Attachment 10: Payroll

(For Contractor’s Optional Use; See Instructions at www.dol.gov/whd/forms/wh347instr.htm)

Unless otherwise noted, the information requested is specific to the named project below. Persons are not required to respond to the collection of information unless it displays a currently valid OMB control number.

 SUBMISSION OF FINAL DBRA CERTIFIED PAYROLL FORM

 PRIME CONTRACTOR

Rev. January 2025

OMB No.: 1235-0008

Expires: 01/31/2028

 SUBCONTRACTOR

PROJECT NO. or CONTRACT NO.

CERTIFIED PAYROLL NO.

PRIME CONTRACTOR’S/SUBCONTRACTOR’S BUSINESS NAME

PROJECT LOCATION

WAGE DETERMINATION NO.

WEEK ENDING DATE

PRIME CONTRACTOR’S/SUBCONTRACTOR’S BUSINESS ADDRESS

DEDUCTIONS FOR ALL WORK

OTHER (MUST

SPECIFY, SEE

INSTRUCTIONS)

(8)

FICA

(7B)

TAX WITHHOLDINGS

(7A)

GROSS AMT EARNED

(6C)

PAYMENT IN LIEU OF

FRINGE BENEFITS

(6B)

TOTAL FRINGE

BENEFIT CREDIT

HOURS WORKED

EACH DAY

(6A)

HOURLY WAGE RATE

PAID FOR ST AND OT

(TOP) DAYS OF WORK WEEK

(BOTTOM) DATES

(5)

TOTAL HOURS

WORKED FOR WEEK

(4)

ST = STRAIGHT TIME

OT = OVERTIME

(3)

LABOR

CLASSIFICATION

(2)

(J) JOURNEYWORKER

(RA) REGISTERD

APPRENTICE

(1E)

WORKER

IDENTIFYING NO.

(1D)

WORKER MIDDLE

INITIAL

(1C)

WORKER FIRST

NAME

(1B)

WORKER LAST NAME

WORKER ENTRY NO.

(1A)

GROSS AMT EARNED

FOR ALL WORK

PROJECT NAME

(9)

NET PAY TO WORKER

FOR ALL WORK

Wage and Hour Division

Davis-Bacon and Related Acts Weekly Certified Payroll Form

TOTAL

DEDUCTIONS

U.S. Department of Labor

ST
OT
ST
OT
ST
OT
ST
OT
ST
OT
ST
OT
ST
OT
ST
OT
While use of Form WH-347 itself is optional, covered contractors and subcontractors performing work on Federal or federally assisted construction contracts are required by the DBRA regulations and the contract clauses to submit payroll information on a weekly basis. The Copeland Act (40 U.S.C. § 3145) requires contractors and subcontractors performing work on Federal or federally financed construction contracts to, on a weekly basis, “furnish a statement on the wages paid each employee during the prior week.” U.S. Department of Labor (DOL) Regulations at 29 C.F.R. § 5.5(a)(3)(ii) require contractors and subcontractors to submit weekly certified payrolls to the appropriate Federal agency if the agency is a party to the contract (or, if the agency is not such a party, to the applicant, sponsor, owner, or other entity, as the case may be, that maintains such records, for transmission to the Federal agency). Each certified payroll must be accompanied by a signed “Statement of Compliance” (e.g., page 2 of the WH-347 or another document with identical wording) indicating that the certified payrolls are accurate and complete, and that each laborer or mechanic has been paid not less than the required Davis-Bacon prevailing wage rate(s) (including