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State of Illinois

CAPITAL DEVELOPMENT BOARD

CHANGE ORER PROPOSAL


LABOR COST BREAKDOWN

Project Number
Project

Contractor
CDB Contract No.
Trade
Contract Expiration Dates
Cost Per Hour
a.

Taxable Wages (incl. Vacation)

b.

Union Benefits & Fringes *

c.

FICA

d.

Fed. Unempl.

e.

State Unempl.

f.

Worker's Comp. **

g.

Travel Cost ( if applicable)

Journeyman

% of a.

Trade
Foreman

Gen. Foreman

Journeyman

Trade
Foreman

Gen. Foreman

Journeyman

Foreman

Gen. Foreman

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

% of a.

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

% of a.

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

h.
i.
Total Labor Cost/Hr
Worker's Comp Rates**

Footnotes:
Notes:

1.
2.
3.

Revised 01/06

*
Only costs required by Union Agreement or IDOL Prevailing Wage Rate allowed.
** Worker's Compensation rate may vary by Trade, include the percentages by Trade
Only the costs shown above may be included in the hourly wage rates. Insurance costs, etc. are included in Overhead. Travel Cost is allowed only
under very limited circumstances.
It is suggested that this form be completed for the initial change order on a CDB project and a master copy maintained in the contractor's office. A
copy must be included with each change order package and the master copy revised at the beginning of any new wage agreement period.
E-MAIL THIS FORM: This form may be submitted to CDB electronically for review. Attach a completed form to an e-mail addressed to the CDB
Project Manager. All CDB e-mail addresses are available on our website: www.cdb.state/il.us

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