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1.16 plttll T1r1�ill�ltg Goal C1lwleull�tiolt arld 1'"t1,i°trtersi�ip ,grernent <br />Step 1: Determine the total number of hours worked in the highway construction trades on INDOT <br />federal -aid contracts (either as a prime contractor or subcontractor) during the past three years. <br />Do not include hours worked on state -funded and private work. <br />HOURS WORKED DURING 2016 HOURS 2017 HOURS 2018 HOURS <br />TOTAL <br />Step 2: Add the total number of hours from each year and divide by three (3): <br />2016 2017 2018 Average Hours <br />Step 3: Multiply the "Average Hours" by five percent (5%): <br />X <br />Average Hours 2019 Training <br />Goal <br />I 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 INDOT USE <br />Company Name I Authorized Signature Dale <br />1/15/19 <br />Authorized Signature Dale <br />Katie Daniels. OJT Program Lead <br />,�\ =,�a, I \ ')'.- ) zi, <br />printed Name alld Title <br />._ <br />rc, n c. �.,... "S^+.. t" .cx 4 ... C` <br />,_^"i....- C.,.. ,rut '�wt».. 1"q, C »r e,.�:�„ tt c-,r r U <br />r` ' C <br />Please detach Section 1.16 and return to INDOT c% Katie Daniels at <br />lydanieIs 2 ra indot.1n gqy. <br />Please submit your approved OJT training program documentation as well. <br />8 <br />