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2021-03-21 thru 2021-04-04 Cert Payroll - CORRECTIONSeCPR Online Confirmation Your payroll submission request has been processed. ?lease review the results of your submission. Should you have any questions please contact the eCPR unit at publicworks@d'ir.ca.gov, There is an existing payroll transaction for this contractor on this project for this week ending date. Transaction ID for that transaction is: 11761754 This certified payroll will be treated as an amendment #: 2 Contractor Name: PWLC 11, INC. Contractor Address: 3584 E LA CAMPANA WAY PALM SPRINGS CA 92262 Awarding Body; CITY OF LA QUINTA Project ID: 290440 Contract With: CITY OF LA QUINTA Week Ending Date: 2021-04-04 Payroll Number: 92 Amendment Number. 2 14 employee payroll record(s) processed Your Transaction ID is: 11761844 Print this Page 7Adoibme 'iew your submission Submit another set of payroll records Public Works Certifi. ayroll Reporting Form Certification under penally of perjury: "I, KRISTY SOUTH, the undersigned, am the CONTROLLER (position in business) with the authority to act for and on behalf of PWLC Il, INC. (name of business and/or contractor), certify under penalty of perjury that the records or copies thereof submitted and consisting of certified payroll records for the week ending 2021-04-04 are the originals or true, full, and correct copies of the originals which depict the payroll record(s) of the actual disbursements by way of cash, check, or whatever form to the individual or individuals named. I certify this on 2021-08-05." Contractor Name: PWLC II, INC. Contractor PWCR: 1000037373 License Type: CSLB License Number 855783 Address: 3584 E LA CAMPANA WAY, PALM SPRINGS, CA FEIN: 510532726 Contractor Email: KRISTYS@PWLC2.COM 92202 Insurance Number: WSD 5059867-00 Awarding Body: CITY OF LA QUINTA DIR Project ID: 290440 Project Name: LANDSCAPE & LIGHTING DISTRICT 89-1 Contract With: CITY OF LA QUINTA County: RIVERSIDE Location Description: LIGHTING AND LANDSCAPE DISTRICT 89-1 LANDSCAPE MAINTENANCE OF CITYWIDE MEDIANS Payroll Number: 92- 2 For Week Ending: 04/04/2021 ' is this a 'Statement of Non -Performance?' Name, Address and Social Security Number of Worker Number of Withholding Day Deductions, Contributions, and Payments Man Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gross Amount Earned Federal Tax FICA Stale Tax SDI Vad Holiday Health 6 Well. Pension Net Wage Paid For Week Check Number D Dale APOLINAR GONZALF2 MARTMEZ 33255 DATE PALM 019 CATHEDRAL CITY CA Work Classification 03129 03130 03131 t14101 04102 04103 04104 This Pro e, i All Projects 0 00 36,72 0.00 5.70 0.00 0.00 0.00 Hours Worked Each Day LANDSCAPE MAINTENANCE LABORER S 0.00 8.00 8.D0 5.00 8.00 0.00 0.00 32.00 0.00 0.00 15.00 22.5092234 30.00 480,00 480.00 Admin Dues Trnv1 Subs Savings Other Total Deduct 437.52 3J473 O 0.00 0.00 0.00 0.00 0.00 0.00 0.DD L310n.IngFund 0,00 0.00 0,00 0.00 0.00 42.48 D 0,00 0.00 D.00 0.00 0.00 0.00 0.00 NOTE: Name, Address and Social Security Number of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tuo Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gross Amount Earned Federal Tax FICA Stale Tax SDI Vad Holiday Health 8 We1f, Pension Net Wage Paid Far Week Check Number 3 bola ARMANDO RICO CHAVE2 2103 JACQUES DR PALM SPRINGS CA 92252 Work Classification 03129 03130 03131 04101 04102 04103 04104 This Project All Projects 53.29 61.20 14.10 960 0.00 0.00 0.00 Hours Worked Each Day LANDSCAPE MAINTENANCE LABORER 5 8.00 8.00 8.00 8.00 8.00 0.00 0.00 40.00 0.00 1 0.09 20.00 30.00 40,00 800.00 BOO.DO Trainin g Fund Admin Dues Travl Subs Savings g Other Total Deduct 661.81 33472 O 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 138.19 D 4,nn n On 0.06 1 0.00 0.00 0.00 0.00 NOTE: Name, Address and Social Security Number of Worker Number of Withhaldin9 Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sal Sun Tole/ Hours Hourly Pay Rate Gross Amount Federal Tax FICA State Tax 5bl Vacl Holiday Health & Well. Pension Net Wage Wage Paid For Week Check Number 4 Dale CARLOSi.UNAGON7J1LEz 66145 7TH ST DESERT HOT SPRINGS CA 922417 Work Classification 03129 03130 03131 04101 04102 04103 04104 This Project Alf Projects 30.57 66,63 1.00 10.45 0,00 0.00 0,00 Hours Worked Each Day TREE MAINTENANCE LABORER 5 8,00 8,00 8.00 0.00 8.00 0,00 o,00 32.00 0.0o p,0p 27.22 40.83 54,44 871.OA 871.04 Training g Fund Admin Dues TFav/Subs Subs Savings Other Total Deduct 762.39 33481 O 0.00 0.00 0.00 000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 108.65 D O.Go 0.00 0.00 O.OD D 00 D.DD 0.00 NOTE! Public works certified Payroll Reporting Form 08/05/2021 - Page 1 Public Works Certifil, ayroll Reporting Form Contractor Name: PWLC II, INC. Project Name: LANDSCAPE & LIGHTING DISTRICT 89-1 For Week Ending: 04/04/2021 Payroll Number:92-2 Name, Address and Social SecurityNumber of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gross Amount Earned Federal Tex FICA Stale Tax SDI Vad Holiday y Health & Waif. Pension Net Wage Paid Far Check Number o Date ELIZABETH OJEDA 67145 SAN GABRIEL CIR E CATHEDRAL CITY CA 92234 yy� Classification 03129 03130 03/31 04101 04/02 04103 04104 T�IsAljco.00 PrlsWeek 45.90 1.17 7.20 0.0D 0.00 0.00 Hours Worked Eerr Day LANDSCAPE MAINTENANCE LABORER S 8.00 8.00 B.00 B.00 B.00 0.00 0.00 40.00 0.00 1 0.00 15.00 22.50 30.00 600.00 1 600.00 Training 9 Fund Admire Dues TraviSubs Subs Savings 9 Other Total 545.73 33475 0 0.00 0,00 1 0,00 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0,00 0.00 54.27 p ova 1 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: Name, Address and Social Security Number of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gross Amount Earned Federal Tax FICA Slate Tax I Sol Vaal Holiday I Health & Welf. Pension Nel Wage Paid For Week Check Number 5 Date GENARO VARGAS 69130 VICTORIA DR CATHEDRAL CITY CA 92234 Work Classification 03129 03130 03131 0410t 04102 04103 04104 This Pro'ecl 1 All Pro octs i 0.00 48.55 0.00 7.62 0.00 0.00 0.00 Hours Worked Each Ray LANDSCAPE MAINTENANCE LABORER S 8.go 8,00 8.00 8.00 8.00 0.00 0.00 40.00 0,60 0.00 16_00 24.00 32.00 540.00 640.00 Training Fund Admire Dues Trav! Subs Savings Other Total 578.52 33478 0 0.00 o.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5.31 61.48 D 0.00 0.00 0.00 0.90 0.00 0.00 0.00 NOTE: $5.31 OTHER = FH125D Name, Address and Social SecurityNumber of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gross Amount Earned Federal Tax FICA Stale Tax SDI Vad Holida y Health & Weif. Pension Nat Wage Paid For Week Check Number 0 Dale GUSTAVO HERRERA 32250 AURORA VISTA RD CATHEDRAL CITY CA Work Classification 03129 03130 03131 04101 04102 04103 04104 This Project i All Projects ! 