County of Project:
Prevailing Wage Coordinator Name
Address:
City,
ZIP:
Phone:
Issuing Authority of Bonds:
Estimated Total Overall Project Cost:
Type of Financing:
Type of Construction: New Construction Old Construction
This Project is Residential Commercial
Expected Date of Contract Award:
example 05/31/98
Projected Completion Date:
example 05/31/98
Project Comments: (optional)

Important: If you wish to retain a copy of this form for your records, please print it prior to clicking on the "Submit" button. When you click the "Submit" button, a prompt should appear which will allow you to obtain the necessary wage rates by clicking on the "view wage rates" button. Submitting this form notifies the Bureau of Labor and Worker Safety of your project. Wage rates will not be sent to you by mail as a result of the submission, rather you should obtain them by clicking on the "view wage rates" button.



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LAW 1002