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3966210-647700Phone: 207-623-7917Fax: 207-623-7937E-mail: Bobbie.J.Johnson-DOL@00Phone: 207-623-7917Fax: 207-623-7937E-mail: Bobbie.J.Johnson-DOL@-411480-693420Maine Department of LaborBureau of Labor Standards State House Station 45Augusta, Maine 04333-004500Maine Department of LaborBureau of Labor Standards State House Station 45Augusta, Maine 04333-00451682115-836295Survey of Construction Wage Rates00Survey of Construction Wage Rates-45720046386751. How many hourly paid construction trades workers (including hourly paid working supervisors) were working in Maine for your company during the two-week survey period (July 12, 2020 through July 25, 2020.)? Construction Industry Workers: total: _____________2. If you had divers or flaggers working for your company anytime between 07/12/2020 and 07/25/2020, you must indicate here and include their most recent wage and benefit information in Section D on the back of this form. Underwater Construction Divers total: ____________ Flaggers total: ____________ 001. How many hourly paid construction trades workers (including hourly paid working supervisors) were working in Maine for your company during the two-week survey period (July 12, 2020 through July 25, 2020.)? Construction Industry Workers: total: _____________2. If you had divers or flaggers working for your company anytime between 07/12/2020 and 07/25/2020, you must indicate here and include their most recent wage and benefit information in Section D on the back of this form. Underwater Construction Divers total: ____________ Flaggers total: ____________ -4572004352925Section B. Employment00Section B. Employment-4572007105650The information in this report is true to the best of my knowledge and can be documented by company wage and hour records.Name and Title (print or type)____________________________________ Telephone_____________________ E-mail Address__________________________________________ Fax___________________________The Bureau is authorized by 26 M.R.S. §43 and §1301 – 1315 to require that you provide this information. Any written false statement on this form constitutes an unsworn falsification in violation of 17-A M.R.S. § 453 and is a Class D crime.?00The information in this report is true to the best of my knowledge and can be documented by company wage and hour records.Name and Title (print or type)____________________________________ Telephone_____________________ E-mail Address__________________________________________ Fax___________________________The Bureau is authorized by 26 M.R.S. §43 and §1301 – 1315 to require that you provide this information. Any written false statement on this form constitutes an unsworn falsification in violation of 17-A M.R.S. § 453 and is a Class D crime.?-457200403860000-457200377190000-457200349567500-457200171450Please complete this report using information for the two-week period from July 12, 2020 through July 25, 2020. You may use payroll periods that encompass this time frame.? 00Please complete this report using information for the two-week period from July 12, 2020 through July 25, 2020. You may use payroll periods that encompass this time frame.? 3314700240665Please return your survey form no later than:October 17, 2020 00Please return your survey form no later than:October 17, 2020 -30480039370003406140120015The filing of this report is Mandatory by Law for all construction firms doing work in the State of Maine in accordance with Title?26?M.R.S. Chapter 15 §1303-1315. The information provided is confidential, and the data from individual firms and establishments will not be made public. Failure to complete and return the survey by the date specified will result in the following penalty being assessed against your business.$250 first offense; $500 2nd offense; $1,000 any subsequent offense.00The filing of this report is Mandatory by Law for all construction firms doing work in the State of Maine in accordance with Title?26?M.R.S. Chapter 15 §1303-1315. The information provided is confidential, and the data from individual firms and establishments will not be made public. Failure to complete and return the survey by the date specified will result in the following penalty being assessed against your business.$250 first offense; $500 2nd offense; $1,000 any subsequent offense.-457200271145Complete Sections A through D if you have 5 or more construction workers for the two-week period from July 12, 2020 through July 25, 2020. If you have fewer than 5 construction employees (other than DIVERS or FLAGGERS), complete this page only. All DIVERS and FLAGGERS must be indicated in Section B and listed in Section D.00Complete Sections A through D if you have 5 or more construction workers for the two-week period from July 12, 2020 through July 25, 2020. If you have fewer than 5 construction employees (other than DIVERS or FLAGGERS), complete this page only. All DIVERS and FLAGGERS must be indicated in Section B and listed in Section D.-3429004558030Section C. Company Representative00Section C. Company Representative-2476501262380YesNo (Please describe your new business) ____________________________________________________________Closed-Out of Business: Date: __________________Out 00YesNo (Please describe your new business) ____________________________________________________________Closed-Out of Business: Date: __________________Out -457200948055Section A. Business Type: Are you still in the construction industry?00Section A. Business Type: Are you still in the construction industry?The filing of this report is Mandatory by Law for all construction firms doing work in the State of Maine in accordance with Title?26?M.R.S.A. Chapter 15 §1303-1315. The information provided is confidential, and the data from individual firms and establishments will not be made public.-144780565150031432599695If you have fewer than 5 employees other than DIVERS and FLAGGERS (see Section B, question 2), DO NOT complete this section.00If you have fewer than 5 employees other than DIVERS and FLAGGERS (see Section B, question 2), DO NOT complete this section.-790575-838200(See Occupational Codes, Titles and Description)Hourly Benefits(See Benefit Instructions)CountyConstruction Type (See Instructions) CodeOccupationNumber ofEmployeesHourlyRateI.Health &WelfareII.Annuity,Pension orRetirementIII.Vacation,Holidays,Sick DaysIV. Per Diem in Lieu of WagesV.OtherAndroscoggin, Aroostook, Cumberland, Franklin, Hancock, Kennebec, Knox, Lincoln, Oxford, Penobscot, Piscataquis,Sagadahoc, Somerset, Waldo, Washington, York(B1, B2, HV, HI)**Welders should be listed under the trade to which welding is incidental.(Select One Per Line)(One Per Line)140Painter (example)1$10.00$2.47$3.24$0.83$0.78$0.12AndB112345678910111213141516171819202122232425544830093345Company Name: MERGEFIELD mm_legal_name PRECISION TILE LLC00Company Name: MERGEFIELD mm_legal_name PRECISION TILE LLC20955093345Section D. Employment and Wages by Occupation (July 12-25, 2020)00Section D. Employment and Wages by Occupation (July 12-25, 2020)-533406932295Rev. 6/19/2000Rev. 6/19/2082010256932295Page ___ of ___00Page ___ of ___ ................
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