New York State Website


Public Work Forms Available on the Web

The forms listed below are available for public use in a PDF format.  To print them, you will need an installed copy of Adobe Acrobat Reader ® which is available for no charge from Adobe. The user is free to print as many copies of each form as needed.  They may also be filled electronically and printed. The Wage Schedule Request form may be submitted by fax or by mail.  All other forms require original signatures and must be submitted by mail or in person.  Printed copies of these forms may be obtained by e-mailing your request to PWask@labor.state.ny.us  The requested form(s) will be mailed to you within a week.

CONTRACTING AGENCY FORMS:

Request for Wage and Supplement Information (PW-39) - to be used by contracting agencies and their architects to request an original wage schedule for inclusion in the project specifications as required by law. This form must be mailed or faxed to Bureau of Public Work's Central Office.

COMPLAINT FORMS (the Department does not accept anonymous complaints):

Employee Complaint (PW-4) - to be used by a worker to file a claim that he/she was underpaid prevailing wages or supplements on a public work project.

Non-Employee Complaint (PW-5) - to be used by any interested person or employee organization to file a complaint alleging the underpayment of prevailing wages or supplements on a public work project where the party filing the complaint is not an underpaid worker.

CONTRACTOR FORMS:

Certified Payroll (PW-12) - a form that may be used to record and certify payrolls. Each contractor who works on a public work project must maintain certified payrolls and provide such payrolls, with original certifications, to the contracting agency at least once every 30 days.

Payroll Certification (PW-18.1) - a form for certifying payrolls when a standard state or federal certified payroll form is not used. Important Note - Use this form ONLY for correspondence with the Bureau of Public Work.

Request for a Dispensation to Work Overtime (PW-30) - to be used to request a dispensation regarding hours and days of work.  All work in excess of 8 hours in a day or 5 days in a week must be paid at the applicable overtime rate. No contractor is allowed to work employees more than 8 hours in a day or 5 days in a week, except for the protection of the life and limb of the public, or where the work is deemed of an important nature and delay would be of disadvantage to the public.  The contractor must show a danger to the public or to the preservation of the jobsite in order for the dispensation to be granted.  The form must first be signed by the contracting agency. Failure to have the Department of Jurisdiction (Contracting Agency) complete and sign its portion of the PW-30 will delay the Bureau of Public Work's possible approval. 

Subcontractor Receipt of Wage Schedule (PW-51) - to be used to verify receipt from the Prime Contractor of the original schedule(s) of wages and supplements for a specific public work project.

Employer Registration for Use of 4 Day / 10 Hour Work Schedule (PW-30R) - form to register for use of 4 Day / 10 Hour work schedule. To use the ‘4 Day / 10 Hour Work Schedule’ there MUST be a Dispensation of Hours (PW30) in place on the project AND you MUST register your intent to work 4 / 10 hour days, by completing the PW30R Form.  The ‘4 Day / 10 Hour Work Schedule’ applies ONLY to Job Classifications and Counties listed on the PW30R Form. For each Job Classification check the individual wage schedule for specific details regarding their 4/10 hour day posting. Instructions for completing the PW30R form.