 
 
MISSOURI DEPARTMENT OF LABOR AND INDUSTRIAL RELATIONS
DIVISION OF LABOR STANDARDS
PREVAILING WAGE
PROJECT NOTIFICATION – CONTRACTOR INFORMATION NOTIFICATION
The information below is requested pursuant to Sections 290.210 through 290.340 and 290.550 through 290.580
REVISED STATUTES OF MISSOURI.
| 1. | Date of Notification |   | 2. Annual Wage Order No. Included in Bid Specifications | 
|   |   |   |   |   | 
| 3. | Popular or Descriptive Name of Project |   |   |   | 
|   |   |   |   |   | 
| 4. | Estimated Project Cost of Completion |   |   |   | 
|   | (total construction contracts to be awarded) | $ |   |   | 
|   |   |   | 
| 5. | Exact Location of Project *Specify Name of 1County and 2City, Village or District | 
|   | County | City or Village |   | Township | 
|   |   |   |   |   | 
| 6. | Official Name of Public Body or Agency |   |   |   | 
|   |   |   |   |   | 
| 7. | Name of Contact Person |   |   | 8. Phone Number (include area code) | 
|   |   |   |   |   | 
| 9. | Address |   |   |   | 
|  |  |  |  |  | 
| 10. | E-mail Address | Website |   | 
|   |   |   |   | 
| 11. | Anticipated Date for Soliciting or Advertising for Bids | 12. | Anticipated Date for Contract Awarding | 
|   |   |   |   | 
| 13. | Proposed Date for Start of Work on Project | 14. | Estimated Date of Project Completion | 
|   |   |   |   | 
| 15. | Will There Be Any Federal Funds Used in this Contract? | Yes | No | 
|   |   |   | 
| 16. | Contractor Information Notification (Optional, please provide if available.) |   | 
General Contractor: Name
|  |  |  |  |  |  |  |  | 
| Address |   |   |   |   |   | 
| City |   |   | State |   | Zip |   | 
| List all Sub-Contractors: |   |   |   |   |   | 
| Name |   |   |   |   |   |   | 
| Address |   |   |   |   |   | 
| City |   |   | State |   | Zip |   | 
| Name |   |   |   |   |   |   | 
| Address |   |   |   |   |   | 
| City |   |   | State |   | Zip |   | 
The state of Missouri requires workers on public works projects be paid prevailing wage. Public bodies have certain duties required to fulfill under this law (Section 290.210 - 290.340 RSMo).
Mail, Fax or E-mail completed form to:
DIVISION OF LABOR STANDARDS
Attn: Prevailing Wage Section
P.O. Box 449
Jefferson City, MO 65102-0449
Phone: 573-751-3403
Fax: 573-751-3721
E-mail: prevailingwage@dolir.mo.gov
Website: www.dolir.mo.gov/ls