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Step 1; Determine the tota( number of hours worked, in the highway construction trades on I1DOT <br />federal -aid contracts (either as a prime contractor or subcontractor) during the past three years. <br />Do nat include hours worked on state, -funded and private work. <br />5-1OURS WORKED DURING <br />2015 HOURS <br />.2016 HOURS <br />HOURS <br />TOTAL <br />Step 2: Add the total nlunber of hours from each year and divide by three (3): <br />11, 784 <br />+ 122 _r <br />2526 <br />14 432 <br />- 3 <br />2615 <br />2016 2017 <br />Average Hours <br />Step 3; Multiply the "Average Hours." by five percent (5%); <br />4 �11 X OS w 240 <br />Avcmge Hato 2018 Training <br />G0a1 <br />1 hereby agree to all of the terms and conditions contained herein and affirm under penalty and perjury <br />that the information stated above. is true and accurate. <br />FOR CONTRACTOR USE FOR 1(NDOT USE <br />Company Nanoa - Autfmizcd Si� Date i <br />Sel e Constructio Co. Inc <br />Bruce <br />Safety & Resources <br />n. coin <br />.please Much Section 1.16 and return to INDOT cJo Katie Dunfers tit i��`wi rl,zfr�iorrl�vr'. <br />7 <br />