0.00 36,72 0.00 5.76 0.00 0.00 0.00 Hours Worked Each Day LANDSCAPE MAINTENANCE LABORER $ 8.00 8.00 8.00 6.00 0.00 0.00 0.00480.00 W2,O15.00 480.00 Training 9 Fund Admire Dues Trav! Subs Savings 9 Other Total 437.52 33474 p a.Da 0100 0.00 0.00 0.00 0.00 a.o0z2.5a92234 0.00 0,00 0.00 0,00 0.011 0,00 42,480.00 o.00 D.00 o.00 a.00 o.003o.Do NOT:: Name, Address and Social SecurityNumber of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gross Amount Earned Federal Tax FICA Stale Tax SDI Vad Holiday Health 8, We1f. Pension Net Wage Paid For Week Chock Number 0 Dale HUMBERTO S. VALDEZ 12966 CACTUS OR #A DESERT HOT SPRINGS CA 92240 We* Classification 03129 03130 03131 04101 04102 04103 04104 This Project All Projects 114.57 76.67 30.46 12.03 0.00 0.00 0.00 Hours Worked Each Day TREE MAINTENANCE LABORER 5 8.00 8.00 B.00 8,00 8.00 0.00 0.00 40.00 0.00 0.00 25.17 37.76 0.00 1,006.80 1,005.80 Training Fund Admin Dues Trav! Subs Savings Other Total 758.84 6347165 40 O 0.00 0.00 0.00 0.00 0.D0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4.43 238.16 p 0.00 0.00 0.00 0.04 0.00 0.00 1 0.00 NOTE: $4.43 OTHER = FH125D Public works certified Payroll Reporting Form 08/OS/2021 - Page 2 Public Works Certifi ayroli Reporting Form Contractor Name: PWLC II, INC. Project Name: LANDSCAPE & LIGHTING DISTRICT 89-1 For Week Ending: 04/04/2021 Payroll Number:92-2 Name, Address and Social SecurityNumber of Worker Number of Withholding Day Deductions, Contributions, and Payments Man Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gross Amount Earned Federal Tex FICA Stale Tax SDI Vacl Holiday Health d Wolf. Pension Net Wage Paid For Week Check Number 0 Dale JASSAN J. JAMAND 51963 CALLS AVILA COACHELLA CA 92236 _ Work Classification 03129 03130 03131 04101 04102 04103 04104 This ProJeci Ali Projects 45.49 77.02 30.75 12.08 0.00 0.00 ().Of) Hours Worked Each Day TREE MAINTENANCE LABORER S 8,00 8.00 B.QO 8,00 8,00 0.00 0.00 40.00 0,00 Q.Qo 25.17 37.75 0.00 t,006.80 1,006.80 Trainin g Fund Admin DuesTray/ Subs Subs Savin s 9 Other Total 841.48 3348016 541 O 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Q.00 0.00 O.QO 0.0Q 0,00 0.00 1fi5.34 p Q.Qo 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: 771 Name, Address and Social Security Number of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gross Amount Earned Federal Tax FICA Stale Tax SDI I Vacl Holiday Health & Waif, Pension Net Wage Paid For Week Check Number 4 pate LETICIA BONILLA 33477 NAVAJO TR 98 CATHEDRAL CITY CA 92234 Work Classification 03129 03130 03131 04101 04102 04103 04104 This Project All projects 7.46 49.97 0,00 7.68 0,00 0.00 0.00 Hours Worked Each Day LANDSCAPE MAINTENANCE LABORER $ 8.00 8.00 8.00 B.00 8.00 0.00 0.00 40.00 0.00 0,00 16.00 24.00 32.00 640.00 640.00 Training ng Fund Admin Dues Tray/ Subs Savings 9 Other Total 575.89 33470 O 0,00 0.00 1 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 64.11 p D.Qa o.Q9 0.00 0.00 1 0.00 1 0.00 0.00 NOTE: Name, Address and Social Security Number of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gross Amount Earned Federal Tax FICA State Tax SDI Vacl Holiday Health & Well. Pension Net Wage Paid For Weak Check Number 4 Date MARCELINp RAMIREZ 1500 E SAN RAFAEL DR M1fi4 PALM SPRINGS CA 92262 Work Gtasst0calion 03129 03130 03131 04101 04102 04103 04104 This Project All Projects 63.41 B8.57 10.96 13.89 0.00 0.00 0.00 Hours Worked Each Day TREE MAINTENANC@ LABORER S 8.00 8.00 8,00 8.00 8.00 0.00 0.00 40.00 0.00 0.00 29 42 44.13 58.84 1,576.80 1,176.80 Training 9 Fund Admin Dues Tray/ Subs Savings 9 Other Total 980,78 33482 O 0.00 0.00 0.00LO(') 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00 19.19 19fi.02 p Q.oQ 5,55 Q.Qo 0.00 0.00 0.00 NOTE: $13.88 OTHER = FH125 , $5.31 OTHER = FH125D Name, Address and Social Security Number of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sal Sun Total Hours Hourly Pay Rate Gross Amount Earned Federal Tax FICA Stale Tax SDI Vacl Holiday Health & Weli. Pension Not Wage Paid For Week Check Number 0 Date MARIO VASOLE2 58285 CORTA RD CATHEDRAL CITY CA 92234 yy� Classification 03129 03130 03131 04101 04102 04103 04104 This Pro act i All Pro acts 1 0.00 45.90 0.00 7.20 0.00 0.00 0.00 Hours Worked Each pay LANDSCAPE MAINTENANCE LABORER 5 8.00 8.00 8.00 8.00 8.00 0.00 0.00 40,00 0.00 0.00 15.00 22.50 30.00 600.00 600.00 Training Fund Admin Dues Trav! Subs Savings 9 Other Total 546.90 33477 Q 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Goo 0.0o 0.00 0.00 53.10 p 0.00 Q.00 0.00 0.00 0.00 4.00 0.00 NOTE: Public works Certified Payroll Reporting Form 08/05/2021 - Page 3 Public Works Certifi ayroll Reporting Form Contractor Name: PWLC II, INC. Project Name: LANDSCAPE & LIGHTING DISTRICT 69-1 For Week Ending: 04104/2021 Payroll Number: 92-2 Name, Address and Social SecurityNumber of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gross Amount EarnedTex Federal FICA Stale Tax SDI Vacl I Holida y Health S WeIL pension Net Wage Paid For Week Check Number 0 Dale NOE M. JACINTO 73332 GUADALUPE AVE PALM DESERT CA 92250 411111111111111110 Work Classification 03129 03130 03131 04101 04f02 114103 04104 This Project J All Projects ! 0.00 90.02 40.55 14.12 0.00 0.00 0.00 Hours Worked Each Day TREE MAINTENANCE LABORER S 8,00 8.00 8,00 8.00 8.00 0.00 0.00 40.00 0.00 0.00 29,42 44.13 58.84 7,178.80 1,77$.80 Training 9 Fund Admin Dues Subs Subs Savings 9 Other Total 1,032.00 33479 EDO,000 0.00 0.00 0,00 0,00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 a.aa 144.80 0.00 1 0.00 0.00 0.00 0.00 0.00 NOTE: Name, Address and Social Security Number of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gross Amount Earned Federal Tax FICA Stale Tax SDI Vacl Holiday Health a Well. Pension Net Wage Paid For Week Check Number 0 Date RAMON A. CASTILLO VIGIL 27335 HOPPER RD DESERT HOT SPRINGS CA 92247 Work Classification 03129 03130 03131 04101 04102 04103 04104 This Pro'ecl J All Pro'ocls ! 