DOL Certified Payroll Form WH-347 Compliance Template

U.S. DEPARTMENT OF LABOR (DOL) CERTIFIED PAYROLL: WH-347 COMPLIANCE FORM

DOCUMENT CONTROL

• Effective Date: 2024-05-22
• Version: 2.0 (Compliance Standard)
• Jurisdiction: Davis-Bacon and Related Acts (DBRA) / Copeland Act (40 U.S.C. § 3141 et seq.)
• Scope: Federal/Federally-Assisted Construction Projects

1. OFFICIAL NOTICE / COMPLIANCE DISCLAIMER

NOTICE: This document constitutes a certified payroll record as required by 29 CFR Part 5. Falsification of this record may subject the contractor or subcontractor to civil or criminal prosecution (18 U.S.C. § 1001 and 31 U.S.C. § 3729). Failure to submit this form in accordance with contract specifications may result in the withholding of contract payments.

2. PARTIES & PROJECT IDENTIFICATION

• Contractor Name: [Insert Full Legal Entity Name]
• Project Name: [Insert Official Project Name]
• Project Location: [Insert Site Address/City/State]
• Payroll Period: From [Date] To [Date]
• Contract Number: [Insert Federal Contract ID]

3. OPERATIVE CLAUSES & TERMS

1. Compliance Warranty: The signatory certifies that all laborers and mechanics employed on the project have been paid in full for all hours worked at rates not less than those contained in the applicable Wage Determination.
2. Fringe Benefit Obligations: The signatory certifies that payments required by the wage determination have been met, either by payment to an established fringe benefit plan or via cash-in-lieu payments directly to the employee.
3. Deduction Integrity: The signatory certifies that all payroll deductions taken from employee gross pay are either (a) required by law, (b) authorized by a voluntary written agreement, or (c) permitted under 29 CFR Part 3.
4. Record Retention: The contractor acknowledges the mandate to maintain these records for a period of three (3) years following the completion of the project, accessible for audit by the U.S. Department of Labor or the contracting agency.

4. PAYROLL DATA MATRIX

(Note: Attach standard WH-347 spreadsheet grid here)

5. EXECUTION & ACKNOWLEDGMENT

STATEMENT OF COMPLIANCE: I, the undersigned, [Name of Authorized Representative], acting as [Title] for [Company Name], do hereby attest that the information provided herein is true, accurate, and complete to the best of my knowledge and belief.

• Signature: __________________________
• Date: [Date]
• Warning: Willful falsification of this statement may result in debarment from future federal contracts.

6. EXECUTION & ENFORCEMENT GUIDE

1. Validation: Ensure every employee entry corresponds exactly to the labor classification listed in the project’s specific Wage Determination (Davis-Bacon) attached to your Prime Contract.
2. Fringe Verification: If calculating fringe benefits "in-lieu," maintain itemized proof of calculation for each employee to justify the deduction against the total hourly package.
3. Submittal Protocol: Submit this form to the Contracting Officer or Agency Representative via the method mandated in the contract (e.g., LCPtracker, EMARS, or physical mail) no later than seven (7) days after the designated payroll payment date.
4. Audit Readiness: Store a "Compliance Folder" for each project containing the executed WH-347, signed employee timecards, and proof of electronic fund transfer (EFT) or cancelled check copies to demonstrate actual disbursement.