Filetype Excel XLSX | Posted on 08 Aug 2022 | 3 years ago
Authentication
digital resources
223x Filetype XLSX File size 1.82 MB Source: ogs.ny.gov
Sheet 1: BDC 274
| EMERGENCY CONTRACTOR EXPENSE AND FEE SUMMARY | Project No. | ||||||||||||||||||||||
| 1 | |||||||||||||||||||||||
| Contractor Name: | Fed ID #: | Date: | |||||||||||||||||||||
| Address: | Submission No.: | ||||||||||||||||||||||
| Period: | to | ||||||||||||||||||||||
| Telephone: | Fax: | ||||||||||||||||||||||
| SECTION A: CONTRACTOR WORK | |||||||||||||||||||||||
| For OGS Use Only | |||||||||||||||||||||||
| 1. Total Contractor Labor | (from BDC 271) | $0.00 | |||||||||||||||||||||
| 2. Total Contractor Material | (from BDC 272) | $0.00 | |||||||||||||||||||||
| 3. Total Contractor Equipment | (from BDC 124E) | $0.00 | |||||||||||||||||||||
| 4. Contractor Total | (1 - 3) | $0.00 | |||||||||||||||||||||
| SECTION B: SUBCONTRACTOR WORK (Excluding Travel Expenses) | |||||||||||||||||||||||
| Subcontractor Name | L&M Sub | Lump Sum | |||||||||||||||||||||
| 1. | |||||||||||||||||||||||
| 2. | |||||||||||||||||||||||
| 3. | |||||||||||||||||||||||
| 4. | |||||||||||||||||||||||
| 5. | Subcontractor Total | $0.00 | |||||||||||||||||||||
| SECTION C: COST PLUS | |||||||||||||||||||||||
| COST PLUS PERCENTAGE FEE - Complete Line 2 | COST PLUS FIXED FEE - Complete Line 3 | ||||||||||||||||||||||
| 1. Total Contractor Work Plus Total Subcontractor Work | $0.00 | ||||||||||||||||||||||
| 2. Percentage Fee from Contract | times line 1. | $0.00 | |||||||||||||||||||||
| 3. Fixed Fee from Contract (applies to Fixed Fee Contracts only) | |||||||||||||||||||||||
| 4. Contractor Travel Expenses | (from BDC 275) | $0.00 | |||||||||||||||||||||
| 5. Subcontractor Travel Expenses | (from BDC 275.1) | ||||||||||||||||||||||
| 6. Amount Requested | (1 + 2 + 4 + 5) OR (1 + 3 + 4 + 5) | $0.00 | |||||||||||||||||||||
| SECTION D: CONTRACTOR'S CERTIFICATION | |||||||||||||||||||||||
| I certify compliance with all contract provisions and that all work has been performed and\or material supplied as included in | |||||||||||||||||||||||
| this Expense and Fee Summary. I further certify that the labor rates, material prices, insurance enumerations, labor fringe | |||||||||||||||||||||||
| benefit enumerations, and equipment rental rates are correct and in accordance with actual and true costs incurred. | |||||||||||||||||||||||
| Sworn before me this ____________________ day | |||||||||||||||||||||||
| Contractor's Signature | of _________________________ , 20 _________ . | ||||||||||||||||||||||
| Print Name of Authorized Signature | |||||||||||||||||||||||
| Print Title | Notary Public | ||||||||||||||||||||||
| SECTION E: CERTIFICATION BY DIRECTOR'S REPRESENTATIVE | |||||||||||||||||||||||
| I certify that to the best of my knowledge and belief, all work represented on the attached BDC 268s and BDC 269s is | |||||||||||||||||||||||
| complete, has been inspected by me and/or my duly authorized representative or assistants, and has been performed in | |||||||||||||||||||||||
| accordance with the requirements of the contract documents. | |||||||||||||||||||||||
| PC Date _______________ | |||||||||||||||||||||||
| Signature | Date | ||||||||||||||||||||||
| Print Name | |||||||||||||||||||||||
| BDC 274 (Rev 21_04/2022) | |||||||||||||||||||||||
| Contractor Name: | 0 | Date: | 12/30/99 | ||||||||||||||
| Address: | 0 | Submission No.: | 0 | ||||||||||||||
| 0 | Period: | 12/30/99 | to | 12/30/99 | |||||||||||||
| Telephone No.: | 0 | Fax: | 0 | ||||||||||||||
| Item No. (From BDC 125E) | Employee Name (From BDC 125E) | Regular Time | Premium Time (only when directed) | Total Labor Expense | |||||||||||||
| Hours | Total Rate (From BDC 125E) | Amount Paid | Hours | Total Rate (From BDC 125E) | Amount Paid | ||||||||||||
| 0 | 0 | ||||||||||||||||
| 0 | 0 | 0.00 | |||||||||||||||
