D3 Labor Compliance Onsite Employee Interview

This Form will collect interview information from Employees on CDBG-DR jobsites. All employers using CDBG-DR funding on a DBRA applicable project will submit their copies of employee interviews to ensure that PRDOH will be able to comply with federal and local recordkeeping standards.

Provide the name of the person conducting the interview*

Provide the email of the person conducting the interview*

Provide the phone number of the person conducting the interview*

Provide the Name of the Program*

Select or enter value

Provide the Project Name and Project Number*

Did you Use the HUD 11 Form?*

Select

Did you find an area of concern for follow up?*

Select

Using the List provided choose all the conditions that apply.

You may choose more than 1 option from the list provided.

Select

Provide additional comments to assist describing your interview.*

You may also attach additional information in addition to the copy of the employee interview form.

Please upload your attachment file.*

Please upload the HUD 11 Form in English or Spanish and any additional details needed. You may only provide 1 interview per submission.

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