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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; indicate <br />whether or not the company pays workers wages that meet the wage rates for each classification of laborers and mechanics <br />published by the U. S. Department of Labor; indicate whether or not the company contributes to a health plan for its <br />employees; indicate whether or not the company contributes to a pension plan for its employees; and indicate whether or not <br />the company maintains an affirmative action plan or other similar plan to achieve racial diversity. Additional information <br />may be requested for verification of this information. (If additional space is needed, please photocopy this page). <br />The Contractors to be used for this project are unknown due to its speculative nature <br />Construction Company Cost of All Workers <br />Name and Address W <br />k Pay Contribute Contribute Maintain <br />or <br />Employees or Wage to a to a Affirmative <br />or independent Rate Health Pension Action <br />contractors (y/n) Plan (y/n) Plan (y/n) Plan (v/nl <br />..n <br />s;i <br /> <br />~ <br />c <br />~ <br />. <br />~a r <br /> <br />' ~ <br />I - ~ <br />i ` <br />s W ~s <br />Y p', <br />'4~ I <br />~ <br /> ~ <br />i ~- <br /> U~ i <br />(Rev 8/11/03) 10 <br />