Standard Wage Rate Determination for Certain Service Workers
For Users Using Screen readers:
Red asterisk (*) = required field
State Agent:
*
Contract Name and Number (if applicable):
Location of Work Being Performed:
*
Contract Description:
*
Total Cost of Contract:
*
Estimated Duration of The Project - Start Date:
*
-
Month
-
Day
Year
Date
Estimated Duration of The Project - End Date:
*
-
Month
-
Day
Year
Date
Date Advertised to Bid:
*
-
Month
-
Day
Year
Date
Name:
*
First Name
Last Name
Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number:
*
Please enter a valid phone number.
Email:
*
example@example.com
Please verify that you are human
*
Draw image for verification.
*
Submit
Should be Empty: