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2022-09-27 thru 2022-10-31 Cert PayrolleCPR 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. 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: 2021-10-31 Payroll Number: 122 Amendment Number: 0 11 employee payroll record(s) processed Your Transaction ID is: 12488724 Print this Page View your submission ubmit another set of payroll records Public Works Certifie iyroll Reporting Form Certification under penalty of perjury: "l, KRISTY SOUTH, the undersigned, am the CONTROLLER (position in business) with the authority to act for and on behalf of PWLC II, 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 2021-10-31 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 2021-11-03." Contractor Name: PWLC II, INC. Contractor PWCR: 1000037373 License Type: CSLB License Number 855783 Address: PO BOX 848, THOUSAND PALMS, CA 92276 FEIN: 510532726 Contractor Email: KRISTYS@PWLC2.COM Insurance Number: NA Awarding Body: CITY OF LA QUINTA DIR Project ID: 290440 Project Name: LANDSCAPE & 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: 122- 0 For Week Ending: 10/31/2021 r]Is this a 'Statement of Non -Performance?' Number of Day Deductions, Contributions, and Payments Name, Address and Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sal Sun Gross Amount Federal FICA State SDI Vac! Health Pension Net Date Earned Tax Tax Holiday 8 Welf. ALATORRE, GRISELDA 0 Total Hourly WESTERN AVE Work 10125 10126 10127 10128 10129 10130 10131 Hours Pay Rate This All 0.00 48.96 0.00 7.68 0.00 0.00 0.00 Paid For Week NumberCheckWage 11550 ClassificationHours Worked Each Day Project Projects DESERT HOT SPRINGS CA LANDSCAPE8.00 MAINTENANCE s40.00 8.00 8.00 8.00 6.00 0.00 0.00 16.00 840.00 840.00 Training Fund Admin Dues Tray/Savings subs Subs Other Total Deduct 583.36 11599 LABORER- 0.00 0.00 0.00 0.00 0.00 0.00 0.00 92240 RIVERSIDE O 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 56.64 IMMUNE D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0 00 0.00 NOTE: Name, Address Number of Day Deductions, Contributions, and Payments and Social Security Number of Worker Withholding Mon Tuts Wed Thu Fri Sat Sun Gross Amount Federal FICA Stale SDI Vac/ Health Pension Net Dale Earned Tax Tax Holiday & Well. Wage Check 0 Total Hourly ALFARO, SOCORRO N Work 10125 10126 10127 10128 10729 10/30 10131This Hours Pay Rate All 0.00 48,96 6.17 7.68 0.00 0.00 0.00 Paid For Week Number 11550 WESTERN AVE ClassificationProject Hours Worked Each Day Projects DESERT HOT SPRINGS CA LANDSCAPE MAINTENANCE 5 8.00 8.00 8,00 8.00 B.00 D.00 0.00 40.00 16,00 640.00 640.00 Training Fund Admin Dues Troy! Subs Savings Other Total Deduct 575.19 11600 LABORER- 0.00 0.00 0.00 0 00 0.00 0.00 0.00 92240 RIVERSIDE 0 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 64.81 D 0 00 0 00 0.00 0 Do 0.00 0.00 0.00 0.00 0.00 NOTE: Name, Number of Day Deductions, Contributions, and Payments Address and Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA State SDI Vac/ Health Net Dale Earned Tax Tax Holiday E Welt.Pension Wage Check BRIONES, MARCELINO 2 Total Hourly 50700 CALLE MENDOZA Work 10125 10126 10127 10128 10l29 10/30 10131 Flours Pay Rata This Ail 60.11 59.83 15.02 9.38 0.00 0.00 0.00 Paid For Week Number ClassificationProject Hours Worked Each Day Projects COACHELLA CA LANDSCAPE MAINTENANCE $ 8.00 8.00 8.00 8.00 8.00 0.00 0.00 40.00 17.00 782.00 762.00 Training Fund Admin Dues Tray/ Subs Savings Other Total Deduct 829.84 11601 LABORER- 0 0.00 0.00 0.00 0.00 0.00 2.00 2.00 4.00 ` 97236 RIVERSIDE 25.50 0A0 0,00 0.00 0.00 0.00 7.82 152.16 IMMO D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: OTHER 0- 7.82 401K Public works certified Payroll Reporting Farts 11/03/2021 - Page 1 Public Works Certifie iyroll Reporting Form Contractor Name: PWLC II, INC. Project Name: LANDSCAPE & LIGHTING DISTRICT 89-1 For Week Ending: 10/31/2021 Payroll Number:122-0 Name, Address Number of Day Deductions, Contributions, and Payments and Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA Stale SDI Vac./ Health Pension Net Date Eamed Tax Tax Holiday & Welt. Wage Check 0 Total Hourly CASTILLO VIGIL. RAMON A RD Work 10125 10126 10127 10128 10729 10130 10/31 Hours Pay Rate This All 53.02 61.20 16,19 9.60 0.00 0.00 0.00 Paid For Week Number 27335 HOPPER Classification Hours Worked Each Day Project Projects DESERT HOT SPRINGS CA LANDSCAPE MAINTENANCE S 8.00 8.00 8.00 8.00 8.00 0.00 0.00 40.00 20.00 800.00 800.00 Training Admin Dues Subs Savings Other Total 651.99 11602 LABORER- 0.00 0.00 0.00 0.00 0.00 0.00 0.00 92241 RIVERSIDE o 0.00 0.00 0.00 0.00 0.00 0.00 0.00 8.00 148.01 D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: OTHER = 8.00 401K Name, Address Number of Day Deductions, Contributions, and Payments and Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA Stale SDI Vac/ Health Pension Net Dale Eamed Tax Tax Holiday & Well. Wage FIDELIA 0 Total Hourly Check CORRALES, CALLE GREGORIO Work 10125 10126 10127 10128 10129 10/30 10/31 Hours Pay Rate -This All 5.55 48.96 10.80 7.68 0.00 0.00 0,00 Paid For Week Number 84526 Classification Hours Worked Each Day Project Projects COACHELLA CA LANDSCAPE8.00 MAINTENANCE s 8.00 8.00 8.00 8.00 0.00 0.00 40.00 16.00 640.00 640.00 Training Fund AdminDues Tray/ Subs Savings Other Total 567.01 11603 LABORER- 0 0.00 0.00 0.00 0,00 0.00 0.00 0.00 0.00 92236 RIVERSIDE 0,00 0.00 0.00 0.00 0.00 0.00 0.00 72,99 p 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: Name, Address Number of Day Deductions, Contributions, and Payments and Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA State SDI Vac/ Health Pension Net Date Earned Tax Tax Holiday & Welt. Wage IVETTE 0 Total Hourly Check JIMENEZ. HARRISON ST N40 Work 10125 10/26 10127 10128 10129 10130 10131 Hours Pay Rate This All 37.09 48.96 5.55 7.66 0.00 0.00 0,00 Paid For Week Number 49615 Classification Hours Worked Each Day Project Projects COACHELLA CA LANDSCAPE MAINTENANCE $ 8,00 8.00 8.00 8.00 8.00 0.00 0.00 40.00 16.00 640.00 640.00 Training Fund Admin Dues Tray/ Subs Savings Other Total 540.72 11604 LABORER- 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0.00 92236 RIVERSIDE p 0.00 0.00 0.00 0.00 0.00 0.00 99.28 1- D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: Name, Address Number of Day Deductions, Contributions, and Payments and Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA State SDI Vac/ Health Pension Not Date Earned Tax Tax Holiday & Waif. Wage 4 Total Hourly Check LUNA GONZALEZ. CARLOS 66145 7TH ST Work 10125 10/26 10127 10/28 10/29 10/30 10131 Hours Pay Rale This Ali 15.46 55.08 0.00 8.64 0.00 0.00 0.00 Paid For Week Number Classification Hours Worked Earl, Day Project Projects DESERT HOT SPRINGS CA LANDSCAPE MAINTENANCE s 0.00 0.00 8.00 8.00 8.00 0.00 0.00 24.00 18.00 432.00 720.00 Training Fund Admin Dues Travl Subs Savings Other Total 640.82 11607 LABORER- 0 -0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 92240 RIVERSIDE 0.00 0.00 0.00 0.00 0.00 0.00 79.18 ilMINED D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: Public Works Certified Payroll Reporting Form 11/03/2021 - Page 2 Public Works Certifie .yroll Reporting Form Contractor Name: PWLC II, INC. Project Name: LANDSCAPE & LIGHTING DISTRICT 89-1 For Week Ending: 10l31l2021 Payroll Number: 122-0 Name, Address Number of Day Deductions, Contributions, and Payments and Social Security Number of Worker Withholding Man Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA Stale SDI Vac) Health Pension Net Date Earned Tax Tax Holiday & Welt. Check ESCOBAR. JUAN F 0 Total Hearty Work 10/25 10126 10127 10128 10129 10/30 10131 Hours Pay Rate This All 0.00 55.08 6.45 8.64 0.00 0.00 0.00 Paid For Week Number 65946 DESERT VIEW AVE Classification Hours Worked Each Day Project Projects DESERT HOT SPRINGS CA LANDSCAPE0.00 MAINTENANCE s 0.00 8.00 8.00 8.00 0.00 0.00 24.00 18.00 432.00 720.00 Training Admire 0ucs Subs Savings Other Total 649.83 11581 LABORER- 0.00 0.00 0.00 0.00 0,00 0.00 0.00 92240 RIVERSIDE C 0,00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 70.17 D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: Address Number of Day Deductions, Contributions, and Payments Name, end Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sal Sun Gross Amount Federal FICA State SDI Vac/ Health Pension Net Date Earned Tax Tax Holiday & Well. Wage EVERARDO 0 Total Hourly Check MUNOZ, 74501 42ND AVE Work 10125 10/26 10/27 10/28 10/29 10/30 10/31 Hours Pay Rale This All 0.00 55.08 3.82 8.64 0.00 0.00 0.00 Paid For Week Number Classification Hours Hours Worked Each Day Projects PALM DESERT CA LANDSCAPE MAINTENANCE S 8.00 5.00 8.00 8.00 8.00 0.00 0.00 40.00 18.00 720.00 720.00 Training AFund dmire Dues Subs Savings Other Total 652.46 11605 LABORER- 0 0.00 0.00 0,00 0.00 0.00 0.00 0.00 0.00 0.00 92260 RIVERSIDE 0.00 0.00 0.00 0.00 0.00 0,00 67 54 - D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: Name, Address Number of Day Deductions, Contributions, and Payments and Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA Stale SDI Vac/ Health Pension Net Dale Earned Tax Tax Holiday & Well. Wage RODRIGt1EZ-PINEDA, ALEJANDRO 0 Total Hourly Chock 69 BONAZA RD Work 10/25 10/26 10127 10128 10/29 10/30 10/31 Hours Pay Rate This All 0.00 48.96 8.17 7.68 0.00 0.00 0.00 Paid For Week Number Classification Hours Worked Each Day Project Projects PALM SPRINGS CA LANDSCAPE MAINTENANCE $ 0.00 0.00 8.00 8.00 8.00 0.00 0,00 24.00 16.00 384.00 640.00 Training Fund Admin Dues Tray/ Subs Savings Other Total 575.19 11585 LABORER- 0 0.00 0.00 0.00 0.00 0.00 0,00 0,00 92262 RIVERSIDE 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0,00 64,81 flialffin D o.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: Name, Address Number of Day Deductions, Contributions, and Payments and Social SecurityNumber of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA State SDI Vac! Health Pension Net Date Earned Tax Tax Holiday 8 WeltWage SARABIA, JOSE A 0 Total Hourly ck N INDIAN CANYON DR Work 10/25 10/26 10/27 10/28 10/29 10130 10131 Hours Pay Rate This All 5.55 48.96 12.57 7.68 0.00 0.00 0.00 Paid For Week b r Number 2950 Classification Hours Worked Each Day Project ect Projects PALM SPRINGS CA LANDSCAPE8.00 MAINTENANCE s 8.00 8,00 8.00 8.00 0.00 0.00 40.00 16.00 640.00 640.00 Training Fund Admin Dues Tres! Subs Savings Other Total 565.24 11808 LABORER- p 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 92262 RIVERSIDE 0.00 0.00 0.00 0.00 0.00 0,00 74,76 _ D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: Public Works certified Payroll Reporting Form 11/03/2021 • Page 3 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. 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: 2021-10-24 Payroll Number: 121 Amendment Number: 0 9 employee payroll record(s) processed Your Transaction ID is: 12487035 Print this Page View your submission c ubmit another set of payroll records x Public Works Certifieiyroll 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 II, INC. (name of business andlor contractor), certify under penalty of perjury that the records or copies thereof submitted and consisting of certified payroll records for the week ending 2021-10-24 are the originals or true, full, and correct copies of the originals whiff h depi.:L tliu 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 2021-11-03 " Contractor Name: PWLC II, INC. Contractor PWCR: 1000037373 License Type: CSLH License Number 855783 Address: PO BOX 848, THOUSAND PALMS, CA 92276 FEIN: 510532726 Contractor Email: KRISTYSQPWLC2.COM Insurance Number: NA 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: 121- 0 For Week Ending: 10/24/2021 ' ] Is this a 'Statement of Non -Performance?' Name, Address and Number of Day Deductions, Contributions, and Payments Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA Stale SDI Vac., Health Pension Net Earned Tax Tax Holiday & Wolf. ALATORRE, GRISELDA 0 Date Total Hourly Wage Check 11550 WESTERN AVE Work 10118 10119 10120 10121 10/22 10/23 10124 Hours Pay Rate This All 0,00 48.96 0.00 7,68 0.00 0.00 0,00 Paid For Week Number Ctassifiication Hours Worked Each Day Project Projects DESERT HOT SPRINGS CA LANDSCAPE MAINTENANCE S 8.00 8.00 8.00 8.00 8.00 0.00 0.00 40.00 16.00 640,00 640.00 Training Fund Admin Dues Tray., Subs Savings Other Total Deduct 583 36 11451 LABORER- 0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0 00 0.00 92240 RIVERSIDE 0 00 0 00 0 00 0 00 0.00 0,00 56.64 D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0 00 0.00 NOTE: Name, Address and Number of Day Deductions, Contributions, and Payments Social SecurityNumber of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA State SDI Vac? I Health Pension Net Date Earned Tax Tax Holiday& Welf. ALFARO. SOCORRO N 0 Total Hourly Wage Check 11550 WESTERN AVE Work 10.,18 10/19 10720 10/21 10122 10/23 10/24 Hours Pa Rate Y This All 0.00 48.96 8.17 7.68 