Form 700-010-63 "Employee Interview Form - Labor" - Florida

What Is Form 700-010-63?

This is a legal form that was released by the Florida Department of Transportation - a government authority operating within Florida. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on February 1, 2018;
  • The latest edition provided by the Florida Department of Transportation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 700-010-63 by clicking the link below or browse more documents and templates provided by the Florida Department of Transportation.

ADVERTISEMENT
ADVERTISEMENT

Download Form 700-010-63 "Employee Interview Form - Labor" - Florida

817 times
Rate (4.8 / 5) 48 votes
700-010-63
CONSTRUCTION
02/18
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 A – RCS’S PROJECT IDENTIFICATION
A.
Fin. Project #
B.
F.A.P. #
C.
Contract #
D.
Prime
Section B - INTERVIEWER’S IDENTIFICATION
E.
Interviewer
First & Last Name (print)
Signature
F.
Interviewer’s Employer
G.
Date of Interview
Section 1 - IDENTITY DATA SUPPLIED BY EMPLOYEE
1.
Employee
First & Last Name
Signature
2.
Employee ID or last four of SS No.
3.
Employed by
4.
How long with the company?
5.
How long on this project?
6.
Employee Sex
Male
Female
Caucasian
7.
Employee Race
Black
Hispanic
A m Ind/Al
Asian
2/+races
Native Hi./P. Islander
Section 2 - JOB & PAY DATA SUPPLIED BY EMPLOYEE
8.
What is your job or position?
9.
How much are you paid an hour?
10.
Are you paid every week?
Yes
No
11.
Do you receive time and ½ for hours worked over 40?
Yes
No
Did the company pay for your hardhat and vest?
12.
Yes
No
13.
Have you seen the project bulletin board with the wage and job posters?
Yes
No
14.
Were you told to give someone money or favors to get this job? Or to keep your job?
Yes
No
Section 3 - DEDUCTION DATA SUPPLIED BY EMPLOYEE
15. Is money taken from your check for Insurance, loans, uniforms, child support etc?
Taxes
Repayments
Insurance
Credit Card Charges
Charitable Contributions
401K
Per Diem
Direct Deposits
Uniform
Company Purchases
Union Fees & Dues
Travel
Safety Equipment
Transportation
Loan/Advances
Alimony
Other
Child Support
Stock
Section 4 - FRINGE DATA SUPPLIED BY EMPLOYEE
16.
Are you paid for holidays, sick days, vacation?
Yes
No
17.
Does the company pay any of your insurance?
Yes
No
18.
Employee comments/explanations
Over
700-010-63
CONSTRUCTION
02/18
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 A – RCS’S PROJECT IDENTIFICATION
A.
Fin. Project #
B.
F.A.P. #
C.
Contract #
D.
Prime
Section B - INTERVIEWER’S IDENTIFICATION
E.
Interviewer
First & Last Name (print)
Signature
F.
Interviewer’s Employer
G.
Date of Interview
Section 1 - IDENTITY DATA SUPPLIED BY EMPLOYEE
1.
Employee
First & Last Name
Signature
2.
Employee ID or last four of SS No.
3.
Employed by
4.
How long with the company?
5.
How long on this project?
6.
Employee Sex
Male
Female
Caucasian
7.
Employee Race
Black
Hispanic
A m Ind/Al
Asian
2/+races
Native Hi./P. Islander
Section 2 - JOB & PAY DATA SUPPLIED BY EMPLOYEE
8.
What is your job or position?
9.
How much are you paid an hour?
10.
Are you paid every week?
Yes
No
11.
Do you receive time and ½ for hours worked over 40?
Yes
No
Did the company pay for your hardhat and vest?
12.
Yes
No
13.
Have you seen the project bulletin board with the wage and job posters?
Yes
No
14.
Were you told to give someone money or favors to get this job? Or to keep your job?
Yes
No
Section 3 - DEDUCTION DATA SUPPLIED BY EMPLOYEE
15. Is money taken from your check for Insurance, loans, uniforms, child support etc?
Taxes
Repayments
Insurance
Credit Card Charges
Charitable Contributions
401K
Per Diem
Direct Deposits
Uniform
Company Purchases
Union Fees & Dues
Travel
Safety Equipment
Transportation
Loan/Advances
Alimony
Other
Child Support
Stock
Section 4 - FRINGE DATA SUPPLIED BY EMPLOYEE
16.
