OOC54 3/01/04

CD 07220.100.18

MARYLAND STATE HIGHWAY ADMINISTRATION

PAYROLL SUMMARY REPORT

CONTRACT NO:	F AP NUMBER:

PRIME CONTRACTOR	SUBCONTRACTOR	LOWER TIER SUBCONTRACTOR

FIRM NAME:

PAYROLL

NUMBER	DATES	BY

(INITIAL)	COMMENTS
ENDING	RECEIVED	CHECKED*	VERIFIED**	FILED

Checked* : Prevailing Wages Rates as found in Invitation for Bids.

Verified** : As shown on OOC52 - Payroll Compliance Check.

Payroll Summary Report

ha9999z

2015-07-23

I.R.I.S.