COMMUNITY DEVELOPMENT DEPARTMENT
CITY OF PASADENA, TEXAS
Labor Standards Record
10/2020
Date: ______________________________
Subrecipient: ____________________________________ Ordinance No. _________ IDIS No. ______
Wage Decision Issued (Downloaded from www.wdol.gov) Issue Date: __________________________
Wage Decision Number: TX _______________ Confirmed Wage Decision Number: TX __________________
Published Date: ________ Confirmed Published Date: ________ 10-Day Confirmation Date: __________
Type of Work: HEAVY HIGHWAY BUILDING RESIDENTIAL
(Note: more than one may be check if fully justified in this record)
Contractor Eligibility Verification Contractor Clearance (http://www.sam.gov)
Prime Contractor: __________________________________________ Date Cleared: _____________________
Principal and Title: ___________________________________________________________________________
List of Subcontractors:
Name of Sub-Contractor
Date Cleared
Name of Sub-Contractor
Date Cleared
Construction Contract Amount: __________________ Bid Opening Date: ____________________
Contract Execution Date: _______________________ Construction Start Date: ________________
Verified By LSO: _____________________________ Date Verified: ________________________
LSO Signature: _______________________________________________________________________
LSO Email: __________________________________ LSO phone: _________________________