Employee Interview Form - Labor (Page 4 of 4) in pdf

700-010-63

CONSTRUCTION

04/15

STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION

EMPLOYEE INTERVIEW FORM-LABOR

“Confidential: All information in this form shall remain confidential to the extent permitted by law, including Florida Statutes Chapter 119”

Section 2- JOB & PAY DATA SUPPLIED BY EMPLOYEE

The interviewer records the answers supplied by the employee

8. – 14. Enter Employee Response

Section 3- EEO DATA SUPPLIED BY EMPLOYEE

The interviewer records the answers supplied by the employee.

15. Enter Employee Response

Section 4- FRINGE DATA SUPPLIED BY EMPLOYEE

The interviewer records the answers supplied by the employee.

16. – 18. Enter Employee Response

Section C-INTERVIEWER’S OBSERVATION

The Interviewer completes this section before speaking with the employee and before performing the

interview. The data provided is based on what the interviewer observes just prior to the interview

H. Describe the work observed at the time of the interview (e.g. digging trench for placement of pipe)

I. List/describe the tools/equipment the employee was using/operating. OR mark ‘No Equip’ or ‘No Tools’

if none were used.

J. Interviewer Comments

The interviewer’s work is now complete and the form should be turned into the Resident Compliance

Specialist.

Section D- RCS’S REVIEW & ACTION

K. RCS’s Name and date of review.

L. Payroll versus Wage Determination (‘WD) Minimum Rate and Fringe:

AS SHOWN ON PAYROLL: Review the certified payroll for the week that includes the date

shown in box G (Date of Interview). Record the payroll’s classification, Rate paid, Fringe paid and

Total as well as the Wage Determination Rate, Fringe and Total.

AS INDICATED IN OBSERVATION (‘H’): Review the work/equipment described in ‘H’ and list the

appropriate classification, rate minimum, fringe minimum and total.

Indicate whether the classification shown on the payroll is equal to or greater than the

classification as observed (‘H’ & ‘I’).

IF FRINGE IS REQUIRED, HOW ARE THEY PAID? Indicate if the employee receives cash,

benefits or some

combination if fringe is required. If fringe is not required, mark NA

M. Are there any discrepancies between work, tools and equipment used, classification, rate paid or

fringes? If yes, please explain by selecting the discrepancy. If the discrepancy warrants a payroll

violation, indicate the appropriate code or check no if a payroll violation is not required.

N. Any Concerns from Sections 2 or 3? Do the employee comments indicate any concerns for the RCS: If

so, mark Yes and add comments as noted in box O.

O. RCS comments or mark NA or indicate date Interview Letter was issued.

P. Enter Date payroll was corrected.

Employee Interview Form - Labor Page 4