53.51 55.08 16.94 8.64 0.00 0.00 0.00 Hours worked Each Day LANDSCAPE MAINTENANCE LABORER S 8.00 8.00 8.00 8.00 0.00 0.00 0.00 32.00 0.00 q,qq 18.00 27.00 36.00 576.00 720.00 Training Fund Admin Dues Trav! Subs Savings Other Total 585.73 33471 p 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 734.27 D 0.00 0.00 0.00 0.00 0.00 0.00 0.04 NOTE. Name, Address and Social SecurityNumber of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Toe Wed Thu Fri Sat Sun Total Hours HourlyWage Pay Rate GrossAmounl Eamed Federal Tax FICA State Tax SDI Vac/Health Holiday a Welf. pension Nel Paid For Week Check Number 0 Dale RUBEN F. HENRIOUEZ 15687 PALM DR #113 DESERT HOT SPRINGS CA 922411 _ yy� Classification 03129 03130 03131 04101 04102 04103 04104 Thls Project 1 Ali Projects 1 79.81 61.21 20.19 9.61 0.00 0.00 0.00 Hours Worked Each Day TREE MAINTENANCE LABORER S 0.00 8,00 8.00 8.00 8.00 0.00 0.00 32.00 0.00 0.00 25,17 37.76 0,00 805.44 805.44 Training Fund Admin Dues Trav! Subs Savings Other Total 589.04 3347816 539 O 0.00 1 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 45.58 215.40 D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 [NOTE- S40.27 OTHER -CAL SAVERS. S5.31 OTHER -- FH125D Public works certified Payroll Reporting Form 08/05/2021 - Pag* 4 eCPR Online Confirmation Your payroll submission request has been processed. Please review the results of your submission. Should you have any questions please contact the eCPR unit at publicworks@dir_ca.gov. There is an existing payroll transaction for this contractor on this project for this week ending date. Transaction ID for that transaction is: 10820126 This certified payroll will be treated as an amendment M 1 Contractor Name: PWLC Il, INC. Contractor Address: 3584 E LA CAMPANA WAY PALM SPRINGS CA 92262 Awarding Body: CITY OF LA QUINTA Project ID: 290440 Contract With: CITY OF LA QUINTA Week Ending Date: 2021-04-04 Payroll Number: 92 Amendment Number: 1 15 employee payroll record(s) processed Your Transaction ID is: 11761754 Print this Page F1 MON law your submission Adobe Submit another set of payroll records Public Works CertifiE ayroii Reporting Form Certification under penalty of perjury: "I, KRISTY SOUTH, the undersigned, am the CONTROLLER (position in business) with the authority to act for and on behalf of PWLC 11, INC. (name of business and/or contractor), certify under penalty of perury that the records or copies thereof submitted and consisting of certified payroll records for the week ending 2021-04-04 are the originals or true, full, and correct copies of the originalg whkh deWl the payroll record(s) of the actual disbursements by way of cash, check, or whatever form to the individual or Individuals named. I certify this on 2021-08-05 " Contractor Name: PWLC II, INC. Contractor PWCR: 1000037373 License Type: CSL8 License Number 855783 Address: 3584 E LA CAMPANA WAY, PALM SPRINGS, CA FEIN: 510532726 Contractor Email: KRISTYSQPWLC2.COM 92202 Insurance Number: WSD 5059867-00 Awarding Body: CITY OF LA QUINTA DIR Project ID: 290440 Project Name: LANDSCAPE & LIGHTING DISTRICT 89-1 Contract With: CITY OF LA QUINTA County: RIVERSIDE Location Description: LIGHTING AND LANDSCAPE DISTRICT 89-1 LANDSCAPE MAINTENANCE OF CITYWIDE MEDIANS Payroll Number: 92- 1 For Week Ending: 04104/2021 Is this a'Statement of Non -Performance?' Name, Address and Social SecurityNumber of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gress Amount Earned Federal Tax FICA State Tax 541 Vac/ Holiday Health 6 Welf. Pension Net Wage Paid For Week Check Number 0 Date APOLINAR GONZALEZ MARTINEZ 33255 DATE PALM #19 CATHEDRAL CITY CA 92234 Work Classification 03129 03130 03131 04/01 04102 04103 04104 This Pra ect I All Projects i 0.00 36.72 0.00 5.76 0.00 0.00 D.00 Hours Worked Each Day LANDSCAPE MAINTENANCE LABORER g 0.00 8.00 8.00 8.00 8.00 0.00 0.00 3200 0.00 0.00 15,00 22.50 30.00 480.00 480.00 Training Fund Admin Dues Tray/ Subs Savings Other Total Deduct 437.52 33473 D 0,00 0.00 0.00 0,00 0.00 0.00 0.00 0.00 0 00 0.00 000 0.00 1 000 42.48 D 0.00 1 0.D0 0.00 0.00 0,00 0.00 0.00 NOTE: ::J Name, Address and Social Security Number of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tuo Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gross Amount Earned Federal Tax FICA Slate Tax SDI Vac! Holiday Health & Welf. Pension Nei Wage Paid For Week Check Number 3 Dale ARMANDO RICO CHAVEZ 2103 JACQUES DR PALM SPRINGS CA 92262 Work Classirrcatlon 03129 03130 03I31 04101 04102 04103 04M4 This Project Pra l All Projects 53.29 61.20 14.10 9.60 0.00 0.00 0.00 Hours Worked Each Day H LANDSCAPE MAINTENANCE LABORER $ 8.00 8.00 8.00 8.00 8.00 0.00 0.0f! 40.00 0.00 0.00 20.00 30.00 40.0- 800 00 800.00 Training 9 Fund Admin Dues STray/ubs Subs Savings 9 Other Total Deduct 861.81 33472 O 0.00 0.00 0.00 0.00lig 0.00 0.00 0.00 0.00 0.00 0.00 0.00 13$.19 o.00 0.00 0.00 0.00 NOTE: Name, Address and Social SecurityNumber of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon rue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gress Amount Earned Federal Tax FICA Stale Tax SDI Vac/ Holiday&Wolf. Health Pension Net Wage Paid For Week Check Number 4 Date CARLOS LUNA GONZALEZ 66145 TTH ST DESERT HOT SPRINGS CA 9224D Work Classification 03129 03130 03131 04101 04102 04103 04104 This Project All Prolocts 30.57 66.63 1.00 10.45 0.00 0.00 0,00 Hours Worked Each Day TREE MAINTENANCE LABORER S 8,00 BAD 8.00 0.00 8.00 0.00 0.00 32.00 0.00 0.00 27.22 40.83 54.44 871.04 871.04 Training 9 Fund Admin DuesTravi Subs Subs Savings 9 Other Total762.39 t Deduct 33481 O 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 108.65 D O.OD 0.00 1 0.00 O.00 0.00 0.00 0.00 NOTE: Public Works Certified Payroll Reporting Form 03/05/2021 - Page 1 Public Works Certific ayroll Reporting Form Contractor Name: PWLC II, INC. Project Name: LANDSCAPE & LIGHTING DISTRICT 89-1 For Week Ending: 04/04/2021 Payroll Number:92-1 Name, Address and Social Security Number of Worker Number of Withholding Day Deductions, Contributions, and Payments Man Tue Wed Thu Fri Sat Sun fatal Hours Hourly Pay Rate Gross Amount Earned Federal Tax FICA Stale Tax SDI Vac! Holiday Health & Wall. Pension Net Wage Paid For Week Check Number 0 Date ELIZABETH OJEDA 67145 SAN GABRIEL CIR E CATHEDRAL CITY CA 92234 Work Classification 03129 03130 03131 04101 04102 04103 04104 This Pro act { All P ects rot 0.00 45,90 1,17 7.20 0.00 0.00 0.00 Hoots Worked Each Day LANDSCAPE MAINTENANCE LABORER 5 8.00 B.00 8.00 8.00 8.00 0.00 D.00 40.00 15.00 600.00 600.00 Tralnin 9 Fund Admin Dues Travl Subs Savin s 9 Other Total 545,73 33475 p 0,00 0,00 0,00 0.00 0.00 0.00 0.00 0.0D 22.50 0.00 0.00 0.00 0.00 0.00 0.00 54.27 D 0.00 1 0.00 0.00 0.00 0.00 0.00 0.00 0,00 30.00 NOTE: Name, Address and Social Security Number at Worker Number of Withholding Day Deductions, Contributions, and Payments Man Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay state Gross Amount Earned Federal Tax FICA Stale Tax SDI Vacl Holiday Heallh & Walf. Pension Net Wage Paid For Week Check Number GENARO VARGAS 69130 VICTORIA DR CATHEDRAL CITY CA 92234 5 pale Work Classification 03129 03130 03131 04101 04102 04103 04104 This Project I All rot Projects 0.00 48.55 0.00 7.62 0.00 0,00 0,00 Hours Worked Each pay LANDSCAPE MAINTENANCE LABORER S 8.00 8.00 8,00 8.00 8.00 0.00 0.00 40.00 0.00 0.00 16.00 24.00 32.00 640.00 640.00 Training Fund Admin Dues Tray/ Subs Savings Other Total 578.52 33476 Q 0.00 0.00 0.00 0.00 0.00 D.00 0.00 0.00 0.00 0.00 0.00 0,DD 5,31 61,46 D0.00 O.DD 0.00 O.OD D,00 0,00 O.OQ MOTH: 55.31 OTHER = FH125D Name, Address and Social Security Number of Worker Number of Withholding Day Deductions, Contributfons, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourlyy Pay Rate Gross Amount Earned Federal Tax FICA Stale Tax SDI Vac1 