0.00 0.00 0.00 Paid For Week Number Classification Hours Worked Each Day Protect Projects 1 DESERT HOT SPRINGS CA LANDSCAPE MAINTENANCE 5 8.00 8.00 8.00 8.00 8.00 0.00 0.00 40 00 16,00 640.00 640.00 TrainingFund Admin Duos S Subsubs Savings g Other Total Deduct 575.19 11452 LABORER- O 0,00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 92240 RIVERSIDE 0.00 0.00 0.00 0.00 0.00 0.00 64.81 D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: Name, Address and Number of Day Deductions, Contribution , and Payments Social SecurityNumber of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA State SDI Vac/ Health Pension Net Date Earned Tax Tax Holida y & Well. BRIONES. MARCELINO 2 Total Hourly Wage Check 50700 CALLE MENDOZA Work 10118 10/19 10120 10/21 10/22 10123 10/24 Hours Pay Rate This All 39.92 46.82 6.67 7.34 0.00 0.00 0.00 Paid For Week Number Classification Hours Worked Each Day Project j Pacts COACHELLA CA LANDSCAPE4.00 MAINTENANCE s 8.00 8.00 8,00 8.00 0.00 0.00 36.00 17,00 612.00 612.00 Training Fund Admin Dues S Subsubs Savings Other Total Deduct 505.13 11453 LABORER- 0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0.00 92236 RIVERSIDE 0.00 0.00 0.00 0.00 0.00 6.12 106.87 111•1=B D 0.00 0,00 0.00 0.00 0,00 0,00 0,00 0.00 0.00 NOTE: OTHER = $6,12 401K Public works Certified Payroll Reporting Form 11/03/2021 - Page 1 Public Works Certifie iyroll Reporting Form Contractor Name: PWLC II, INC. Project Name: LANDSCAPE & LIGHTING DISTRICT 89-1 For Week Ending: 10/24/2021 Payroll Number: 121-0 Number of Day Deductions, Contributions, and Payments Name, Address and Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA State SDI Vac/ Health Not Dale Earned Tax Tax Holiday & Welt. Wage Wage Check CASTILLO VIGIL, RAMON A D Total Hourly Work 10/18 10719 10/20 10/21 10122 10123 10f24 Hours Pay Rale This All 67.28 70.38 24.04 11.04 0.00 0.00 0.00 Paid For Week Number 27335 HOPPER RD Classification Hours Worked Each Day Project Projects DESERT HOT SPRINGS CA LANDSCAPE8.00 MAINTENANCE s 8.00 8.00 8.00 8.00 0.00 0.00 40.00 20.00 920.00 920.00 Training Fund Admin Dues Tray/ Subs Savings Other Total 73$.06 11454 0.00 0.00 0.00 0.00 0.00 2.00 2.00 92241 LABORER- RIVERSIDE 0 4.00 30.00 0.00 0.00 0.00 0.00 0.00 9.20 181.94 D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: OTHER a S9.20 401K Number of Day Deductions, Contributions, and Payments Name, Address and Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA Stale SDI Vac! Health Pension Net Date Earned Tax Tax Holiday & Wolf. age Check CORRALES, FIDELIA 0 Total Hourly Work 10/18 10119 10/20 10f21 10122 10/23 10/24 Hours Pay Rate This All 44.01 4B.9G 13.42 7.68 0.00 0.00 0.00 Paid For Week Number 84526 CALLE GREGORIO Classification Hours Worked Each Day Project Projects COACHELLA CA LANDSCAPE MAINTENANCE 5 B.00 8.00 8.00 8.00 8.00 0.00 0.00 40.00 16.00 640.00 640.00 Training Admin Dues Subs Savings Other Total 525.93 11455 LABORER- 0.00 0.00 0,00 0,00 0,00 0.00 0.00 0.00 92236 RIVERSIDE 0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 114.07 MIMI D Q.00 0.00 0.0o Q.Do o.DD o.DD 0.00 0.00 um NOTE: Name, Address Number of Day Deductions, Contributions, and Payments and Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA Stale SDI Vac/ Health Pension Net Date Earned Tax Tax Holiday & Welf. Wage Check 0 Total Hourly JIMENEZ. IVETTE ST WI Work 10/18 10/19 10/20 10/21 10/22 10/23 10/24 Hours Pay Rale This All 37.09 48.96 5.55 7.68 0.00 0.00 0.00 Paid For Week Number 49615 HARRISON Classification Hours Worked Each Day Project Projects COACHELLA CA LANDSCAPE MAINTENANCE 5 8.00 8.00 8.00 8.00 8.00 0.00 0.00 AO 44 16.00 640.00 640.00 Training Admin Dues Tray/ Savings Other Total 540.72 11456 LABORER- 0.00 0.00 0.00 0.00 0,00 0.00 0.00 92236 RIVERSIDE 0 0,00 0.00 0,00 0.00 0.00 0.00 0.00 0.00 99.28 - D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: Name, Address Number of Day Deductions, Contributions, and Payments and Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA State SDI Vac! Health Pension Net Date Earned Tax Tax Holiday & Weif. Wage 0 Total Hourly Check LIZARRAGA, MOISES RECLINATA WAY Work 10l18 10/19 10/20 10121 10/22 10123 10/24 Hours Pay Rale This All 0.00 52.02 4.69 8.16 0.00 0.00 0.00 Paid For Week Number 43795 Classification Hours Worked Each Day Project Projects INDIO CA LANDSCAPE8.00 MAINTENANCE s 8,00 8.00 8.00 8.00 0.00 0.00 40.00 17,00 680.00 680.00 Training Fund Admin Dues Tres! Subs Savings Other Total 615.13 6604 LABORER- 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 92201 RIVERSIDE O 0.00 0.00 0.00 0.00 0.00 0.00 0.00 64.87 411.1111 D 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00 NOTE: Public works Certified Payroll Reporting Form 11/03/2021 - Page 2 Public Works Certifie iyroll Reporting Form Contractor Name: PWLC II, INC. Project Name: LANDSCAPE & LIGHTING DISTRICT 89-1 For Week Ending: 10/24/2021 Payroll Number:121-0 Number of Day Deductions, Contributions, and Payments Name. Address and Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA State SDI Vac! Health Pension Not Dale Earned Tax lax Holiday 8 Well. Wage Check MUNOZ. EVERARDO 0 Total Hourly Work 10/18 10119 10l20 10121 10122 10/23 10/24This Hours PayRate All 0.00 55.08 3.82 8.64 0.00 0.00 0.00 Paid For Week Number 74501 42ND AVE Classification Hours Worked Each Day Project Projects PALM DESERT CA LANDSCAPE MAINTENANCE s 8,00 8.00 8.00 8.00 8.00 0.00 0.00 40.00 18.00 720.00 720.00 Training Fund Admin Dues Travl Subs Savings Other Total 652.46 11457 LABORER- 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 92260 RIVERSIDE p 0.00 0 00 0 00 0.00 0.00 0.00 67.54 D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0 00 0.00 NOTE: Name, Address Number of Day Deductions, Contributions, and Payments and Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA Stale SDI Vac! Health Pension Net Dale Earned Tax Tax Holiday & Well, Wage JOSE A 0 Total Hourly Check SARABIA, DR Work 10/18 10119 10/20 10/21 10/22 10/23 10/24 Hours Pay Rate Thy All 5 55 48 96 12.57 7.68 0.00 O.0P 0.00 Paid For Week Number 2950 N INDIAN CANYON Classification Hours Worked Each Day Pro ect l Projects PALM SPRINGS CA LANDSCAPE MAINTENANCE S 8.00 6.00 8.00 8,00 8,00 0.00 0.00 40.00 16.00 640,00 840.00 Training Fund Admin Dual Tray/Subs Subs Savings Other Total 565.24 11458 LABORER- 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 92262 RIVERSIDE 0 0.00 0,00 OAO 0.00 0 00 0.00 74 76 D 0.00 0.00 0.00 0.00 0.00 0,00 0,00 0.00 0.00 NOTE: Public works Certified Payroll Reporting Form 11/03/2021 - Page 3 eCPR 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@dir.ca.gov. 