Form SF 1444 SF 1444 Request for Authorization of Additional Classification a

AUTHORIZED FOR LOCAL REPRODUCTION
CHECK APPROPRIATE BOX

REQUEST FOR AUTHORIZATION OF
ADDITIONAL CLASSIFICATION AND RATE

OMB Number: 9000-0089
Expiration Date: 7/31/2014

SERVICE CONTRACT
CONSTRUCTION CONTRACT

Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden,
to the Regulatory Secretariat Division (MVCB), GSA, Washington, DC 20417.
INSTRUCTIONS: THE CONTRACTOR SHALL COMPLETE ITEMS 3 THROUGH 16, KEEP A PENDING COPY, AND SUBMIT THE REQUEST, IN
QUADRUPLICATE, TO THE CONTRACTING OFFICER.
1. TO:

2. FROM: (REPORTING OFFICE)

ADMINISTRATOR,
WAGE AND HOUR DIVISION
U.S. DEPARTMENT OF LABOR
WASHINGTON, D.C. 20210

3. CONTRACTOR
5. CONTRACT NUMBER

4. DATE OF REQUEST
6. DATE BID OPENED (SEALED
BIDDING)

7. DATE OF AWARD

8. DATE CONTRACT WORK
STARTED

9. DATE OPTION EXERCISED (If
APPLICABLE) (SERVICE
CONTRACT ONLY)

10. SUBCONTRACTOR (IF ANY)
11. PROJECT AND DESCRIPTION OF WORK (ATTACH ADDITIONAL SHEET IF NEEDED)

12. LOCATION (CITY, COUNTY AND STATE)
13. IN ORDER TO COMPLETE THE WORK PROVIDED FOR UNDER THE ABOVE CONTRACT, IT IS NECESSARY TO ESTABLISH THE FOLLOWING RATE(S) FOR THE
INDICATED CLASSIFICATION(S) NOT INCLUDED IN THE DEPARTMENT OF LABOR DETERMINATION
NUMBER:

DATED:

a. LIST IN ORDER: PROPOSED CLASSIFICATION TITLE(S); JOB DESCRIPTION(S); DUTIES;
AND RATIONALE FOR PROPOSED CLASSIFICATIONS (SCA ONLY)

c. FRINGE BENEFITS
PAYMENTS

b. WAGE RATE(S)

(Use reverse or attach additional sheets, if necessary)

14. SIGNATURE AND TITLE OF SUBCONTRACTOR REPRESENTATIVE
(IF ANY)

15. SIGNATURE AND TITLE OF PRIME CONTRACTOR REPRESENTATIVE

16. SIGNATURE OF EMPLOYEE OR REPRESENTATIVE

TITLE

CHECK APPROPRIATE BOX-REFERENCING BLOCK 13.

AGREE

DISAGREE

TO BE COMPLETED BY CONTRACTING OFFICER (CHECK AS APPROPRIATE - SEE FAR 22.1019 (SERVICE CONTRACT LABOR
STANDARDS) OR FAR 22.406-3 (CONSTRUCTION WAGE RATE REQUIREMENTS))
THE INTERESTED PARTIES AGREE AND THE CONTRACTING OFFICER RECOMMENDS APPROVAL BY THE WAGE AND HOUR DIVISION. AVAILABLE
INFORMATION AND RECOMMENDATIONS ARE ATTACHED.

THE INTERESTED PARTIES CANNOT AGREE ON THE PROPOSED CLASSIFICATION AND WAGE RATE. A DETERMINATION OF THE QUESTION BY THE WAGE
AND HOUR DIVISION IS THEREFORE REQUESTED. AVAILABLE INFORMATION AND RECOMMENDATIONS ARE ATTACHED.
(Send 3 copies to the Department of Labor)

SIGNATURE OF CONTRACTING OFFICER OR
REPRESENTATIVE

PREVIOUS EDITION IS USABLE

TITLE AND COMMERCIAL TELEPHONE NUMBER

DATE SUBMITTED

STANDARD FORM 1444 (REV. 2/2012)
Prescribed by GSA-FAR (48 CFR) 53.222(f)