HomeMy WebLinkAboutCertification of Understanding and Authorization Payroll- LB CERTIFICATION OF
UNDERSTANDING AND AUTHORIZATION
Project No: CDBG Project no.2.LE.84-22 / CIP NO. Z10084
Project Name: City of Lake Elsinore - SB-821 Lakeshore Drive ADA Sidewalk Improvement (CDBG Prc
This is to certify that the principals, and the authorized payroll officer, below, have read and
understand the minutes of the Pre-Construction Conference and the labor standards clauses
pertaining to the subject project.
The following person(s) is designated as the payroll officer for the undersigned and is authorized
to sign the Statement of Compliance, which will accompany our weekly-certified payroll reports
for this project.
This is to certify that the principals and the authorized payroll officer listed below have the
following:
➢ Read and understand the minutes of the Pre-Construction Conference;
➢ Read and understand the Federal Labor Standards Provisions ( HUD 4010) and/or;
if applicable
➢ Read and understand the State Prevailing Wage Requirements (California Labor Code
Section 1770 et esq.)
Panagiotis Leonida
Print or Type Payroll Officer(Name) Payroll Officer Signature)
05/27/2025
Date
Leonida Builders, Inc. 896772
Company Name(Contractor/Sub-contractor) Contractor/Sub- tr r License Number
Panagiotis Leonida
Print or type Owner/CEO(Name) Signature( ner/CEO)
President, Secretary & Treasurer 05/27/2025
Title Date
S:\CDBG\CONSTRUCTION\PRE CONSTRUCTION FORMS and CHECKLIST\Prime Connactor Fonns\New folder\Certification of Understanding and
Authorization Payroll,doc