Are you paid for holidays, sick days, vacation?
Yes
No
17.
Does the company pay any of your insurance?
Yes
No
18.
Employee comments/explanations
Over
700-010-63
CONSTRUCTION
02/18
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 C - INTERVIEWER’S OBSERVATION
H.
Describe employee’s work you observed at time of interview.
I.
List/describe the tools/equipment the employee was using/operating.
No Tools
No Equip
Interviewer Comments
J.
Section D – RCS’ REVIEW & ACTION
K.
RCS
First & Last Name
Date
L.
Payroll vs. Wage Determination Minimum Rate and Fringe
As shown on Payroll:
As indicated in observation (“H” and “I”):
Classification
Classification
Rate Paid
Fringe Paid
Total
Rate Minimum
Fringe Minimum
Total
$ 0.00
$ 0.00
WD Rate
WD Fringe
WD Total
Is the classification shown on the payroll equal to or greater than
the classification as observed (“H” and “I”)?
Yes
No
$ 0.00
If Fringe Benefits are required, how are they paid to the employee?
NA – not required
Cash
Benefits
Combination
M.
Are there any discrepancies between work observed, tools and equipment used, classification and rate of pay?
Yes
No If yes, please explain.
Discrepancy:
Was a payroll violation issued?
Improper Classification
Yes
Code #
Wages paid
No
Not Listed on payroll
Other:
N.
Any concerns from Section 2 or 3?
Yes
No
O.
Comments
N/A
P.
Payroll Correction received if applicable:
Date
700-010-63
CONSTRUCTION
02/18
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”
GENERAL
This form should be electronically signed by the employee and the Interviewer.
Data is collected by observing and communicating with project workers and it is recorded on this form to
assist in determining EEO and payroll compliance.
The Interviewer records data collected from the employee in Sections 1, 2, 3 & 4
The interviewer completes Section B
The interviewer completes Section C based on the work observed the employee performing
Section A & Section D is completed by the RCS
RCS Completes
Sect. A+D
Interviewer records
Section 1
Section A
Data collected from
Section B
Employee (Sect 1+2+3+4)
Interviewer completes
Section 2
Section C
B+C
Section 3
Section D
Section 4
Section D
EMPLOYEE INTERVIEW FORM
Information recorded on the Employee Interview Form is to be kept confidential and separate from
standard Compliance program records.
DIRECTIONS FOR COMPLETING FORM
Section A- PROJECT IDENTITY SUPPLIED BY RCS
The RCS completes this section before giving the form to the Interviewer.
A. Financial Project No. – The Florida Department of Transportation’s Financial Project Number
B. F.A.P. Number – The Federal Aid Project Number assigned to federally funded projects
C. Contract Number- FDOT contract number
D. Prime Contractor- Name of Prime
Section B-INTERVIEWER’S IDENTIFICATION
This is the first section that the Interviewer completes
E. Interviewer’s Name and Electronic Signature.
An electronic signature can be applied by stylus or finger, utilizing Adobe Reader on a computer or iPad.
For more information, visit [http://www.fdot.gov/construction/Wage.shtm].
F. Interviewers’ Employer: FDOT or CCEI firm on the project
G. Date of interview: Month/Day /year
Section 1- IDENTITY DATA SUPPLIED BY EMPLOYEE
The interviewer records the answers supplied by the employee
1. Employee: Print first and last name & have employee electronically sign below their name.
2. Employee Identification number or last four of Social Security number.
3. Employed by: name of the contractor or temporary agency the employee is working for.
4. How long with Company? Months and/or years employee has worked for company
5. How long on this project? Months and or years employee has worked on this project.
6. Employee Sex: Record male or female
7. Employee Race: Record the race which the employee identifies with
700-010-63
CONSTRUCTION
02/18
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.
Page of 4