Form HUD 4230A HUD 4230A REPORT OF ADDITIONAL CLASSIFICATION AND RATE

Report of Additional Classification and Wage Rate and Maintenance Wage Rate Recommendation and Maintenance Wage Survey

4230A-Report of Additional Classification and Rate

HUD-4230A Report of Additional Classification and Wage Rate and Instructions

OMB: 2501-0011

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U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT

REPORT OF ADDITIONAL CLASSIFICATION AND RATE

HUD FORM 4230A


OMB Approval Number 2501-0011

(Exp. xx/xx/xxxx)


1. FROM (name and address of requesting agency)

     


2. PROJECT NAME AND NUMBER

     

     


3. LOCATION OF PROJECT (City, County and State)

     


4. BRIEF DESCRIPTION OF PROJECT

     


5. CHARACTER OF CONSTRUCTION


Building

Heavy

Highway

Residential

Other (specify)

     


6. WAGE DECISION NO. (include modification number, if any)

     

COPY ATTACHED

DATE of WAGE DECISION

     

7. WAGE DECISION EFFECTIVE DATE or LOCK-IN?

     


8.

WORK CLASSIFICATION(S)

HOURLY WAGE RATES




BASIC WAGE

FRINGE BENEFIT(S) (if any)


     

     

     

     

     

     

     

     

     

     

     


     

     

     

     

     

     

     

     

     

     

     


     

     

     

     

     

     

     

     

     

     

     



9. PRIME CONTRACTOR (name, address)

     

     

9c.


Agree


Disagree

10. SUBCONTRACTOR/EMPLOYER, IF APPLICABLE (name, address)

     

     

     

     


9a. SIGNATURE

     

DATE



Check All That Apply:


The work to be performed by the additional classification(s) is not performed by a classification in the applicable wage decision.


The proposed classification is utilized in the area by the construction industry.


The proposed wage rate(s), including any bona fide fringe benefits, bears a reasonable relationship to the wage rates contained in the wage decision.


The interested parties, including the employees or their authorized representatives, agree on the classification(s) and wage rate(s).


Supporting documentation attached, including applicable wage decision.


Check One:


Approved, meets all criteria. DOL confirmation requested.


One or more classifications fail to meet all criteria as explained in agency referral. DOL decision requested.



     



     


FOR HUD USE ONLY

LR2000:






Agency Representative

(Typed name and signature)



Date


Log in:      








     


Log out:      








Phone Number





HUD-4230A (2-19) PREVIOUS EDITION IS OBSOLETE



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