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� � <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 /> owneNoperator workforce and positions of ownership. ❑ <br /> � � <br /> N�ti� <br /> � <br /> � The re uirements of this cert�cation and disclosure are a material a of the contr ct and the c n r r <br /> q p rt a , o t acto 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 /> ��� �� � <br /> , ; ` ;� <br /> Bidder: � t `, ' � <br /> �'�142��E�1c.wi� ��;►�i,�� Lu, By' ' . I <br /> `�'(Signature) <br /> � Address: I��� SI . ���� �iC K� Title: ��c�{:,�.c. �4,�7�L <br /> ���aC��iv�.J� h� C�30�4 <br /> � <br /> ' <br /> � I <br /> r <br /> � <br /> � <br /> � <br /> � <br /> � <br /> i <br /> Printed 4/812016 Page 2 of 2 BLR 12325(Rev.4/07) <br /> � <br />