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23. In the following chart please list the companies that will be used for the construction associated with the project. lncilcate the name anu <br />address of each company; list the dollar amount of the work to be provided by each company; indicate whether or not 100% of the workers <br />are employees of that company and not independent contractors; indicate whether or not the company pays workers wages that meet the <br />wage rates for each classification of laborers and mechanics published by the U.S. Department of Labor; indicate whether or not the <br />company contributes to a health plan for its employees; indicate whether or not the company contributes to a pension plan for its <br />employees; and indicate whether or not the company maintains an affirmative action plan or other similar plan to achieve racial diversity. <br />Local companies include those located in St. Joseph County. Additional information may be requested for verification of this <br />informations. (If additional space is needed, please photocopy this page). <br />Name and Address of <br />Construction Company <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. <br />- 2. <br />`3. <br />4. <br />5. <br />Total Non-Local <br />GRAND TOTAL <br />Total Project Cost from Petition <br />Difference (Please explain): <br />100% Workers <br />are Employees <br />Contract (Not Independent <br />Pay <br />U.S. Dept. Contribute <br />Labor Wage to a Health <br />Rata /Y/N1 Plan (Y/Nl <br />F~f~;a (~~ C;~~'~'~ ~ 1( <br />MAR 1 9 2008 <br />~crN vco»~ <br />9 CITY CLCt1K, SQ, aEn'D, 11V. <br />Maintain <br />Contribute <br />to a Pension Action <br />(Rev 12/29/06) <br />