Hotida Heallh & Wolf. Ponslon Net Wage Paid For Week Check Number 0 bale GUSTAVO HERRERA 32250 AURORA VISTA RD CATHEDRAL CITY CA 92234 Work Classification 03129 03130 03131 04101 04102 04103 04104 This Project I All Projects 1 0.00 36,72 0.00 5.76 0,00 0.00 0.00 H Hours Worked Each pay LANDSCAPE MAINTENANCE LABORER S 8.00 8.00 8.00 8.00 0.00 0.00 0.00 32.00 0.00 0,00 15.00 22.50 30.00 480.00 480.00 Training Fund Admin Dues Tray? Subs Savings Other Total 437,52 33474 p 0.00 0.00 O.DQ 0.00 0.00 0.00 0,00 0.00 0.00 0.00 0.00 0.00 0.00 42.48 D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 rN0TE- Name, Address and Social SecurityNumber of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Houdy Pay Rate Grass Amount Earned Federal Tax FICA Stale Tax SDI Vac! Holiday Health A Wolf, Pension Net Wage Paid For Week Check Number 0 pate HUMBERTO S. VALDEZ 12966 CACTUS OR qA DESERT HOT SPRINGS CA 92240 - Work03129 Classification 03130 03131 04101 04102 04103 04104 file Project All Projects 114,57 76.67 30.46 12.03 0.00 0.00 0.00 Hours Worked Each Day TREE MAINTENANCE LABORER S 8.00 8,00 B4O0 8.00 8.D0 0,00 0.00 40.00 p,00 0.00 25.17 37.76 0.00 1.008.80 1,008.80 Trainin Admin Fund Dues Trav! Subs Savings Other Total 768.64 6347165 40 p 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4.43 238.16 p Q.DQ 0.00 o.oa 000 0.00 0.00 0,00 [NOTE: $4.43 OTHER = FH1250 Public works Certified Payroll Reporting Form 08/05/2021 - Page 2 Public Works CertifiE 3yroli Reporting Form Contractor Name: PWLC II, INC. Project Name: LANDSCAPE & LIGHTING DISTRICT 89-1 For Week Ending: 04/04/2021 Payroll Number:92-1 Name, Address and Social SecurityNumber of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sal Sun Total Hours Hourlyy Pay Rate Gross Amount Earned Federal Tex FICA Stale Tax SDI Vac/ Hollda Health & Welf. Pension Net Wage Paid Far Week Check Number D Onto JASSAN J. JAMAND 51963 CALLE AVIlJI COACHELLA CA 92236 MEOW YV1ork Classification 03129 03130 03131 04101 04102 04103 04104 This Pro'act i All Proects 1 45.49 77.02 30.75 12.00 0.00 0.00 0,00 Hours Worked Each Day TREE MAINTENANCE LABORER 5 8.00 8.00 8.00 8,00 8.00 0.00 0.00 40.00 0.00 1 0.00 25.17 37.76 0.00 1,006.80 1,006.80 Training Fund Admin Dues S Subsubs Savings Other Total 841.46 33 541 541 O 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0 .00 0.00 0.00 0.00 0.00 0.00 165.34 D D,00 0,00 0.00 O.OD 0.00 0.00 0.00 NOTE: Name, Address and Social Security Number of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gross Amount Earoed Federal Tax FICA I State Tax SDI Vac1 Holiday Health 6 Well. Pension Net Wage Paid For Week Check Number 4 Date LETICIABONILLA 33477 NAVAJO TR #B CATHEDRAL CITY CA 92234 yy� Classification 03129 03130 03131 04101 04102 04103 04104 This Project All Projects 7.46 48.97 0.00 7,68 0.00 0.0E O.00 Hours Worked Each Day LANDSCAPE MAINTENANCE LABORER S 8.00 8.00 8,00 8.00 B.DO 0.00 0,00 40.00 0.00 1 0.00 16.00 24.00 32.00 640.00 640.00 Training Fund Admin Dues Subs Subs Sayings Other Total 575.89 33470 O 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 64.11 D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: Name, Address and Social Security Number of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gross Amount Earned Federal Tax FICA State Tex SDI Vac! Holiday Health 8 Welf. Pension Net Paid For Week Check Number 4 Date MARCELINO RAMIREZ 1500 E SAN RAFAEL DR #164 PALM SPRINGS CA 92262 Work03129 Classification 03130 03131 04101 D4102 04103 04104 This Protect Ali Projects 53.41 88,57 10.96 13.89 0.D0 0.00 0,00 Hours Worked Each Day TREE MAINTENANC LABORER S 8,00 8.00 8.00 8,00 8,00 0.00 0.00 40.00 0.00 0.00 29.42 I 44.13 58.84 1,176.80 1,176.80 Training Fund Admin Dues Travl Subs Savings Other Total 980.78 33482 O 0,00 0,00 0.00 0.00 0,00 0.00 0.00 0.00 0.0E 0.00 0.00 0.00 19.19 196.02 D 0.00 0,00 0.00 0.00 0.00 0,00 0.00 NOTE: S13.88 OTHER = FH125 , 35.31 OTHER = FH125D Name, Address and Social SecurityNumber of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gross Amount Eamed Federal Fax FICA State Tax SDi Vac! Hollda y Health R Well. Pension Not Wage Paid For Week Check Number 0 Date MARIO VASQUEZ 60285 CORTA RD CATHEDRAL CITY CA 92234 work03129 Classifi 03130 03131 04101 04102 04103 04104 Proacts T7i.-tPcation All 1 0.00 45.90 0.00 7.20 0.00 0.00 0.00 Hours Worked Earn Day LANDSCAPE MAINTENANCE LABORER S 8.00 B.Da 8.00 8.00 8.00 0.00 0.00 40.04 0.00 0.00 15.00 22.50 30.00 600.00 600.00 Training 9 Fund Admin Duos Subs Subs Savings 9 Other Total 546.90 33477 Q 0.00 0.00 0,00 0.00 O.00 0.00 0.00 0,00 0.00 0.00 0.00 0.00 0.00 53,10 D 0.00 0.00 0.00 1 0.00 0.00 1 0.00 0.00 NOTE: Public works Certified Payroll Reporting Form 08/OS/2021 Page 3 Public Works Certifie ayroll Reporting Form Contractor Name: PWLC II, INC. Project Name: LANDSCAPE & LIGHTING DISTRICT 89-1 For Week Ending: 04/0412021 Payroll Number:92-1 Name, Address and Social securityNumber of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sal Sun Total Hours Hourly Pay Rate Gross Amount Earned Federal Tax FICA Stale Tax SDI Vac/ Holiday Health S Welf, Pension Nat Wage Paid For Week Check Number D Data NOE M. JACINTO 73332 GUADALUPE AVE PALM DESERT CA 92260 Work03129 Classification 03130 03131 04101 04102 04103 04104 This Protect All Projects 0.00 90.02 40.66 14.12 0.00 0.00 0.00 Hours Worked Each Day TREE MAINTENANCE LABORER S 6.0o S.oa B.00 8.00 a.00 0.00 0.00 40.00 0.00 0,0 29.42 44.13 58.84 1,176.80 1,176.80 Training g Fund Admin Dues Trav! Subs Savings g Other Total 1,032,00 33479 Q 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 144.80 D 0,00 0.00 0.00 0.00 0.00 0.00 0.00 �NOTE- Name, Address and Social Security Number of Worker Y Number of Withholding Day Deductions, Contributions, and Payments Man Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gross Amount Earned Federal Tax FICA Stale Tax SDI Vacf Holiday Health iS Welt. Pension Net Wage Paid For Week Check Number 0 Date RAMON A. CASTILLO VIGIL 27335 HOPPER RD DESERT HOT SPRINGS CA 92241 Work Classification 03129 03130 03131 04101 04102 04103 04104 *his Project[Projects Alt 53,61 55.08 16.94 8,64 0.00 0.00 0.00 Hours Worked Each Day LANDSCAPE MAINTENANCE LABORER 5 8.00 8.00 8.00 8.00 0.00 0.00 0.00 32.00 0,00 D.00 18.00 27.00 36.00 576.00 720.00 Training Fund Admin Trav/Dues Subs Subs Savings Other Total 585.73 33471 O 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0,00 D.DD 0.00 0.00 0.00 I 0.00 134.27 D 0.00 0.00 0.00 0,00 0.00 0.00 0.00 NOTE: Name, Address and Social SecurityNumber of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Grass Amount Earned Federal Taz FICA State Tax SDI I Vac! Holiday Health 3 Well. Pension Net Wage Paid For Week Check Number 0 Dale RUBEN F. HENRIOUEZ 15687 PALM OR #83 DESERT HOT SPRINGS CA 92240 Work Classification 03129 03130 03131 04101 