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: 2021-10-17 Payroll Number: 120 Amendment Number: 0 12 employee payroll record(s) processed Your Transaction ID is: 12404754 Print this Page View your submission ,ubmit another set of payroll records Public Works Certifit ayroll 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 II, 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 2021-10-17 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 2021-10-22 " Contractor Name: PWLC II. INC. Contractor PWCR: 1000037373 License Type: CSLB License Number 855783 Address: PO BOX 848, THOUSAND PALMS, CA 92276 FEIN: 510532726 Contractor Email: KRISTYS@PWLC2.COM Insurance Number: NA 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: 120- 0 For Week Ending: 10/17/2021 Is this a 'Statement of Non -Performance?' Name, Address and Number of Day Deductions, Contributions, and Payments Social SecurityNumber of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA Stale SDI Vac/ Health Pension Net Date Earned Tax Tax Holiday & Wall. ALATORRE, GRISELDA 0 Total Hourly Wage Check 11550 WESTERN AVE Work 10/11 t0112 10/13 10/14 10/1S 10/16 10/17 Hours Pay Rate This All 0.00 63.64 6.52 9.98 0.00 0.00 0.00 Paid For Week Number Classification Hours Worked Each Day Project Projects DESERT HOT SPRINGS CA LANDSCAPE MAINTENANCE S 8.00 8.00 8.00 8.00 8.00 0.00 0.00 40.00 16.00 640.00 632.00 TrainingFund Admin Dues Tray/ Subsuhs Savings 9 Other Total Deduct 749•tl6 11416 LABORER- 0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 92240 RIVERSIDE 0.00 0.00 0.00 0.00 0.00 0.00 82.14 D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: Name, Address and Number of Day Deductions, Contributions, and Payments Social SecurityNumber of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA Stale SDI Vac/ Health Pension Net Date Earned Tax Tax Holiday & Well. ALFARO, SOCORRO N 0 Total Hourly Wage Check 11550 WESTERN AVE Work 10111 10/12 10113 10114 10115 10116 10/17 Hours Pay Rate This MI 0.00 48.96 8.17 7.68 0.00 0.00 0.00 Paid Far Week Number Classification Hours Worked Each Day Project Projects DESERT HOT SPRINGS CA LANDSCAPE8.00 MAINTENANCE s 8.00 8 00 8.00 8.00 0.00 0.00 40.00 16.00 640.00 640.00 Training Fund Admin Dues Tray/ Subs Savings Other Total Deduct 575.19 11417 LABORER- 0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 92240 RIVERSIDE 0.00 0.00 0.00 0.00 0.00 0.00 64.61 faiimmis D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: Name, Address and Number of Day Deductions, Contributions, and Payments Social SecurityNumber of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA Stale SDI Vac/ Health Not Date Earned Tax Tax Holiday & WeltPension BRIONES, MARCELINO 2 Total Hourly Wage Check 50700 CALLE MENDOZA Work 10111 10/12 10/13 10/14 10/15 10/16 10117 Hours Pay Rate This All 39.92 46.81 6.67 7.34 0.00 0.00 0,00 Paid For Week Number Classification Hours Worked Each Day Project 1 Projects 1 COACHELLA CA LANDSCAPE MAINTENANCE S 8.00 8.00 8.00 0.00 4.00 0.00 0.00 28.00 17.00 476.00 612.00 TrainingFund Admire Dues S Subsubs Savings 9 Other Total Deduct 505.14 11418 LABORER- 0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0,00 92236 RIVERSIDE 0.00 0.00 0.00 0.00 0.00 6.12 106.86 D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: OTHER o 6.12 401K Public works Certified Payroll Reporting Form 10/22/2021 - Page 1 Public Works Certifi{ ayroll Reporting Form Contractor Name: PWLC II, INC. Project Name: LANDSCAPE & LIGHTING DISTRICT 89-1 For Week Ending: 10/17/2021 Payroll Number:120-0 Name, Address and Number of Day Deductions, Contributions, and Payments Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA State ri SDI Vac! Health Pension Net Date Earned Tax Tax Holiday & Welt. CORRALES, FIDELIA 0 Total Hourly -- Wage Check 84526 CALLE GREGORIO W� 10/11 10112 10/13 10114 10/15 10116 10/17 Hours Pa Rafe Y This All 44.01 48.96 13.42 7.68 0.00 0.00 0.00 Paid For Week Number Classification Hours Worked Each Day Project j Projects COACHELLA CA LANDSCAPE MAINTENANCE 5 8.00 8.00 8.00 8.00 8.00 0.00 0.00 40.00 16.00 640.00 640.00 Training Fund Admin Dues Tray/ Subs Sayings Other Total 525.93 11419 LABORER- 0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 92236 RIVERSIDE 0.00 0.00 0.00 0.00 0.00 0.00 114.07 _ D 0.00 0.00 0.00 0,00 0.00 0.00 0.00 (too 0.00 NOTE: Name, Address and Number of Day Deductions, Contributions, and Payments Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sal Sun Gross Amount Federal FICA State SDI Vac/ Health Pension Net Earned Tax Tax Holiday A Well. JIMENE2, IVETTE 49615 HARRISON ST #40 Work 10/11 10/12 10/13 10/14 10/15 10116 10/17 Hours Pay Rate This ' All 37.09 48.96 5.55 7.68 D.00 0.00 0.00 Paid For Week Number Classification Hours Worked Each Day Project Projects COACHELLA CA LANDSCAPE8.00 MAINTENANCE S 8.00 8.00 8.00 8.00 0.00 0.00 40.00 16.00 640.00 640.00 Training Fund Admin Dues S Sububss Savings Other Total 540.72 11420 LABORER- Q 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 92236 RIVERSIDE 0.00 0.00 0.00 0.00 0.00 0.00 99.28 ilMNIMP D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: Name, Address and Number of Day Deductions, Contributions, and Payments Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal F1CA State SDI Vac/ Health Pension Net Date Earned Tax Tax Holiday & Well. LIZARRAGA, NOISES 0 Total Hourly Wage Check 43795 RECLINATA WAY Work 10/11 10/12 10/13 10114 10/15 10/16 10/17 Hours Pay Rata This All 0.00 52.02 4.69 8.16 0.00 0.00 0.00 Paid For Week Number Classification Hours Worked Each Day Project Projects INDIO CA LANDSCAPE MAINTENANCE 5 8.00 8.00 8.00 8.00 8.00 0.00 0.00 40.00 77.00 660.00 680.00 TrainingFund Admin Dues Smut Subs Savings Other Total 615.73 11421 LABORER- I 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00 92201 RIVERSIDE 0.00 0,00 0.00 0.00 0.00 0.00 64.87 - D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: Name, Address and Number of Day Deductions, Contributions, and Payments Social SecurityNumber of Worker Withholding Mon Tue Wed Thu Fri Sal Sun Gross Amount Federal FICA State SDI Vac! Health Pension Net Earned Tax Tax HolidayA Well. LUNAGONZALEZ CARLOS 4 Date Total Hourly Wage Check 66145 7TH ST Work 10/11 10/12 10/13 10114 10/15 10/16 10/17 Hours Pay Rate This All 18.03 57.04 0.00 8.95 