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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 <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 />information. (If additional space is needed, please photocopy this page). <br />100% Workers Pay Maintain <br />are Employees U.S. Dept. Contribute Contribute AffoTotue <br />Name and Address of Contract (Not Independent Labor Wage to a Health to a Pension Action <br />Construction Companv Amount Contractors) Rate (Y /N) Plan (Y /N) Plan (Y /N) Plan(YR <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 />W <br />(Rev 12/29/06) <br />