Fringe Benefit Statement used by various organizations

There are a few different types of Fringe Benefit Statement forms.

This particular fringe benefit statement is required by various governmental agencies such as:

• The San Diego Unified School District

• The Port of San Diego

• The Los Angeles Community College District

• Other governmental agencies

• And various construction companies

When this particular fringe benefit statement form is required, it is to be submitted with the first certified payroll report.

In order that the proper fringe benefit rates can be verified when checking payrolls on the contract, the hourly rates for fringe benefits, subsistence and/or travel allowance payment made for employees on the various classes of work are tabulated on this form.

Supplemental fringe benefit statements must be submitted during the progress of work should a change in rate of any of the classifications be made.

This fringe benefit statement:

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