0.00 0.00 0.00 Pald For Week Number Classification Hours Worked Each Day1 Project Pro acts DESERT HOT SPRINGS CA TREE0.00 MAINTENANCE s2.00 0.00 0.00 2.00 0.00 0.00 0.00 30.82 67.64 745.64 TrainingFund Admin Dues S Subsubs Sayings 9 Other Total 661.62 11424 (LABORER} p 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0.00 92240 GROUNDSPERS 0.00 0.00 0.00 0.00 0.00 0.00 84.02 _ ON D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: Public works Certified Payroll Reporting Form 10/22/2021 - Page 2 Public: Works Certifis ayroll Reporting Form Contractor Name: PWLC II, INC. Project Name: LANDSCAPE & LIGHTING DISTRICT 89-1 For Week Ending: 10/17/2021 Payroll Number:120-0 Name, Address Number of Day Deductions, Contributions, and Payments and Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA Stale SDI Vac/ Health Pension Net Date Earned Tax Tax Holiday & Well. MEDINA ESCOBAR, JUAN F 0 Talal Hourly Wage Check 65946 DESERT VIEW AVE Work 10111 10112 10/13 10114 10/15 10/16 10/17 Hours PaY Rate This All 0,00 60,33 10.73 9.46 0.00 0.00 0.00 Paid For Week Number Classification Hours Worked Each Day Project Projects DESERT HOT SPRINGS CA LANDSCAPE0.00 MAINTENANCE s 0.00 0.00 8.00 0.00 0.00 0.00 6.00 26.57 212.56 788.56 Training Fund Admin Duos Tray/ Subs Savings Other Total 708.04 11400 LABORER- 0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 92240 RIVERSIDE 0.00 0.00 0.00 0.00 0.00 0.00 80.52 D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: Name, Address and Number of Day Deductions, Contributions, and Payments Social SecurityNumber of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA Stale SDI Vac/ Health Pension Net Date Earned Tax Tax Holiday &Well. MUNOZ, EVERARDO 0 Total Hourly Wage Check 74501 42ND AVE Work 10/11 10/12 10/13 10/14 10/15 10/16 10117 Hours Pay Rate This All 0.00 55.08 3,82 8.64 0.00 0.00 0.00 Paid For Week Number Classification Hours Worked Each Day Project acts Projects PALM DESERT CA LANDSCAPE MAINTENANCE S 8.00 8.00 8.00 8.00 8.00 0.00 0.00 40.00 18.00 720.00 720.00 Training Fund Admin Dues Sray/ubs Subs Savings Other Total 652.46 11422 LABORER- 0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 92260 RIVERSIDE 0.00 0.00 0.00 0.00 0.00 0.00 67,54 D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: Name, Address and Number of Day Deductions, Contributions, and Payments Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA Stale SDI Vac! Health Pension Net Date Earned Tax Tax Holiday & Well.. RAMIREZ, MARCELINO 4 Total Hourly Wage Check 1500 E SAN RAFAEL DR f1164 Work 10111 10/12 10/13 10/14 10/15 10116 10/17 Hours PaY Rate This All 22.04 60.74 0.00 9.53 0.00 0.00 0.00 Paid For Week Number Classification Hours Worked Each Day Project Projects PALM SPRINGS CA TREE MAINTENANCE 5 0.00 0,0G 0.00 2,00 0,00 0.00 0.00 2.00 26.57 53.14 813.14 TrainingFund Admin Dues S Subsubs Sayings 9 Other Total 693.51 11425 itABORERj- 0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 92262 GROUNDSPERS 0.00 0.00 0.00 0.00 0.00 27.32 119.63 IMMO ON D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: OTHER = 13.88 HEALTH INSURANCE, 5.31 DENTAL INSURANCE & 8.13 401K Name, Address and Number of Day Deductions, Contributions, and Payments Social SecurityNumber of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA Stale SDI Vac/ Health Pension Net Dale Earned Tax Tax Holiday & Waif. SARABIA, JOSE A 0 Total Hourly Wage Check 2950 N INDIAN CANYON DR Work 10/11 10/12 10113 10/14 10115 10/16 10117 Hours Pay Rale This All 5.55 48.96 12.57 7.66 0.00 0.00 0.00 Paid For Week Number Classification Hours Worked Each Day Project Projects PALM SPRINGS CA LANDSCAPE8.00 MAINTENANCE s 8.00 8.00 16.00 8.00 0.00 0.00 40.00 16.00 640.00 640.00 Training Fund Admin Dues S Subs uhs Sayings 9 Other Total 565.24 11423 LABORER- 0 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 92262 RIVERSIDE 0.00 0.00 0.00 0.00 0.00 0.00 74.76 1 D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: Public Works Certified Payroll Reporting form 10/22/2021 - Page 3 Public Works Certifi. ayroll Reporting Form Contractor Name: PWLC II, INC. Project Name: LANDSCAPE & LIGHTING DISTRICT 89-1 For Week Ending: 10/17/2021 Payroll Number:120-0 Number of Day Deductions, Contributions, and Payments Name, Address and Social Security Number of Worker Withholding Man Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA Slate SDI Vac/ Health Pension Net Dale Earned Tax Tax Holiday & Well. Wage Check S a Total Hourly VALDEZ, HUMBERTO Work 10111 10112 10/13 10/14 10115 10116 10117 Hours Pay Rate This All 73.99 55 98 14.52 6.78 0.00 0,00 0.00 Paid For Week Number 12966 CACTUS OR #A Classification Hours Worked Each Day Project Projects DESERT HOT SPRINGS CA TREE MAINTENANCE $ 0.00 0.00 0.00 2.00 0.00 0.00 0.00 2.00 26.57 53.14 737.14 Training Fund Admin Dues Trav/ Subs Savings Other Total 425.22 11426 (LABORER} 0 0.00 0.00 0.00 0.00 0.00 0,00 0.00 92240 GROUNDSPERS 0.00 0.00 0.00 0.00 0.00 0.00 0.00 158.65 311.92 1.1111.1.1 ON D 0.00 0,00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: OTHER = 5.31 DENTAL INSURANCE. 145.97 GARNISHMENT d 7.37 401K Public works Certified Payroll Reporting Form 10/22/2021 - Page 4 eCPR 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@dir.ca. gov_ 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: 2021-10-10 Payroll Number: 119 Amendment Number: 0 11 employee payroll record(s) processed Your Transaction ID is: 12400148 Print this Page View your submission i, ubmit another set of payroll records l Public Works Certifle ayroll 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 II. 