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r <br /> IV. Except for any work identified above,any bidder or subcontractor that shall perform all or part of the work of the <br /> contract or deliver and install proposal solely by individual owners, partners or members and not by employees to <br /> whom the payment of prevailing rates of wages would be required, check the following box, and identify the <br /> owner/operator workforce and positions of ownership. p <br /> The requirements of this certification and disclosure are a material part of the contract, and the contractor shall require this <br /> ' certification provision to be included in all approved subcontracts. The bidder is responsible for making a complete report <br /> and shall make certain that each type of work or craft job category that will be utilized on the project is accounted for and <br /> listed. The Department at any time before or after award may require the production of a copy of each applicable <br /> Certificate of Registration issued by the United States Department of Labor evidencing such participation by the contractor <br /> and any or all of its subcontractors. In order to fulfill the participation requirement, it shall not be necessary that any <br /> applicable program sponsor be currently taking or that it will take applications for apprenticeship,training or employment <br /> during the performance of the work of this contract or deliver and install proposal. <br /> IV0113 DOM OW'q IDC 1-1-2 <br /> Bidder: _ J1C lic A t (� By: <br /> 31,q ckli %1O (Signature) <br /> Address: /(�p�i( , 1��f�j,2, Title: Whig e �5 <br /> 1 <br /> 1 <br /> 1 <br /> 1 <br /> 1 <br /> 1 <br /> 1 <br /> 1 <br /> 1 <br /> ' Printed 5/4/2018 Page 2 of 2 BLR 12325(Rev.4/07) <br />