Attachment 11: SF1444-23b Additional Classification and Rate

Check Appropriate Box
OMB Control Number: 9000-0066
Service Contract
Expiration Date: 5/31/2027
Construction Contract
Instructions: The Contractor shall complete items 3 through 16, keep a pending copy, and submit the request, in quadruplicate, to the Contracting Officer. Request For Authorization Of
Additional Classification And Rate

1. To:

Administrator,
Wage And Hour Division
U.S. Department Of Labor
Washington, DC 20210

3. Contractor

2. From: (Reporting Office)

4. Date Of Request

7. Date Of

5. Contract Number 6. Date Bid

Award
Opened (Sealed
Bidding)

8. Date Contract 9. Date Option Exercised
(If Applicable) (Service
Work Started
Contract Only)

10. Subcontractor (If Any)

11. Project And Description Of Work (Attach Additional Sheet If Needed)

12. Location (City, County, And State)

13. In Order To Complete The Work Provided For Under The Above Contract, It Is Necessary To Establish The Following Rate(s) For The Indicated Classification(s) Not Included In The Department Of Labor Determination
Number:
Dated:
b. Wage Rate(s)
c. Fringe Benefits
a. List In Order: Proposed Classification Title(s); Job Payments
Description(s); Duties; And Rationale For Proposed
Classifications (Service contracts only)
(Use reverse or attach additional sheets, if necessary)

14. Signature And Title Of Subcontractor

Representative (If Any)

Authorized For Local Reproduction
Previous Edition Is Not Usable

15. Signature And Title Of Prime Contractor
Representative

STANDARD FORM 1444 (REV. 10/2023)

Prescribed by GSA-FAR (48 CFR) 53.222(f)

16. Signature Of Employee Or Representative

Check Appropriate Box Referencing Block 13.
Agree
Disagree

Title

To Be Completed By Contracting Officer (Check As Appropriate - See FAR 22.1019 (Service Contract Labor Standards) Or FAR 22.406-3 (Construction Wage Rate Requirements)) The Interested Parties Agree And The Contracting Officer Recommends Approval By The Wage And Hour Division. Available Information And Recommendations Are Attached. The Interested Parties Cannot Agree On The Proposed Classification And Wage Rate. A Determination Of The Question By The Wage And Hour Division Is Therefore Requested. Available Information And Recommendations Are Attached.
(Send 3 copies to the Department of Labor)
Signature Of Contracting Officer Or
Representative

Title And Commercial
Telephone Number

Date Submitted

Paperwork Reduction Act Statement
This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the