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 2021-10-10 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 2021-10-22 " Contractor Name: PWLC II, INC. Contractor PWCR: 1000037373 License Type: CSLH License Number 855783 Address: PO BOX 848. THOUSAND PALMS, CA 92276 FEIN: 510532726 Contractor Email: KRISTYSQPWLC2,COM Insurance Number: NA Awarding Body: CITY OF LA QUINTA DIR Project ID: 290440 Project Name: LANDSCAPE & LIGHTING DISTRICT89-1 Contract With: CITY OF LA OUINTA County: RIVERSIDE Location Description: LIGHTING AND LANDSCAPE DISTRICT 89-1 LANDSCAPE MAINTENANCE OF CITYWIDE MEDIANS Payroll Number: 119- 0 For Week Ending: 10/10/2021 E Is this a 'Statement of Non -Performance?' Name, Address Number el Day Deductions, Contributions, and Payments end Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA State SDI Vac/ Health Pension Net Dale Earned Tax Tax Holiday & Welf. Wage Al AT03tRE, GRISELDA 0 Total Hourly Check WESTERN AVE Work 10l04 10105 10/06 10107 10I08 10/09 10/10This Hours Pay Rate All 0.00 63.65 8 52 9.98 0.00 0.00 0.00 Paid For Week Number 11550 Classification Hours Worked Each Day Project Projects DESERT HOT SPRINGS CA LANDSCAPE8.00 MAINTENANCE S40.00 8.00 8.00 6.00 8.00 0.00 0.00 16.00 644.00 832.00 Training Fund Admin Dues Tray/ Subs Savings Other Total Deduct 749.85 11268 LABORER- O 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0 00 92240 RIVERSIDE 0.00 0.00 0.00 0.00 0.00 0 00 82.15 - D 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 NOTE: Name, Address Number of Day Deductions, Contributions, and Payments and Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA State SDI Vac! Health Pension Net Dale Earned Tax Tax Holiday 8 Welf. ALFARO, SOCORRO N p Total Hourly Wage Check 11550WESTERNAVE Work 10/04 10/05 10106 10107 10l08 10/09 10/10 Hours Pay Rale This All 0.40 48.96 8.17 7 68 0,00 0.00 0 00 Paid For Week Number Classification H Hours Worked Each Day Project Projects DESERT HOT SPRINGS CA LANDSCAPE MAINTENANCE 5 8.00 8.00 B.00 8,00 8.00 0.00 0.00 40,04 16 44 640.00 640.00 Trainin 9 Fund Admire Dues Tray;Savings Subs 9 Other Total Deduct 575,19 11269 LABORER- 0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 92240 RIVERSIDE 0.00 0.00 0.00 0.00 0.00 0.00 64.81 - D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: Name, Address and Number of Day Deductions, Contributions, and Payments Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA Stale SDI Vac! Health Pension Net Date Earned Tax Tax Holiday & Well, BRIONES MARCELINO 2 Total Hourly Wage Check 50700 CA! LE MENDOZA Work 10l04 10/05 10/06 10107 10l08 10109 10/10 Hours Pay Rate This All 60.11 59.83 15.02 9.38 0.00 0.00 0,00 Paid For Week Number Classification Hours Worked Each Day Project Projects COACHELLA CA LANDSCAPE8.00 MAINTENANCE s 8.00 8.00 8.00 8.00 0 00 0.00 40.00 17.00 782.00 782.00 Training Fund Admin Dues Trav! Subs Savings Other Total Deduct 629.84 11270 LABORER- D 0.00 0.00 0.00 0.00 0.00 2 00 2.00 4.00 25.50 92236 RIVERSIDE 0.00 0.00 0.00 0.00 0.00 7.82 152.16 r D 0.00 0.00 0,00 0.00 0.00 000 000 0.00 0.00 NOTE: OTHER = 7.82 401K Public works Certified Payroll Reporting Form 10/22/2021 Page 1 Public Works Certifit ayroll Reporting Form Contractor Name: PWLC II, INC. Project Name: LANDSCAPE & LIGHTING DISTRICT 89-1 For Week Ending: 10/10/2021 Payroll Number:119-0 Name, Address and Number of Day Deductions, Contributions, and Payments Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA Slate SDI Vac/ Health Pension Net DaleEarned Tax Tax Holiday & Well. CORRALES, FIDELIA 0 Total Hourly Wage Check 84526 CALLE GREGORIO Work 10/04 10105 10106 10/07 10/08 10109 10/10 Hours Pay Rale This All 67,05 63,64 24.08 9.98 0.00 0.00 0.00 Paid For Week Number Classification Hours Worked Each Day Project Projects COACHELLA CA LANDSCAPE MAINTENANCE 5 8.00 8.00 8.00 6.00 8.00 0.00 0.00 40.00 16.00 640.06 832.00 Training Fund Admin Dues S Subsubs Savings Other Total 607.25 11272 LABORER- 0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 92236 RIVERSIDE 0.00 0.00 0.00 0.00 0.00 0.00 164,75 MIIMMII D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0.00 NOTE: Name, Address and Number of Day Deductions, Contributions, and Payments Social SecurityNumber of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA Stale SDI Vac/ Health Pension Net Earned Tax Tax Holiday & Well. JIMENEZ, IVETTE 0 Date Total Hourly Wage Check 49615 HARRISON ST 440 Work 10104 10105 10/06 10107 10/08 10/09 10/10 Hours Pay Rate This All 37.09 48.96 5.55 7.68 0.00 0.00 0.00 Paid For Week Number Classification Hours Worked Each Day Pro1 Projects F COACHELLA CA LANDSCAPE MAINTENANCE S 8,00 8.00 8.00 8,00 8,00 0.00 0.00 40.00 18.00 640.00 640.00 Training Fund Admin Dues Tray/ Subs Savings Other Total 540.72 11273 LABORER- 0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 92236 RIVERSIDE 0.00 0.00 0.00 0.00 0.00 0.00 99,28 i D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: Name, Address and Number of Day Deductions, Contributions, and Payments Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA Slate SDI Vac/ Health Pension Net Date Earned Tax Tax Holiday & Well, LIZARRAGA, MOISES 0 Total Hourly Wage Check 43795 RECLINATA WAY Work 10104 10/05 10/06 10/07 10/08 10/09 10/10 Hours Pay Rale This All 0.00 52.02 4.69 8.16 0.00 0.00 0,00 Paid For Week Number ClassificationProject Hours Worked Each Day I Projects 1 INDIO CA LANDSCAPE MAINTENANCE $ 8.00 8.00 5.00 8.00 6.00 0.00 0.00 40.OQ 17.00 680.00 680.00 TrainingFund Admin Dues S Subsubs Sayings 9 Other Total 615,13 11274 LABORER- 0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 92201 RIVERSIDE 0.00 0.00 0.00 0.00 0.00 0,00 64,87 D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 - NOTE: Name, Address and Number of Day Deductions, Contributions, and Payments Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA Stale SDI Vac/ Health Pension Net Tax Holiday &Well. LUNA GONZALEZ. CARLOS Total Hourly Wage Check 66145 7TH ST Work 10104 10/05 10/06 10/07 10108 10/09 10/10 Hours Pay Rate This All 25,72 62,93 0.00 9,87 0.00 0.00 0,00 Paid For Week Number Classification Hours Worked Each Day Project Projects DESERT HOT SPRINGS CA TREE MAINTENANCE S 8.00 0.00 0.00 0.00 0.00 0.00 0.00 6.00 30.82 246.5$ 622.56 Trainin g Fund Admin Dues S Subsubs Savings Other Total 724,04 11277 (LABORER} 0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 92240 SENIOR TREE 0.00 0.00 0.00 0.00 0.00 0.00 98.52 2111111111 TRIMMER D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 . 