Key Personnel Residential Agreement Request

The Labor/Management Cooperation Trust will reimburse companies for the total value of fringe benefits of key personnel who are running crews on projects using the residential rate. Contractors are responsible for paying the difference in wages to their key personnel.

In applying for a grant on a particular project, the contractor (undersigned) agrees that the decision of this application is within the full and complete discretion of the trustees. The undersigned agrees to waive and release the trustees of the fund from any claim the undersigned may have now or in the future.

Applicant Section

Company Name *

Company Address *

Company Address

City

State/Province

Zip/Postal

Country

Signature *

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Drawing or typing your name above certifies that you are an authorized applicant for the company listed and that all of the information on the form is valid.

Email Address *

Fax Number

Project Section and Calculations

Project Name *

Project Address *

Project Address

City

State/Province

Zip/Postal

Country

Projected End Date *

Total Estimated Crew Size *

Number of Key Personnel Requested *

Total Number of Hours Requested *

Per hour Cost of Fringe Benefits for Key Personnel *

Total Estimated Grant Amount for Key Personnel *

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