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23.In the following chart please list the companies that will be used for the construction or rehabilitation associated with <br />the project. Indicate the name and address of each company; list the dollar amount of the work to be provided by each <br />company; indicate whether or not 100% of the workers are employees of that company or independent contractors; <br />indicate whether or not the company pays workers wages that meet the wage rates for each classification of laborers <br />and mechanics published by the U.S. Department of Labor; indicate whether or not the company contributes to a <br />health plan for its employees; indicate whether or not the company contributes to a pension plan for its employees; <br />and indicate whether or not the company maintains an affirmative action plan or other similar plan to achieve racial <br />diversity. Additional information may be requested for verification of this information. (If additional space is needed, <br />please photocopy this page). <br /> <br />~ <br /> _ <br /> C <br />r ~- Z <br />c <br />~~ N <br /> <br />~ <br />o <br />~ ~ O <br />Construction Company Cost of All Workers Pay Contribute Contribute Maintain <br />Name and Address Work Employees or Wage to a to a Affirmative <br />independent Rate Health Plan Pension Plan Action Plan <br />contractors /n /n /n /n <br />c <br />Mid-States Construction, Inc. $300, 000 Employees -100% Y Y Y N <br />53697 C.R. 9 North <br />Elkhart, IN 4651 S <br /> <br /> <br /> <br /> <br /> <br /> <br />t`7 <br />~'L <br />~7 <br />n= m o ~- <br />°' ,~.. <br />r.,. <br />z °"' <br />CJ <br />9 <br />