0.00 NOTE: Public Works Certified Payroll Reporting Fern 10/22/2021 - Page 2 Public Works Certifit.. ayroll Reporting Form Contractor Name: PWLC II, INC. Project Name: LANDSCAPE & LIGHTING DISTRICT 89-1 For Week Ending: 10/10/2021 Payroll Number:119-0 Name, Address and Number of Day Deductions, Contributions, and Payments Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Grass Amount Federal FICA Slate SDI Vac! Health Pension Ncl Date Earned Tax Tax Holiday & Well. MUNOZ EVERARDO 0 Total Hourly Wage Check 74501 42ND AVE Work 10104 10/05 10f06 10/07 10/08 10/09 10110 Hours Pay Rate This All 0.00 55.08 3.82 8.64 0.00 0.00 0.00 Paid For Week Number Classification Hours Worked Each Day Project Projects PALM DESERT CA LANDSCAPE8.00 MAINTENANCE s �8.00 8,00 8.00 8.00 0,00 0.00 40.00 18.00 720.00 745.00 TrainingFund Admin Over Trav/ Sufisubs 9 s Other Total 877.46 11275 LABORER- O 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 92260 RIVERSIDE 0.00 0.00 0.00 0.00 0.00 0.00 67.54 INEMB D 0,00 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0.00 NOTE: Name, Address and Number of Day Deductions, Contributions, and Payments Social SecurityNumber of Worker Withholding Mon Tue Wed Thu Fri Sal Sun Gross Amount Federal FICA State SDI Vac! Health Pension Net Earned Tax Tax Holiday 8 Welt. RAMIREZ MARCELINO 4 Date Total Hourly Wage Check 1500 E SAN RAFAEL DR S164 Work 10104 10f05 10106 10/07 10f08 10/09 10110 Hours Pay Rate This All 25.95 63.75 0.00 10.00 0.00 0.00 0.00 Paid For Week Number Classification Hours Worked Each Day Project Projects PALM SPRINGS CA TREE MAINTENANCE 5 8.00 0,00 0.00 0,00 0.00 0.00 0.00 8.00 26.57 212.56 852.56 Training Fund Admin Dues S Subsubs Savings Other Total 725.14 11278 (LABORER)- 0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 92262 GROUNDSPERS 0.00 0.00 0.00 0.00 0.00 27.72 127.42 - ON D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 D,00 D.00 NOTE: OTHER = 13.88 HEALTH INSURANCE, 5.31 DENTAL INSURANCE & 8.53 401K Name, Address and Number at Day Deductions, Contributions, and Payments Social SecurityNumber of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA Stale SDI Vac/ Health Pension Net Earned Earned Tax Tax Holide & Well. SARABIA, JOSE A 0 Date Total Heady Wage Check 2950 N INDIAN CANYON DR Work 10104 10/05 10/06 10f07 10/06 10109 10/10 Hours Pay Rate This All 5.55 48.96 12.57 7.68 0.00 0,00 0.00 Paid Far Week Number Classification Hours Worked Each Day Project Projects PALM SPRINGS CA LANDSCAPE MAINTENANCEAdmin 5 8,00 8.00 8,00 8.00 8,00 0.00 0,00 40.00 16.00 646.00 640.00 TrainingFund Tray/Duas Subs Subs Savin s g Other Total 565,24 11276 LABORER- Q 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 92262 RIVERSIDE 0.00 0.00 0.00 0.00 0.00 0.00 74.76 MONO D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: Name, Address and Number of Day Deductions, Contributions, and Payments Social SecurityNumber of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA State SDI Vac/ Health Pension Nel Earned Tax Tax Holiday8 Well, VALDEZ. HUMBERTO S 0 Date Total Hourly Wage Check 12966 CACTUS DR SA Work 10104 10/05 10/06 10107 10/08 10/09 10/10 Hours Pay Rale This All 80.10 59.92 17.73 9.40 0.00 0.00 0,00 Paid For Week Number Classification Hours Worked Each Day Pra } ect Pr oeelsf DESERT HOT SPRINGS CA TREE MAINTENANCEAdmin S 8.00 0.00 0.00 0.00 0.00 0.00 0.00 8.00 26.57 212.56 788.56 TrainingFund Dues Trav/ Sups Savings 9 Other Total 452.66 11279 (LABORER). 0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 s 92240 GROUNDSPERS 0.00 0.00 0.00 0.00 0.00 168.55 335.70 "MEM ON D D.00 o.00 D.Do D.00 o.o0 0.DD am 0.00 0.00 NOTE: OTHER = 5.31 DENTAL INSURANCE, 155.35 GARNISHMENT & 7.89 401K Public Works Certified Payroll Reporting Farm 10/22/2021 - Page 3 eCPR Online Confirmation Your payroll submission request has been processed. ( .Tease review the results of your submission. Should you have any questions please contact the eCPR unit at publicworks@dir.ca.gov. I. 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: 2021-10-03 Payroll Number: 118 Amendment Number: 0 10 employee payroll record(s) processed Your Transaction ID is: 12398185 Print this Page View your submission 'ubmit another set of payroll records Public Works Certifii ayroll Reporting Form Certification untie, 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 II, 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 2021-10-03 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 2021-10-22." Contractor Name: PWLC II, INC. Contractor PWCR: 1000037373 License Type: CSLB License Number 855783 Address: PO BOX 848, THOUSAND PALMS, CA 92276 FEIN: 510532726 Contractor Email: KRISTYS@PWLC2.COM Insurance Number: NA 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: 118- 0 For Week Ending: 10/03/2021 ill Is this a 'Statement of Non -Performances Name, Address and Number of Day Deductions, Contributions, and Payments Social Security Number of Worker Withholding Man Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA Stale 5G[ Vac/ Health Pension Net Earned Tax Tax Holiday & Wed. ALATORRE, GRISELDA 0 Date Total Hourly Wage Check 11550 WESTERN AVE Work 09127 09128 09129 09/30 10/01 10/02 10103 Hours Pay Rate This All 0 00 63.65 8.52 9.98 0.00 0,00 0.00 Paid For Week Number ClassificationH Hours Worked Each Day Pro ect i Pro acts i DESERT HOT SPRINGS CA LANDSCAPE MAINTENANCE S 8.00 6.00 8.00 8.00 8.00 0.00 0.00 40.00 16.00 640.00 832.00 Training Fund Admin Dues Troy/ Subs Savings Other Total Deduct 749.85 11236 LABORER- 0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0 00 92240 RIVERSIDE 0.00 0.00 0.00 0.00 0.00 0.00 82.15 D 0.00 0.00 0.06 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: Name, Address and Number of Day Deductions, Contributions, and Payments Social SecurityNumber of Worker Withholding Mon Tiro Wed Thu Fri Sat Sun Gross Amount Federal FICA State SDI Vac! Health Pension Net Dale Earned Tax Tax Holiday& Welf. BRIONES, MARCELINO 2 Total Hourly Wage Check 50700 CALLE MENDOZA Work 09/27 09/28 09/29 09/30 10/01 10/02 10103 Hours Pay Rate This All 78.29 71.53 25.02 11.22 0.00 0.00 0.00 Paid Far Number Classification ours Worked Hours Each Day Project P ProjectsWeek COACHELLA CA LANDSCAPE MAINTENANCE S 8.00 8.00 8.0o 8 00 8.00 0.00 0,00 40,Q0 17.00 731.00 935.00 Training Fund Admin Dues Tray/ Subs Savings Other Total Deduct 739.59 11237 LABORER- Q 0.00 0.00 a.oa 0.00 0.00 0.00 2.00 2.00 25.50 92236 RIVERSIDE 0,00 0.00 0.00 0.00 0.00 9.35 195.41 IMIIIIND D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0.00 NOTE: OTHER = 9.35 401K Name, Address and Number of Day Deductions, Contributions, and Payments Social SecurityNumber of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA State SDI Vac! Health Pension Not Earned Tax Tax Holida Y & Welf. CASTILL4 VIGIL. RAMON A 0 Dale Total Hourly Wage Check 27335 HOPPER RD Work 09127 09/28 09/29 09/30 10/01 10/02 10/03 Hours Pay Role This All 53.02 61.20 16.19 9.60 0.00 0.00 0.00 Paid For Week Number Classification Hours Worked Each Dayi Project Pro acts DESERT HOT SPRINGS CA LANDSCAPE MAINTENANCE 540.00 8.00 8.00 8.00 8.00 8.00 0.00 0.00 20.00 800.00 800.00 TrainingFund Admin Dues Tray/ Subs Sayings 9 Other Total Deduct 651.99 11238 LABORER- O 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0,00 