PROJECT NAME:



|Project Name: |Wage Decision Number/Modification Number: |

|      |      |

|Project Number: |Project County: |

|      |      |

| |Basic Hourly Rate (BHR)|Fringe Benefits|Total Hourly Wage Rate |Laborers | |

|Work Classification | | | |Fringe Benefits: |$       |

| | | | |Group # |BHR |Total Wage |

|Bricklayers |      |      |$      | | | |

| | | | | | | |

|Cement Masons |      |      |$      |      |      |$      |

| | | | | | | |

|Drywall Hangers |      |      |$      |      |      |$      |

| | | | | | | |

|Electricians |      |      |$      |      |      |$      |

| | | | | | | |

|Iron Workers |      |      |$      |      |      |$      |

| | | | |Operators | |

|Painters |      |      |$      |Fringe Benefits: |$      |

| | | | |Group # |BHR |Total Wage |

|Plumbers |      |      |$      | | | |

| | | | | | | |

|Sheet Metal Workers |      |      |$      |      |      |$      |

| | | | | | | |

|Soft Floor Layers |      |      |$      |      |      |$      |

| | | | | | | |

|Tapers |      |      |$      |      |      |$      |

| | | | |Truck Drivers | |

|Tile Setters |      |      |$      |Fringe Benefits: |$      |

| | |Group # |BHR |Total Wage |

|Other Classifications | | | | |

| | | | | | | |

|      |      |      |$      |      |      |$      |

| | | | | | | |

|      |      |      |$      |      |      |$      |

| | | | | | | |

|      |      |      |$      |      |      |$      |

| |

|Additional Classifications (HUD Form 4230-A) |

| | | | |Date of HUD | |

| |Basic Hourly Rate |Fringe Benefits|Total Hourly Wage Rate |Submission to DOL |Date of DOL Approval |

|Work Classification | | | | | |

| | | | | | |

|      |      |      |$      |      |      |

| | | | | | |

|      |      |      |$      |      |      |

| | | | | | |

|      |      |      |$      |      |      |

| | | | | | |

|      |      |      |$      |      |      |

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