04102 04103 04104 This Project All Projects 79.81 61.21 20.19 9.61 0.00 0.00 O.QO Hours Worked Each Day TREE MAINTENANCE LABORER S 0.00 B.00 8.00 8.00 8.00 0.00 0,00 32.00 0.00 1 0.00 25.17 37.76 0.00 805.44 805.44 Training Fund Admin Dues Trav! Subs Savings Other Total 589.04 3347816 539 p 0.00 O.Go 0,00 0,00 0.00 0.00 0,00 0.00 0.00 0.00 0.00 0.00 45.58 216.40 D 0.00 0.00 0.00 1 0.00 0.00 0.00 0.00 1 [NOTE- S40.27 OTHER = CAL SAVERS, S5.31 OTHER = FH125D Name, Address and Social Security Number of Worker Number of Withholding Day Deductions, Contributions, and Payments Man Tue Wed Thu Fri Sal Sun Total Hours Hourly Pay Rate Gross Amount Earned Federal Tax FICA State Tax SDI Vac! Holiday& Health Welt. Pension Net Wage Paid Far Week Check Number 0 Data RUBEN F, HENRIOUE7 15687 PALM OR #83 DESERT HOT SPRINGS CA 92240 yy� Classification 03129 03130 03131 04101 04102 04103 04104 This pro ect 1 All Pro eGS 1 79.81 69.13 20.19 9.28 0.00 0.00 0.00 Hours Worked Each Day TREE MAINTENANCE LABORER S 0.00 8.00 B.00 8.00 8.00 0.00 0.00 32.00 0.00 0.00 24.32 36.48 48.64 778.24 778.24 Training g Fund Admin Dues TraviSubs Sups Savings g Other Total 565.61 33478 0 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00 0.00 0.00 0.00 5.31 173.72 D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: S38.91 OTHER = CAL SAVERS. S5.31 OTHER = FH125D Public works Certified Payroll Reporting Farm 08/OS/2021 - Page 4 eCPR Online Confirmation Your payroll submission request has been processed. Please review the results of your submission. Should you have any questions please contact the eCPR unit at publicworks@dir.ca-gov. There is an existing payroll transaction for this contractor on this project for this week ending date. Transaction ID for that transaction is: 10779205 This certified payroll will be treated as an amendment #: 2 Contractor Name; PWLC 11, INC. Contractor Address: 3584 E LA CAMPANA WAY PALM SPRINGS CA 92262 Awarding Body: CITY OF LA QUINTA Project ID: 290440 Contract With: CITY OF LA QUINTA Week Ending Date: 2021-03-28 Payroll Number: 91 Amendment Number: 2 13 employee payroll record(s) processed Your Transaction ID is: 11760854 Print this Page 'iew your submission Adobe Submit another set of payroll records Public Works Certifie _iyroll Reporting Form Certification under penalty of perjury: "I, KRISTY SOUTH, the undersigned, am the CONTROLLER (position in business) with the authority to act for and an behalf of PWLC II, INC. (name of business and/or contractor), certify under penally of perjury that the records or copies thereof submitted and consisting of certified payroll records for the week ending 2021-03-28 are the originals or true, full, and correct copies of the originals wNrh fJAWI the payroll record(s) of the actual disbursements by way of cash, check, or whatever form to the individual or individuals named. I certify this on 2021-08-05 Contractor Name: PWLC II, INC. Contractor PWCR: 1000037373 License Type: CSLB License Number 855783 Address: 3584 E LA CAMPANA WAY, PALM SPRINGS, CA FEIN: 510532726 Contractor Email: KRISTYS@PWLC2.COM 92202 Insurance Number: WSD 5059867-00 Awarding Body: CITY OF LA OUINTA DIR Project ID: 290440 Project Name: LANDSCAPE E, LIGHTING DISTRICT 89-1 Contract With: CITY OF LA OUINTA County: RIVERSIDE Location Description: LIGHTING AND LANDSCAPE DISTRICT 89-1 LANDSCAPE MAINTENANCE OF CITYWIDE MEDIANS Payroll Number: 91- 2 For Week Ending: 03/2812021 - Is this a'Statement of Mon -Performance?' Name, Address and Social Security Number of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Grass Amount Earned Federal Tax FICA Stale Tax SDI Vac! Holiday Health d Well. Pension Net Wage Paid For Week Check Number 3 Date ARMANDO RICO CHAVE2 2103 JACQUES DR PALM SPRINGS CA 92262 Work Classification 03122 03123 03124 03r25 03126 03r27 03128 This Project All Projects 53.29 61.20 14.10 9.60 0.00 0.00 0.00 Hours Worked Each Day LANDSCAPE MAINTENANCE LABORER S 8.00 8.00 8.D0 8.00 8.00 0.00 0,00 40.00 0.00 0.00 20.00 30.00 40,00 800.00 800.00 Training Fund Admin Dues Travl Subs Savings Other Total Deduct 661.81 33439 O 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 138.19 D 0.00 D.00 0.00 4.00 0.00 0.40 0.00 NOTE: Name, Address and Social SecurityNumber of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sal Sun Total Hours Hourly Pay Rate Grass Amount Earned Federal Tax FICA State Tax SDI VaG Holiday8 Health Welt. Pension Net Wage Paid For Week Check Number 4 Data CARLOS LUNA GONZALEZ 66145 7TH ST DESERT HOT SPRINGS CA 92240 Work Classification 03122 03123 03124 03125 D3126 03127 03128 This Project P All Projects 1 55.16 83.29 7.93 13.07 0.00 0.00 0.00 Hours Worked Each Day TREE MAINTENANCE LABORER S 8.00 8.00 8.00 8.00 8.11g 0.00 0.00 40.00 0.00 0.00 27.22 40.83 54.44 1,088.86 1,088.80 Training Fund Admin DUOS Trav! Subs Savings Other Total Deduct 929.35 33448 O 0.00 O.DO 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 159.45 D 0.00 4.00 0100 0.00 0.00 0.00 0.00 NOTE: Name. Address and Social Security Number of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Grass Amount Earned Federal Tax FICA State Tax SDI Vad Holiday Health A Wolf. Pension Nei Wage Paid Far Week Cheb.e Number 0 Date ELIZABETH OJEDA 67145 SAN GABRIEL CIR E CATHEDRAL CITY CA 92234 some Work Classification 03122 OW23 03124 03125 03126 03127 03128 This Pro ect i All Projects 0.00 45.90 1.17 7.20 0.00 0.00 0.00 Hours Worked Each Day LANDSCAPE MAINTENANCE LABORER S 8.00 8.00 8.00 6.D0 8.00 0.00 0.00 40.00 0.00 1 0.00 15.00 22.50 30.00 fi00.00 600.00 Training Fund Admin TraviDues Subs Subs Savings Other Total Deduct 545.73 33442 O 0.00 0.00 0.00 0,00 O.00 0.00 0.00 1 0.00 0.00 0.00 1 0.00 0.00 0.00 54.27 D 0.00 0.00 1 0.00 0.00 1 0.00 0.00 0.00 1 NOTE: Public works Certified Payroll Reporting Form 08/05/2021 - Page 1 Public Works CertifiE ayroll Reporting Farm Contractor Name: PWLC II, INC. Project Name: LANDSCAPE & LIGHTING DISTRICT 89-1 For Week Ending: 03/28/2021 Payroll Number:91-2 Day Deductions, Contributions, and Payments Name, Address and Social Security Number of Worker Number of Withholding Mon Tue Wed Thu Fri Sal Sun Total Hours Hourly Pay Role Gross Amount Earned Federal Tax FICA State Tax SDI Vac! Holiday Health a wolf. Pension Net wage Paid For Week Check Number 5 Date GENARO VARGAS 69130 VICTORIA DR CATHEDRAL CITY CA 92234 work Classification 03122 03125 03124 07125 03126 03127 03128 This Project All Projects 0,00 48.56 0.00 7.62 0.00 0.00 MOD Hours Worked Each Day LANDSCAPE MAINTENANCE LABORER S 8.00 8.00 8.00 8.00 8.00 0,00 0.00 40.00 0.00 16.00 24.00 640.00 640.00 Training Fund Admin Dues Tir Subs Savings Other Total 578.51 33443 O 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5.31 61.49 D 0.00 0.00 0,00 0.00 0.00 0.00 "032.00 NOTE: $5.31 OTHER = FH1250 Name, Address and Social