92241 RIVERSIDE 0.00 0.00 0.00 0.00 0.00 8.00 148.01 D 0.00 0.00 0.00 0.00 0.00 0.Oo 0.00 0.00 0.00 NOTE: OTHER = 8.00 401K Public Works Certified Payroll Reporting Form 10/22/2021 - Page 1 Public Works Certifi ayroll Reporting Form Contractor Name: PWLC II, INC. Project Name: LANDSCAPE & LIGHTING DISTRICT 89-1 For Week Ending: 10/03/2021 Payroll Number:118-0 Name, Address and Number of Day Deductions, Contributions, and Payments Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA Slate SDI Vac/ Health Pension Net Date Earned Tax Tax Holiday 8 Well. JIMENEZ. !VETTE 0 Total Hourly Wage Chock 49615 HARRISON ST 440 Work 09/27 09/28 09/29 09/30 10/01 10/02 10103 Hours Pay Rate This All 37.09 48.96 5.55 7.68 0.00 0.00 0.00 Paid For Week Number Classification Hours Worked Each Day Project Projects COACHELLA CA LANDSCAPE MAINTENANCE S 8.00 6.00 e.00 8.00 8.00 0.00 0.ee 40.00 18.00 640.00 640.00 TrainingFund Admin Dues S Subsubs Sayings g Other Total 540.72 11239 LABORER- 0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 92236 RIVERSIDE 0.00 0.00 0.00 0.00 0.00 0.00 99.28 IIIIMMISI D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0.00 NOTE: Name, Address and Number of Day Deductions, Contributions, and Payments Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sal Sun Gross Amount Federal FICA Stale SDI Vac/ Health Pension Net Earned Tax Tax Holiday A Wall LIZARRAGA, MOISES 0 Date Total Hourly Wage Check 43795 RECLINATA WAY Work 09/27 09/26 09/29 09/30 10/01 10/02 10/03 Hours Pay Rate This All 0.00 52.02 4.69 8.16 0.00 0.60 0.00 Paid For Week Number Classification Hours Worked Each Day Project 1 Projecls INOIO CA LANDSCAPE MAINTENANCE 5 8.00 8.00 8.00 8.00 8.00 0.00 0.00 40.00 17.00 660.00 680.00 Training und qdm n Dues Tray/ Subs Savings Other Total 815.13 11240 LABORER- 0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 92201 RIVERSIDE 0.00 0.00 0.00 0.00 0.00 0.00 64.87 81011111111 D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: Name, Address and Number of Day Deductions, Contributions, and Payments Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA Stale SDI Vac/ Health Pension Net Earned Tax Tax Holiday 8 Well. LUNA GONZALEZ. CARLOS 4 Dale Total Hourly Wage Check 66145 7TH ST Wo 09/27 09/28 09/29 09130 10/01 10/02 10/03 Haws Pay Rale This Ail 52.00 81.28 6.78 12.75 0.00 0.00 0.00 Paid For Week Number Classificatione Hours Worked Each Day Project Projects i DESERT HOT SPRINGS CA TREE MAINTENANCE 5 0.00 8.00 0.00 8.00 8.00 0.00 0.00 24.00 30.82 760.97 1.082.47 TrainingFund Admin Dues Tray/ Subs Sayings g Other Total 909.66 11243 (LABORER)- O 0.00 0.00 0.00 0.50 0.00 0.00 0.00 0.50 42.57 92240 SENIOR TREE 0.00 0.00 0.00 0.00 0.00 0.00 152.81 TRIMMER D 0.00 0.00 0.00 0.00 0.00 0.00 0.0G 0.00 0.00 NOTE: Name, Address and Number of Day Deductions, Contributions, and Payments Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA State SDI Vac/ Health Pension Net I Earned Tax Fax Holiday 8 Welt. MUNOZ, EVERARDO 0 Dale Total Houdy Wage Check 74501 42N0 AVE Work 09/27 09/28 09/29 09/30 10/01 10102 10/03 Hours Pay Rale This All 0.00 55.08 3.82 8.64 0.00 0.00 0,00 Paid For Week Number Classification Hours Worked Each Day Project Projects PALM DESERT CA LANDSCAPE MAINTENANCE 5 8.00 8.00 8.00 8.00 8.00 0.00 0.00 40.00 18.00 720.00 745.00 TrainingFvnd Admin Dues Tray/ Subs Savings Other Total 677.46 11241 LABORER- 0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 92260 RIVERSIDE 0.00 0.00 0.00 0.00 0.00 0.00 67.54 Iiii D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NOTE: Public works Certified Payroll Reporting Form 10/22/2021 - Page 2 Public Works Certifil{ ayroll Reporting Form Contractor Name: PWLC II, INC. Project Name: LANDSCAPE & LIGHTING DISTRICT 89-1 For Week Ending: 10/03/2021 Payroll Number:118-0 Number of Day Deductions, Contributions, and Payments Nemo, Address and Social Security Number of Worker Withholding Mon Tue Wed Thu Fri 5a1 Sun Gross Amount Federal FICA Stale SDI Vac/ Health Pension Nat Dale Earned Tax Tax Holiday & Well. Wage Check RAMIREZ, MARCEUNO 4 Total Hourly Work 09127 09128 09/29 09/30 10101 10102 10103 Hours Pay Rate This AB 39.91 74.34 3.00 11.66 0.00 0.00 0.00 Paid For Week Number 1500 E SAN RAFAEL DR #164 Classification Hours Worked Each Day Project Projects PALM SPRINGS CA TREE0.00 MAINTENANCE s 8.00 0.00 8.00 8.00 0.00 0,0Q 24.00 26.57 655.87 990.87 Training Fund Admin Duos Tray/ Subs Savings Other Total 832.86 11244 0.00 0.00 Q.Qa 0.50 0.00 0.00 0.00 36.38 92262 (LABORER)- GROUNDSPERS G 0.50 0.00 0.00 0.00 0 00 0.00 29,10 158.01 IMMO ON D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0.00 NOTE: OTHER = 13.88 HEALTH INSURANCE, 5.31 DENTAL INSURANCE & 9.91 401K Number of Day Deductions, Contributions, and Payments Name, Address and Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA State 501 Vac/ Health Pension Net Date Earned Earned Tax Tax Holiday 8 Wolf. Check 0 Total Hourly SARABIA,JO5EA N INDIAN CANYON DR Work 09127 09/28 09/29 09/30 10/01 10102 10/03 Hours Pay Rate Thls All 5.55 48.96 12 57 7 68 0.00 0.00 0.00 Pald For Week Number 2950 Classification Hours Worked Each Day Project Pro,eels PALM SPRINGS CA LANDSCAPE8.00 MAINTENANCE s 8.00 8.00 8.00 8.00 0.00 0.00 40.00 16.00 640.00 640.00 Training AdminFund Dues Subs Savings Other Total 565.24 11242 LABORER- 0.00 0.00 0.00 Q.00 0.00 0.00 0.00 i;p 92262 RIVERSIDE 0 0 0.00 0.00 0.00 0.00 0.00 a ❑n 0,00 74.76 UMW D 0.60 0.00 0.00 0.00 0.00 0.00 0.00 a.Gc. 0.00 NOTE: Name, Address Number of Day Deductions, Contributions, and Payments and Social Security Number of Worker Withholding Mon Tue Wed Thu Fri Sat Sun Gross Amount Federal FICA Stale SDI Vac/ Health Pension Net Date Earned Tax Tax Holiday & Well. Wage S 0 Total Hourly Chock VALDEZ, HUMBERTO 12966 CACTUS DR #A Work 09/27 09/28 09/29 09/30 10/01 10/02 10103 Hours Pay Rate This All 108.88 72.83 28.76 11.42 0.00 0.00 0 00 Paid For Week Number Classification Hours Worked Each Day Project Projects DESERT HOT SPRINGS CA TREE0.00 MAINTENANCE s 8.00 0.00 8.00 8.00 0.00 0.00 24.69 26.57 655 87 957.37 Training Fund Admin Dues Tray/ Subs Savings Other Total 536.73 11245 (LABORER)- 0 0.00 0.00 0.00 0.50 0.00 0.00 0.00 92240 GROUNDSPERS 0.50 36.38 0.00 0.00 0 00 0.00 0.00 198,75 420.64 r ON D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0.00 NOTE: OTHER w 5.31 DENTAL INSURANCE. 183.87 GARNISHMENT 8 9.57 401K r•ub11c works Certified Payroll Reporting Form 10/22/2021 - Page 1