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23. In the following chart please list the companies that will be used for the construction associated with the project. Indicate the name and address of each company; <br />list the dollar amount of the work to be provided by each company; indicate whether or not 100% of the workers are employees of that company and not independent <br />contractors; indicate whether or not the company pays workers wages that meet the wage rates for each classification of laborers and mechanics published by the <br />U.S. Department of Labor; indicate whether or not the company contributes to a health plan for its employees; indicate whether or not the companycontributes to a <br />pension plan for its employees; and indicate whether or not the company maintains an affirmative action plan or other similar plan to achieve racial diversity. Local <br />companies include those located in St. Joseph County. Additional information may be requested for verification of this information. (If additional space is <br />needed, please photocopy this page). . <br />100% Workers Pay Maintain <br />are Employees U.S. Dept. Contribute Contribute Affirr~Gue <br />Name and Address of Contract (Not Independent Labor Wage to a Health to a Pension Action <br />Construction Company Amount Contractors) Rate (Y/Nl Plan (YIN) Plan (Y/N) Plan(YIM <br />Local Companies (see above): <br />1. <br />2. <br />3. <br />+ 4. <br />5. <br />6. <br />7. <br />8. <br />9. <br />10. <br />Total Local <br />Non-Local Companies: <br />1.Ancon Construction <br />2. <br />3. <br />4. <br />5. <br />Yes No Yes <br />Yes Yes <br />Total Non-Local <br />GRAND TOTAL <br />Total Project Cost from Petition <br />Difference (Please explain): <br />$72,000.00 <br />n;~~... to a.~c`W~`.. ~~'~'(~,E: <br />F E B - a 2003 <br />J0~~1 VGCf?~[ <br />CITYCLc~dK '_ ~'" ~ <br />~... ~=c~~, i^l. <br />. 17 <br />(Rev 12/29/06) <br />