Security Number of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Howdy Pay Rate Gross Amount Earned Federal Tax FICA Slate Tax SDI Vacl Holiday Health a Wolf. Pension Not Paid For Week CheckWage Number 0 Date GUSTAVO HERRERA 32250 AURORA VISTA RD CATHEDRAL CITY CA 92234 Work Classification 03122 03123 03124 03125 03I26 03127 03128 This Project All Projects 0.00 45.90 0.00 7.20 4.00 0.00 0.00 Hours Worked Each Day LANDSCAPE MAINTENANCE LABORER 5 8.00 8.00 8.00 8.00 8.D0 0.00 0.00 40.00 0.00 0.00 15.00 22.50 30.00 600.00 600.00 Training Admin Dues Travi Subs Savings Other Total 546.90 33441 U 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 O.Do 0.00 0.00 0.00 53.10 D 0,00 0.00 0.00 0.00 0,00 0.00 0.00 NOTE: Name, Address and Social Security Number of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tuo Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gross Amount Earned Federal Tax FICA Slate Tax SDI Vacly H olida Health a Weil. Pension Nel Wage Paid For Check Number 0 bale HUMBERTO S. VALOFZ 12966 CACTUS DR MA DESERT HOT SPRINGS CA 92240 Work Classification 03122 03123 03124 03125 03126 03127 03128 This Project All ProjectsWeek 115.54 77.01 30.75 12.08 0.40 0.00 D.00 Hours Worked Each Day TREE MAINTENANCE LABORER S 8 00 8.00 8.00 0.00 8.00 0.00 0.00 40.00 0.00 0.00 25.17 37.76 0.00 ] 1,OD6,60 7,006.60 Training Fund Admin Dues Trav! Subs Savings Other Total 1 1 771,42 3345016 537 0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0,00 235.38 D 0.00 0,00 0.00 0.00 0.00 0.00 0.00 NOTE: 7t] Name, Address and Social Security Number of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gross Amount Earned Earned Federal Tax State Tax SDI Vacl Holiday Health a welt. Pen sion Net Wage Paid For Week Check Number 0 Date JASSAN J. JAMAND 51963 CALLE AVILA COACHELLA CA 92236 Noma Work Classification 03122 03123 03124 03125 03126 03127 03128 This Project All Projects 45.49 77.01 30.75 12.08 O.Qo 0.00 0.00 Hours Worked Each Day1 TREE MAINTENANCE LABORER 5 8.00 8.00 8,00 B4O0 8.00 0.00 0.00 40,00 0.00 0.00 25,17 37.76 0.00 1.006.80 1.006,80 Training Fund AdminLues Tray/ Subs Savings Other Total 841.47 3344716 538 O 0.00 0.00 0.00 0.00 0.00 0.00 0.on 0.00 0.00 0.00 0.00 0.00 165.33 p 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: Public works certified Payroll Reporting Form 08/05/2021 - Page 2 Public Works CertifiE 3yroll Reporting Form Contractor Name: PWLC II, INC. Project Name: LANDSCAPE & LIGHTING DISTRICT 89-1 For Week Ending: 03128/2021 Payroll Number:91-2 Name, Address and Social Security Number of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tuo Wad Thu Fd Sot Sun Total Hours Hourly Pay Rate Gross Amount Earned Federal FICA State Tax SDI Vac! Holiday Health d Welf. Pension Not Wage Paid For Week Check Number 4 Date LETICIA BONILLA 33477 NAVAJO TR NB CATHEDRAL CITY CA 92234 Work Classification 03122 03123 03124 03125 03126 03r27 03128 This Project Alt Projects 0.00 39.16 D.00 6.14 0.00 0.00 0.00 Hoots Worked Each Day LANDSCAPE MAINTENANCE LABORER 5 8.00 8.00 8.00 8.00 0.00 0.00 0,00Fund 32.00 0.00 1 0.00 16.00 24.00 32.00 512.00 512.00 Training Admin Dues Travi Subs Savings Other Total 466,70 33437 Q 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 45,30 D 0.00 0.00 0.00 0.00 1 0.00 1 0.00 1 0.00 NOTE: Name, Address and Social Security Number of Worker Number of Withholding flay Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gross Amount Earned Federal Tax FICA Stale Tax SDI Vacl Holiday Health A Welf. Pension Net Wage Paid For Week Check Number 4 Dale MARCELINO RAMIREZ 1500 E SAN RAFAEL DR 0164 PALM SPRINGS CA 92262 yy Classification 03122 03123 03r24 03125 03126 03127 03r28 This ProJeCi All Projects 63.41 88.56 10.96 13.99 0.00 0.00 0.00 Hours Worked Each Day TREE MAINTENANCE LABORER S 8.0) 8.00 8,00 8,00 8.00 0.00 0.00 40.00 0,00 0,00 29.42 11 44.13 58.84 1,176.80 1,176.80 Training Fund Admin Dues Subs Subs Savings Other Total 980.79 33449 p 0.00 0.00 0.00 0,00 0.00 0.00 D,00 0.00 0.00 0.00 0.00 0.00 19.19 196.01 D D.QO 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: $13.88 OTHER z FH125 , S5.31 OTHER = FH125D Name, Address and Social SecurityNumber of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sal Sun Total Hours Hourly Pay Rate Gross Amount Earned Federal Tax FICA State Tax SDI Vac/Health Holiday I 8 Welf, Pension Net Wage Paid Far Week Number r 0 Date MARIO VASOUE2 68205 CORTA RD CATHEDRALCITY CA 92234 Work Classification 03122 03123 03124 03125 03126 03127 03128 This Project ect All Projects 0,00 45,90 0.00 7.20 D.D0 0.00 0.00 Hours Worked Each Day LANDSCAPE MAINTENANCE LABORER 5 8.00 8.00 8.00 6.00 8.00 0.00 0.00 40.00 0.00 0.00 15.00 22,50 30.00 600.00 600.00 Training Fund Admin puns Travl Subs Savings Other Total 546.90 33444 p 0.00 0.00 0.00 0,00 0,00 0.00 0,00 0.00 0.00 0.00 0.00 5.00 0.00 53,10 D 0.00 0.00 1 0.00 1 0.00 0.00 1 0.00 1 0.00 NOTE: Name, Address and Social Security Number of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gross Amount Earned Federal Tax FICA State Tax SDI VaW Holiday Health 3 Well. Parisian Net Wage Paid For Week Number 0 Date NOE M. JACINTO 73332 GUApALUPE AVE PALM DESERT CA now yy� Classification 03122 03123 03124 03125 03126 03127 03128 This P ', Cl 1 All Pro acts I 0.00 9D.02 4D.66 14.i2 D.00 0.00 0.40 Hours Worked Each Day TREE MAINTENANCE LABORER S 9,00 8.00 a,00 8,00 6,00 0.00 0.00 40.00 0.00 0.00 29.42 44,1392260 58.84 1,176.80 1,176.80Ea'n(')ngFund Admin Duos Trav! Subs Savngs Other Total 1,032.00 33446 Q 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00 0.00 7180 D 0.00 0,00 0.00 0.00 0.00 0.01) 0.00 NOTE: Public works Certified Payroll Reporting Form 08/0512021. Page 3 Public Works Certifie ayroll Reporting Form Contractor Name: PWLC 11, INC. Project Name: LANDSCAPE & LIGHTING DISTRICT 89-1 For Week Ending: 03/2812021 Payroll Number:91-2 Name, Address and Social Security Number of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gross Amount Earned Federal Tax FICA State Tax SDI Vac! Holiday Health d Weif. Pension Net Wage Paid For Week Check Number 0 Date RAMON A. CASTILLO VIGIL 27335 HOPPER RD DESERT HOT SPRINGS CA yy Classification 03122 03123 03124 03425 03126 03127 03l28 Thls Projeel IT All 53.61 55.08 16.94 8.64 0.00 0.00 0.00 Hours Worked Each Day LANDSCAPE MAINTENANCE LABORER 5 8.00 8.00 8.00 8.00 8.00 0.00 0,00 40.00 0.00 0.00 18.00 27.0092241 36.04 720.00 72D.aD Training Admix Dues Subs Savings Other Total 585.73 33438 ro D.00 0.00 0.00 0,00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 134.27 0.00 0.00 O.Cm 0.00 0.00 0.00 0.00 NOTE: Name, Address and Social Security Number of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gross Amount Earned Federal Tax FICA Slate Tax SDI Vac/ Holiday Health & Wetf. Pension Net wage Paid Far Week Check Number 0 Date RUBEN F. HENRIOUEZ 15687 PALM DR #83 DESERT HOT SPRINGS CA 9224D 1 Work Classification 03122 03123 03124 03l25 03126 03127 03128 This Project All Projects 101.00 71.80 29.01 11.26 0.00 0.00 000 Hours Worked Each Day TREE MAINTENANCE LABORER S 5.50 8.00 8.00 0.00 0.00 37.50 0,00 0,00 25.17 37.76 48.64 943 88 943.88 Training Fund Admtn Dues Tray/ Subs Savings Other Total 078.31 3344516 536 O 0.00 t0000, 0.00 0,00 0.00 0.00 0 00 0.00 0.40 0.00 0.40 52.50 265.57 D 0.00 0,00 0.00 0.00 0.00 NOTE: S47.19 OTHER = CAL SAVERS, SS 31 OTHER = FH125D Public works Certified Payroll Reporting Form 08/OS/2021 - Page 4 eCPR Online Confirmation Your payroll submission request has been processed. Please review the results of your submission. Should you have any questions please contact the eCPR unit at publicworks@dir.ca.gov. There is an existing payroll transaction for this contractor on this project for this week ending date. Transaction ID for that transaction is: 10718639 This certified payroll will be treated as an amendment #. 