(Insert) AGENCY LETTERHEAD

Pre-Construction Conference Checklist

Date:


Contract No.:

Enclosures:

___ Pre-Construction Conference/Labor Compliance Outline
___ CEM 2501, Fringe Benefit Statement*
___ CEM 2502, Payroll*
___ CEM 2503, Statement of Compliance*
___ CEM 2505, Owner-Operator Listing*
___ CEM 2505, Owner-Operator Listing Statement of Compliance*
___ CEM 2510, Truck Owner-Operator Certification of Ownership*
___ DIR General Prevailing Wage Determinations

Posters: (Two Each - One for Job Site & One for Home Office)

___ Your Rights Under The Family and Medical Leave Act of 1993, (DLSE) (Federal)
___ PAYDAY Notice, Department of Labor Standards Enforcement, (DLSE) 8 (State)
___ EMERGENCY NUMBER LISTING (CAL/OSHA)S-500 (State)
___ EEO is THE LAW (English and Spanish) (OFFCP) (Federal)
___ Notice Federal Project (Federal aid Projects Only) (FHWA)-1022 (Federal)
___ Important Wage Rate Information (English and Spanish) (FHWA)-1495 (Federal)
___ Fraud, Waste or Abuse (FHWA) (Federal)
___ Safety and Health Protection (English and Spanish) (CAL/OSHA) (State)
___ All Employees Working on Federal or Federally Financed Construction Projects (DLSE) (Federal)
___ NOTICE Employee Polygraph Protection (English and Spanish) (DLSE) 1462 (Federal)
___ Discrimination and Harassment in Employment (English and Spanish) (DFEH)-162 (State)
___ Employee Rights on Government Constracts (DLSE) - 1313 (State)


By signature below, receipt of the Signature Form with enclosures is hereby acknowledged.

_____________________________________   _____________________________________
Prime Construction Representative (please print) Labor Compliance Representative or Resident Engineer
_____________________________________   _____________________________________
Prime Contractor Representative (signature) Date

Rev. 01/29/09

*These forms can be found in the Appendix in the Caltrans Construction Manual or at the following website: www.dot.gov/hq/construc/forms.htm