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[null,null,null,null,null,null,"FHWA Missouri Division"]
[null,null,null,null,null,null,"Focused Review – Civil Rights/Cert Payroll"]
[null,null,null,null,null,null,"MoDOT Job #:",null,null,null,null,"Federal Project #:"]
[null,null,null,null,null,null,"Contract #:",null,null,null,null,"Inspection Date:"]
[null,null,null,null,null,null,"MoDOT District:",null,null,null,null,"Report Date:"]
[null,null,null,null,null,null,"Contractor:",null,null,null,null,"Report #:"]
[null,null,null,null,null,null,"Inspection By:",null,null,null,null,"MoDOT RE:"]
[null,null,null,null,null,null,"Time Elapsed:",null,null,null,"%","Work Complete:",null,null,"%"]
[null,null,null,null,null,null,"Accompanied By:"]
[]
["Question","Yes","Partial","No","Not Applicable","Not Verified","Questions",null,null,null,null,null,null,null,"Reference (CFR, MoDOT Spec, EPG)"]
["Executed Contract"]
[1,null,null,null,null,null,"Is the correct Federal Wage Rate Order included in the advertisement within 10 days of letting and in the contract? (see page 2)\n(If the project is a functional classification of local road or rural minor collector, then the project is exempt from Davis-Bacon requirements.)"]
[2,null,null,null,null,null,"Is the correct State Wage Rate Order included in the advertisement within 10 days of letting and in the contract?  (see page 2)"]
[3,null,null,null,null,null,"Does the state or LPA justify why they can only meet the 10 day requirement?"]
[4,null,null,null,null,null,"Does the executed contract include DBE Goals and JSPs as applicable?"]
[5,null,null,null,null,null,"Does the executed contract include OJT Goals and JSPs as applicable?"]
["Construction Phase"]
["Commercially Useful Function (CUF)"]
[6,null,null,null,null,null,"Has a CUF determination been made and recorded for each DBE under contract currently performing or that has performed work on the project?",null,null,null,null,null,null,null,"49CFR 26"]
[7,null,null,null,null,null,"Was the completed CUF performed adequately?  (Minimum of 1 must be reviewed)"]
["Wage Rate Interviews (Minimum of 2 must be reviewed - see page 2)"]
[8,null,null,null,null,null,"Have wage rate interviews of the prime contractors and subcontractor’s employees been conducted per the EPG requirements (1 every 2 weeks)?",null,null,null,null,null,null,null,"23CFR 633.101 \nEPG 110.3.1 "]
[9,null,null,null,null,null,"Do wage rate interviews confirm information on contractor’s and subcontractor’s certified payrolls?",null,null,null,null,null,null,null,"23CFR 633.101  "]
[10,null,null,null,null,null,"Is project staff interviewing a wide variety of contractor and subcontractor employees?"]
[11,null,null,null,null,null,"Are the wage rate interviews being finalized and signed by verification against the certified payrolls?"]
["Payrolls (Review of Payrolls associated with Wage Rate Interviews)"]
[12,null,null,null,null,null,"Have weekly payrolls been submitted by the prime contractor and approved subcontractors?",null,null,null,null,null,null,null,"23CFR 635.118\n23CFR 633.101\n"]
[13,null,null,null,null,null,"Do the certified payrolls have appropriate wage rates for normal and overtime hours, classifications for employees, and contain no personal information?",null,null,null,null,null,null,null,"23CFR 633.101"]
[14,null,null,null,null,null,"Have all wage rate fringe benefits been properly accounted for?"]
[15,null,null,null,null,null,"Have all the \"Other\" deductions been properly identified on the certified payrolls?"]
[16,null,null,null,null,null,"If an employee has a court ordered payroll deduction (i.e. child support), has that documentation been provided and saved in the project file?"]
[17,null,null,null,null,null,"Are any employees exempt from Davis Bacon Prevailing Wage Rates (i.e.; Specialty Contractors or Haul Trucks Operators (not project specific))?  If so, additional information is required.\n(Information may be required - see page 2)"]
[18,null,null,null,null,null,"Are trainees or apprentices being paid the appropriate wages on the certified payroll?  If so, additional information is required.\n(Information may be required - see page 2)"]
["Miscellaneous"]
[19,null,null,null,null,null,"Has the contractor erected a bulletin board with all required information and posters? \n(Include filled out MoDOT Bulletin Board Checklist as attachment)",null,null,null,null,null,null,null,"23CFR 633.101  "]
[20,null,null,null,null,null,"If other topics were inspected for Civil Right related content, were findings in conformance with applicable specifications or regulations? \n(Question only intended to record findings from a review performed by a Civil Rights Specialist)"]
[21,null,null,null,null,null,"If the project has a OJT Goal, can project documentation verify the contractor will exceed or show progress towards achieving the OJT Goal and Commitment?\n(Information Required for this Question - see page 2)\n"]
[]
["Question","Required Information"]
[1,"Letting Date:"]
[null,"Federal Wage Rate Order:"]
[null,"State Wage Rate Order:"]
["Wage Rate Interview"]
[1,"Name:"]
[null,"Contractor Name:"]
[null,"Classification:"]
[null,"Wage Rate:"]
[null,"Fringe Rate:"]
[null,"Prevailing Wage Rate:"]
[2,"Name:"]
[null,"Contractor Name:"]
[null,"Classification:"]
[null,"Wage Rate:"]
[null,"Fringe Rate:"]
[null,"Prevailing Wage Rate:"]
["Exempt Personnel (if applicable)"]
[1,"Contractor Name:  "]
[null,"Type of Contractor:  "]
[2,"Contractor Name:  "]
[null,"Type of Contractor:  "]
["OJT Information"]
[1,"OJT Goal: "]
[null,"OJT Commitment:   "]
[null,"Contractor Name:"]
[null,"Name:"]
[null,"Total Hours Worked:  "]
[2,"OJT Goal: "]
[null,"OJT Commitment:   "]
[null,"Contractor Name:"]
[null,"Name:"]
[null,"Total Hours Worked:  "]
[]
[null,"Y/N"]
["Question","Best Practice",null,"Major\nFinding",null,"Issue\nResolved",null,"Comments"]
[" "]
[" "]
[" "]
[" "]
[]
["Checklist Follow-Up Action Requirements\n\n1. All Questions answered as “Partial” or “No” are required to have a comment in the comment section.  \n2. Comments must describe the deficiency and required follow-up action (if not completed) or the best practice.\n3. Comments must contain information on what type of follow-up is required, the manner in which it must be completed (if applicable) and the timeframe to complete the follow-up.\n4. Completion of any follow-up required, that is not to be completed prior to the completion of the inspection report, is the responsibility of the MoDOT to complete and/or provide direction to the Contractor to resolve.\n5. For general findings or observations that cannot be characterized by a given question and are worthy of being noted, a comment can be provided in the comments section on the checklist."]