1 Contractor Name: PWLC II, INC. Contractor Address: 3584 E LA CAMPANA WAY PALM SPRINGS CA 92262 Awarding Body; CITY OF LA QUINTA Project ID: 290440 Contract With: CITY OF LA QUINTA Week Ending Date: 2021-03-21 Payroll Number. 90 Amendment Number: 1 13 employee payroll record(s) processed Your Transaction ID is; 11759950 Print this Page �I 'iew your submission Submit another set of payroll records Public Works Certifier ayroll Reporting Form Certification under penalty of perjury: "I, KRI STY SOUTH, the undersigned, am the CONTROLLER (position in business) with the authority to act for and on behalf of PWLC Il, INC, (name of business and/or contractor), certify under penalty of perjury that the records or copies thereof submitted and consisting of certified payroll records for the week ending 2021-03-21 are the originals or true, full, and correct copies of the originals which depict the payroll record(s) of the actual disbursements by way of cash, check, or whatever form to the individual or individuals named. I certify this on 2021-08-05." Contractor Name: PWLC It, INC. Contractor PWCR: 1000037373 License Type: CSLB License Number 855783 Address: 3584 E LA CAMPANA WAY, PALM SPRINGS, CA FEIN: 510532726 Contractor Email: KRISTYS@PWLC2.COM 92202 Insurance Number: WSD 5059867-00 Awarding Body: CITY OF LA OUINTA DIR Project ID: 290440 Project Name: LANDSCAPE 8 LIGHTING DISTRICT 89-1 Contract With: CITY OF LA OUINTA County: RIVERSIDE Location Description: LIGHTING AND LANDSCAPE DISTRICT 89-1 LANDSCAPE MAINTENANCE OF CITYWIDE MEDIANS Payroll Number: 90- 1 For Week Ending: 03/21/2021 Is this a'Statement of Non -Performance?' i Name. Address and Social Security Number of Worker Number of Withholding Day Deductions, Contrlbutions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gross Amount Earned Federal Tax FICA State Tax SDI vac/ Holiday Health 6 Welf. Pension Not Wage Paid For Week Check Number 0 Date APOLINAR GONZALEZ MARTINEZ 33255 RATE PALM #14 CATHEDRAL CITY CA 92234 Work Classification 03115 03/16 03117 03118 03119 03120 03121 This Protect Alt Projects 0.00 45.90 0.00 7.20 0.00 0.00 0.00 Hours Worked Each Ray LANDSCAPE MAINTENANCE LABORER S e.pp 8 00 a 00 8 09 8.00 0,00 0.00 40.06 0.00 0,00 15.00 I 22.50 30.00 600.00 600.44 Training Fund Admin Dues Trav! Subs Savings Other Total Deduct 546.90 33297 0 0.00 0.00 o qv 0.00 O.OD 0A0 o 00 4.00 000 0.00 0.00 0.00 0.00 53.10 D 0.00 0.00 0 00 0.00 0.00 0.00 600 NOTE: Name, Address and Social Security Number of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Teal Hours Hourly Pay Rate Gross Amount Earned Federal Tax FICA Slate Tax SDI Vac/ Holiday Health 8 Wait, Pension Net Wage Paid For Week Check Numbor 4 Data CARLOSLt1NAGONZALEZ 66145 7TH 5T DESERT HOT SPRINGS CA 92240 Work Classification 03115 03116 03117 03118 03119 03120 03121 This Project AIi Projects 55.16 83.30 7.93 13.07 0.00 0.00 0.00 Hours Worked Each Day TREE MAINTENANCE LABORER 8.00 4.00 0.00 8.00 D DO 0.00 28.00 0.00 0.00 27.22 40.83 54.44 1 762.16 1.088.80 L Tralning Fund Admin Duas Trav/ Subs Savings Other Total Deduct 929.34 33305 tD. 0.00 0.00 0.00 0.00 0.00 0.00 q,p0 0,pp 0,00 0.00 0,00 0.00 159.46 0.00 0.00 0,00 0.00 0.00 0.00 NOTE: Name, Address and Social Security Number of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Grass Amount Earned Federal Tax FICA State Tax SDI Vacl Holiday Health E Well, Pension Net Wage Paid For Week Check Number 0 Date ELIZABETH OJEDA 67145 SAN GABRIEL CIR E CATHEDRAL CITY CA 92234 OEM yy Classification 03115 03116 03117 03118 03119 03120 03121 This Project i All Projects � 0.00 36.72 0.00 5.76 0.00 0.00 0,00 Hours Worked Each Day LANOSCAPE MAINTENANCE LABORER S 0.00 8.00 8.00 8.00 8.00 0.00 0.00 32,00 0.00 0.00 15,00 22.50 30.00 480.00 480.00 Training Fund Admin Dues Travl Subs Savings Other Total Deduct 437.52 33299 0 0.00 0.00 1 0.00 0,00 0,00 0,00 1 0.00 0.00 0.00 0.00 0.00 0.00 1 0.00 42.48 D 0.00 0.00 0.00 0.00 0.00 0.00 1 0.00 NOTE: Public works certified Payroll Reporting Form 08/05/2021 - Page 1 Public Works CertifiE 3yroll Reporting Form Contractor Name: PWLC II, INC. Project Name., LANDSCAPE & LIGHTING DISTRICT 89-1 For Week Ending: 03/21/2021 Payroll Number.90-1 Name, Address and Social Security Number of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gross Amount Yarned Federal Tax FICA State Tax SDI Vac/ Holiday y Health &Well. Pension Net Wage Paid For Week Check Number 5 Date GENARO VARGAS 69130 VICTORIA OR CATHEDRAL CITY CA 92234 work Classification 03115 03116 03117 03118 03119 03120 03121 ThisTtProjects I Proje All 0.00 48.55 0.00 7,62 0,00 0,00 0.o0 Hours Worked Each pay LANDSCAPE MAINTENANCE LABORER 5 8.00 8.00 8.00 8.00 8,00 0.00 0,00 40.00 0.00 0.00 16.00 24.00 32.00 640.00 640.00 Training Fund Admin Duos Tray! Subs Savings Other Total 578.52 33300 Q 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.001: 5.31 61.48 D 0,00 0,00 0,00 0,00 0.00 0.00 0,00 NOTE: 55.31 OTHER = FH 1250 Name, Address and Social SecurityNumber of Worker Number of Withholding Day Deductions, Contributions. and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gross Amount Earned Pectoral Tax FICA State Tax SDI Vac/ Holida y Health & Wolf. Pension Ne t Wage Paid For Week Check Number 0 Date GUSTAVO HERRERA 32250 AURORA VISTA Rb CATHEDRAL CITY CA 92234 Work Classification 03115 03116 03117 03118 03119 03J20 03121 This Pra 5 1 All Projects 1 0.00 45.9D 0.00 7.20 0.00 0.00 0.00 Hours Worked Each Day LANDSCAPE MAINTENANCE LABORER S 8.00 8.00 B.00 8.00 8.00 0.00 0.00 40.00 0.00 p,00 15.90 22.50 30.00 600.00 fi00.00 Training 9 Fund Admin Dues Tray! Subs Savings 9 Other Total 546.90 33298 Q 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 53.10 p 0.00 0,00 0.00 0.00 0.00 0.00 0.00 TE: �No Name, Address and Social SecurityNumber of Worker Number of Withholding