| 0 | 0 | 0.00 | |||||||||||||||
| 0 | 0 | 0.00 | |||||||||||||||
| 0 | 0 | 0.00 | |||||||||||||||
| 0 | 0 | 0.00 | |||||||||||||||
| 0 | 0 | 0.00 | |||||||||||||||
| 0 | 0 | 0.00 | |||||||||||||||
| 0 | 0 | 0.00 | |||||||||||||||
| 0 | 0 | 0.00 | |||||||||||||||
| 0 | 0 | 0.00 | |||||||||||||||
| 0 | 0 | 0.00 | |||||||||||||||
| 0 | 0.00 | ||||||||||||||||
| 0 | 0 | 0.00 | |||||||||||||||
| 0 | 0 | 0.00 | |||||||||||||||
| 0 | 0 | 0.00 | |||||||||||||||
| 0 | 0 | 0.00 | |||||||||||||||
| 0 | 0 | 0.00 | |||||||||||||||
| 0 | 0 | 0.00 | |||||||||||||||
| Total Contractor Labor | (Carry forward to BDC 274.) | $0.00 | |||||||||||||||
| Comments: | |||||||||||||||||
| BDC 271 (Rev 21_04/2022) | |||||||||||||||||
| EMERGENCY CONTRACTOR LABOR RATE WORKSHEET | Project No. | 0 | ||||||||||||||||||
| Contractor Name: | 0 | Date: | 12/30/99 | |||||||||||||||||
| Address: | 0 | Submission No.: | 0 | |||||||||||||||||
| 0 | Period: | 12/30/99 | to | 12/30/99 | ||||||||||||||||
| Telephone Number: | 0 | Fax: | 0 | County: | ||||||||||||||||
| LABOR RATE BREAKDOWN (ALL LABOR RATE BREAKDOWN FIELDS ARE REQUIRED ENTRIES. Use a separate worksheet for each employee.) | ||||||||||||||||||||
| Item No. (from BDC 268): | Trade: | Trade Sub-category | ||||||||||||||||||
| Employee Name: | ||||||||||||||||||||
| Social Security No.: | ||||||||||||||||||||
| Gross Pay Year-to-Date: | as of | (First date of payment submission) | REGULAR TIME BASE RATE | PREMIUM TIME BASE RATE | ||||||||||||||||
| MONTH | DAY | YEAR | ||||||||||||||||||
| A. WAGE RATE PER HOUR | ||||||||||||||||||||
| BENEFITS ( * Identifies benefits paid as wages to the employee and/or subject to payroll taxes and insurance.) | * | % per hour | $ per hour | |||||||||||||||||
| Vacation and Holiday | $0.00 | $0.00 | ||||||||||||||||||
| Health and Welfare | $0.00 | $0.00 | ||||||||||||||||||
| Pension | $0.00 | $0.00 | ||||||||||||||||||
| Annuity | $0.00 | $0.00 | ||||||||||||||||||
| Education / Apprentice Training | $0.00 | $0.00 | ||||||||||||||||||
| Supplemental Unemployment | $0.00 | $0.00 | ||||||||||||||||||
| Security Fund | $0.00 | $0.00 | ||||||||||||||||||
| $0.00 | $0.00 | |||||||||||||||||||
| $0.00 | $0.00 | |||||||||||||||||||
| $0.00 | $0.00 | |||||||||||||||||||
| $0.00 | $0.00 | |||||||||||||||||||
| B. TOTAL BENEFITS PER HOUR | $0.00 | $0.00 | $0.00 | |||||||||||||||||
| PAYROLL TAXES AND INSURANCE | ||||||||||||||||||||
| F.I.C.A. / Social Security (up to the maximum required by law) | % | |||||||||||||||||||
| Medicare | 1.45 | % | ||||||||||||||||||
| Federal Unemployment (up to 1st $7,000 of base salary per employee / year) | Rate: | % | ||||||||||||||||||
| State Unemployment (up to 1st $12,000 of base salary per employee per year) | Rate: | 0.00 | % | |||||||||||||||||
| Disability | Rate: | 0.00 | % | C.1 | ||||||||||||||||
| Workers' Compensation | Code: | Rate: | 0 | % | $0.00 | |||||||||||||||
| Other Payroll Tax: | ( i.e., MTA Tax - Attach Backup) | Rate: | 0.00 | % | ||||||||||||||||
| C. TOTAL TAXES AND INSURANCE PER HOUR | ||||||||||||||||||||
| 0 | (a.) | (b.) | C.2 | |||||||||||||||||
| x | 1.45 | % = | ||||||||||||||||||
| D. TOTAL LABOR RATE | ( A + B + C.1 + C.2 ) = | |||||||||||||||||||
| E. CONTRACTOR'S CERTIFICATION | ||||||||||||||||||||
| I certify that the labor rates, insurance enumerations, labor fringe enumerations and expenses are correct and in accordance with actual and true | ||||||||||||||||||||
| cost incurred. | ||||||||||||||||||||
| Sworn before me this _____________ day | ||||||||||||||||||||
| Signature | ||||||||||||||||||||
| of _______________________ , 20 ______. | ||||||||||||||||||||
| Print Name of Authorized Representative | ||||||||||||||||||||
| Print Title | Notary Public | |||||||||||||||||||
| BDC 125E (Rev 21 - 04/2022) | ||||||||||||||||||||
no reviews yet
Please Login to review.
