Web Content Viewer

Prevailing Wage Complaint Form

Prevailing Wage Complaint Form

You May File a Complaint With This Division If...

  1. You were or are employed on the project.
  2. You meet one of the following:
    1. Any person who submits a bid for the purpose of securing the award of a contract for construction of the public improvement.
    2. Any person acting as a subcontractor of a person mentioned in (B.1.) above.
    3. Any bona fide organization of labor which has as members or is authorized to represent employees of a person mentioned in (B.1. or B.2.) and which exists, in whole or in part, for the purpose of negotiating with employers concerning the wages, hours, or terms and conditions of employment of employees.
    4. Any association having as members any of the persons mentioned in (B.1. or B.2.) of this section.

Do Not Fill Out This Form If...

  • The project has been completed for two (2) years.
  • You acted as an 'independent contractor' and not as an 'employee' of the business, or you were self-employed.
  • You already have a judgement involving the same wage claim.
  • The contractor has filed for bankruptcy. (If so, you will need to contact the Bankruptcy Court for further instructions.)

Filing More Than One Complaint

  • You must use a separate complaint form for filing against each contractor and/or project.
  • Each claimant intending to file against a contractor and/or project must use a separate complaint form.

Completing The Prevailing Wage Complaint Form

  1. Download or view the form, then print out a copy of the form (it is a legal size document, 8½' by 11').
  2. Read all questions on the wage claim form carefully before answering. Please fill out your claim completely, legibly, and accurately. You must sign, date, and have it notarized.
  3. Provide the contractor's name, name of business, correct address, county, and telephone number.
    **You as the claimant are responsible for providing this information.**
  4. To help prove your claim, please provide copies of any documentation you have available. For example, pay stubs or a personal record of hours worked on the project. DO NOT SEND ORIGINALS.
  5. Be certain that your name, address, social security number, and telephone number are correct. If you do not have a telephone number, please supply this Division with a telephone number where we can reach you. If your address or telephone number changes, it is your responsibility to notify us immediately or your claim could be closed.