Day Deductions, Contributions, and Payments Men Tue Wed Thu Fri Sat Sun Total Hours Haudy Pay Rate GrossAmoun! Earned ed Federal Tax FICA State Tax SDI Vac! Holiday& Health Welt. Pension Net Wage Paid For Week Check Number 0 Date HUM13ERTO S. VALDEZ 12966 CACTUS DR #A DESERT NOT SPRINGS CA 92240 Work Classification 03115 03116 03117 03118 03119 03120 03121 This Pro eel I All Pro eels i 07.31 76.13 7.15 11.95 0.00 0.00 0.00 Hours worked Each Ray TREE MAINTENANCE LABORER $ 8.00 8.00 8,00 8.00 8.00 0,00 0.04 40.00 0,00 0.00 25.17 37.76 0.00 1,006.80 1,006.00 Training Fund Admin Dues Trav! Subs Savings Other Total 812.76 3330716 534 Q 0.00 0,D0 0,00 0.00 0.00 0.00 0,00 0.00 0.00 0.00 0.00 0.00 11.50 194.04 D 0.D0 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: 311.50 OTHER = FH125D Name, Address and Social Security Number of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gross Amount Earned Federal Tax FICA State Tex SDI Vac! Holiday Health & Well. Pension Net Wage Paid Far Week Check Number 0 Dale JASSAN J. JAMAND 51963 CALLE AVILA COACHELLA Work Classification 03115 03116 03117 03118 03119 03f20 03121 Thts Project All Projects 0.00 77.01 7.41 12.08 0.00 0.00 0.00 Hours Worked Each Day TREE MAINTENANCEAdmin S 8.00 8,00 8.00 8.00 8.00 0,00 0.00 40.00 0,00 O.OD 25.17 37.7692236 0.00 1,006.80 1,006,80Lain,'"Fund DuesTray/Subs Subs Savin s 9 Other Total 910.303330416 5CA 535LABORER Q 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 96.50 p 0.00 O.OD D.DO 0.00 0.04 0.00 0.00 ROTE: Public works certified Payroll Reporting Form 00/05/2021 - Page 2 Public: Works Certific ayroll Reporting Form Contractor Name: PWLC II, INC. Project Name: LANDSCAPE & LIGHTING DISTRICT 89-1 For Week Ending: 03121/2021 Payroll Number:9O-1 Name, Address and Social Security Number of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sal Sun Total Hours Hourly Pay Rale Gross Amount Eamed Federal Tax FICA I State Tax SDI I Vac! Holiday Health 8 Wolf. Pension Net Wage Paid For Week Check Number 4 Date LETICIA BONILLA 33477 NAVAJO TR #0 CATHEDRAL CITY CA 42234 Work Classification 03115 03116 03117 03118 03119 03120 03121 This Project Atl Projects 7.46 48,96 0,00 7.68 0.00 0.00 0.00 Hours Worked Each Day LANDSCAPE MAINTENANCE LABORER S 8.00 8.00 8.00 8.00 9.00 0,00 0.00 46.00 0.00 0.00 16.00 24.00 32.00 640.00 6410.00 Trainin 9 Fund Admin Dues Trav! Subs Savin s 9 Other Total 575.90 33294 0 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 1 64.10 D 0.00 0.00 0.00 0.00 0.00 0,00 0.00 NOTE: Name, Address and Social Security Number of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gross Amount Earned Federal Tax FICA Stale Tax SDI Vacf Holiday Health d Welf. Pension Net Wage Paid For Week Check Number 4 Date MARCELINO RAMIREZ 1500 E SAN RAFAEL OR 9164 PALM SPRINGS CA 92262 Work Classifrcalmn 03115 03116 03117 03118 03119 03120 03121 This Project All Projects 63.41 88.56 10.96 13.69 0.00 0.00 0.00 Hours Worked Each Day TREE MAINTENANCE LABORER 5 8.00 8.00 4.00 0.00 8.00 0.00 0.00 28.00 0,()()44.13 0.00 29.42 58,84 823.78 1,176.80 Training Fund Admin DuesTrav/ Subs subs Savior 9s Other Total 980.79 33300 O 0,00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00some O.00 19.i9 196.0t p O.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: $13.89 OTHER = FH125 , $5.31 OTHER = FH125D Name, Address and Social SecurityNumber of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Raie Gross Amount Earned Federal Tax FICA Slate Tax SDt VaW Hotiday Health 8 WelL Pansies Net Wage Paid For Week Check Number 0 Dale MARIO VASOUEZ 68285 CORTA RD I CATHEDRAL CITY CA 42234 Work Classification 03115 03116 03117 03118 03119 03120 03121 This Project All Projects 0.00 45.90 0.00 7.20 0.00 0.00 0.00 Hours Worked Each Day LANDSCAPE MANTENANCE LABORER S 8.00 9.00 8,00 8,00 8.00 0,00 0,00 40.00 0.00 0.00 15.00 22.50 30.00 600.00 600.00 Training 9 Fund Admin Dues Trav! Subs Savin s 9 Other Total 546.90 33301 D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0,00 0,00 0100 0,00 53,10 D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: Name, Address and Social SecurityNumber of Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rale Gross Amount Earned federal Tax FICA State Tax SDI Vac! Holiday Health & Welf. Pension Net Wage Paid For Week Check Number 0 Date NOE M. JACINTO 73332 GUADALUPE AVE PALM DESERT CA 92260 S Work Classification 03115 03116 03117 03118 03119 03120 03121 This Projec[ All Projects 0.00 90.03 0.00 14.12 0.00 0.00 0.00 Hours Worked Each Day TREE MAINTENANCE LABORER 5 8.09 8.00 8.00 8.00 8.00 0.00 0.00 41.11 0.00 0,00 29.42 A4.13 5a.6a 1.176,80 1.176.80 Training g Fund Admin Dues Subs Subs Savings g Other Total 1,072.65 33303 p 0.00 0.00 0.00 0,00 0.00 0.00 0.00 0.00 Q.00 0.00 0.00 0.00 0.00 104.15 p a.aa v.oQ 0.00 O.aa v.00 a.aa o.av NOTE: Public works Certified Payroll Reporting Form 08/05/2021 - Page 3 Public Works CertifiE ayroll Reporting Form Contractor Name: PWLC I!, INC. Project Name: LANDSCAPE S LIGHTING DISTRICT 89-1 For Week Ending: 03/2112021 Payroll Number:90-1 Name, Address and Social Security Number of worker ty Number of Withholding Day Deductions, Contributions, and Payments Man Tue Wed Thu Frl Sat Sun Total Hours Hourly Pay Rate Gross Amount Esmed Federal Tax FICA Stale Tax SD1 Vacl Hailda y Heallh d Welf. Pension Not Wage Paid For week Check Number 0 Date RAMON A. CASTILLO VIGIL 27335 HOPPER Rp DESERT HOT SPRINGS CA 92241 Work Classification 03115 03116 03117 03118 03119 03120 03121 This Project Afl Projects 53.61 55.08 16.94 8.64 0.00 0.00 0.00 Hours Worked Each Day LANDSCAPE MAINTENANCE LABORER S 8.00 8,00 8.00 8,00 8.00 0,00 0,60 40.00 0.00 0.00 18.00 27.00 36,00 720.00 720.00 Training Fund Admin Duos Trav1 Subs Savings Other Total 585.73 33295 O 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0,00 700 134.27 D 0.00 0,00 0,00 0.00 0.00 0.00 0.0D NOTE: 7�7j Name, Address and Social Security Number at Worker Number of Withholding Day Deductions, Contributions, and Payments Mon Tue Wed Thu Fri Sat Sun Total Hours Hourly Pay Rate Gross Amount Earned Federal Tax FICA State Tax SDI Vae! Hetida y Health 3 Welf. Pension Net Wage Paid For Week Check Number 0 Dale RUBEN F HENRIOUEZ 15687 PALM OR 983 DESERT HOT SPRINGS CA 92240 Work Classifrcation 03115 03116 03117 03118 03119 03120 03121 This Proiect All Projects 114.38 76.62 33.03 12.02 0.00 0.00 000 Hours Worked Each Day TREE MAINTENANCE LABORER S 8.00 8.00 4.DQ 0.00 8.00 0.00 0.00 28.00 0,00 0.00 25.17 37.7fi 0.00 734.13 1,006.80 Training Fund Admin Dues Trav1 Subs Savings Other Total 715.10 3330216 531 O 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 000 0.00 0 00 55.65 291,70 D 0.00 0.00 0.00 0.00 0.00 1 0.00 0.00 [NOTE. $50.34 OTHER = CAL SAVERS. S5.31 OTHER = FH125D Public works certified Payroll Reporting Form 08/05/2021 - Page 4