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Get AK 07-6058 2013

Ll be made at least monthly to an approved plan. The name of the plan is: and; □ (c) Each laborer, mechanic or field surveyor listed on this payroll has been paid, as indicated on the payroll, an amount not less than the sum of the applicable basic hourly wage rate plus the amount of the required fringe benefits as currently published by DOLWD, except as noted in Section Signature (original signature required) Name & Title (print or type) CERTIFIED PAYROLL Name, SSN, Permanent Domicile.

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