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INSTRUCTIONS FOR C(7MPLETING PAYROLUCERTIFIED STATEMFNT FORM, <br />WH-38 (Rev 6/96) <br />~Qlsdtriil__$_-_T4I31~2~~s1~Ii4Lts. _E-JS~A. .f_.EI~._~T~3TE~~I~~ Enter the total arnount oi deductic~ns withheld irom <br />each employce for just those haurs reporied on this payrolllcertified statement for tiiis project. All deductions <br />must be in accordance with the provisions of ORS 652.610. <br />~_41~1z111 ~__-._I`1~I_~1/~g~~__F's2iS~ 14C YV~~k~ Enter the amount of wage actually paid to the employee after <br />subtracting the total deductions reported in ~1~~~$ from the flross amour7t eamed shown in ~I~p7r~_~_ <br />~Ql~[na_~_4_~_ti~suly_~ru~~_E~~n4fii f'~i~_t4__P_~r1Y~.-~la1~Es~n~~1_~'s.Q~r~m; Fnter the hourly amount of fringc <br />benefits paid to each individually approved party, plan, fund or program tor eac,h employee. List these amounts <br />separately on the lines provided. Any contactor who is making payments ta approved parties, plans, funds or <br />programs in ~mQ~ilt~1~~~_II]~r1_Ihf; t~q~if~~_f14~[lY_111II9~_12~Il~iI is obligated to pay the difference directly to <br />the employee as wages in lie~.i of iringe benefits, and to show that emount in ~41S~i1]iLS of this form. <br />~Q1S1~lII~_I__I~l~~_41~~[1.~fiI~P~.CtY._L'l~n Fund or Progr~m: Enter the name of the party, plan, fund or proflram <br />that corresponds to the amount shown as an hourly (ringe benefit in ~Q1Slmn_14~ <br />~~m~[X - In order to determinc if the wages and fringe benefits being certified by this statement are sufficient <br />to meet prevailinq wage rate reyuiremenis, the following check may be periormed: <br />1. Consider each Trade C;lassiticetion listed in Column 2. <br />Z For that Trade Classiticatior~, take the sum of: <br />a) the Basic Hourly Rate of Pay (Column 51, <br />b) the Nourly Fringe Benefit Paid as Wage to Employee (Column G~, <br />c) and the Hourly Fringe Benefit Paid 7o Party, Plan, Fund or Proc~ram lColumn 10). <br />3. This sum must equal ar exceed the sum of the Basic Hourly Rate (including zone pay and special <br />wac~e differentials, ii anyl and the Fringe Benefit as they are listed for that Trade Classification <br />in the appropriately dated issue of the Bureau of Labor and Industries publication p1~ys~ili~g_1/1!2g4_ <br />R~ts,~_for Public Y~CQrk~_~s~ntr~s~t~~n oregon. <br />•N <br />NOTICE TO CONTRACTORS: YOU ARF NO LONGER REQUIHEU TO SUE3MIT COPIFS OF THE PAYROLL/CFRTIFIED <br />STATEM[NT TO 7HE BUR[AU <)F LABOR AND INDUSTRIES. THE STATEM[NT MUS7 RE SUF3MITTED TO THE PHOJECT <br />CONTFACTING AGENCY. <br />G:\WIID\PWR\BOOKLET\3l1IN51 $AM <br />