SilverRock - CPRsProject
Work Pay Sun Mon Tue Wed Thu Fri Sat Timesheet Paid Pay Job Fringe Check Total Social Medi-Federal State Total
Employee Name SSN Classification Type 6 7 8 9 10 11 12 Hours Hours Rate Gross Pay Rate Number Gross Pay Security care Tax Tax SDI Deduct Net Pay
Cubillas, Valentin 614-43-4401 Striping PW Grp 2 RT 5.75 5.75 5.75 40.36 232.07 21.19 26939 1,444.61 89.56 20.95 128.00 37.72 14.45 290.68 1,153.93
962 Rimpau Ave $208
Corona, CA 92879
Lopez, Pavel 634-90-3418 Striping PW Grp 1 RT 5.75 5.75 5.75 39.06 224.60 21.19 26953 1,021.89 63.36 14.82 110.00 35.67 10.22 234.07 787.82
716 Railroad St
Corona, CA 92882
Trujillo, Jose De Jesus 765-86-2711 Striping PW Grp 3 RT 5.75 5.75 5.75 42.37 243.63 21.19 26968 1,776.32 110.14 25.75 158.00 51.27 17.77 362.93 1,413.39
23759 Suncrest Ave
Moreno Valley, CA 92553
Vasquez Cortes, Jhair E 647-21-6539 Striping PW Grp 1 RT 5.75 5.75 5.75 39.06 224.60 21.19 26973 901.62 55.90 13.07 43.00 4.53 9.02 125.52 776.10
1896 S. Starfire Ave
Corona, CA 92879
Zamora, Joshua 621-11-3243 Striping Apprentice Prd 1 RT 5.75 5.75 5.75 24.87 143.00 11.23 26974 861.15 53.40 12.48 92.00 0.00 0.00 157.88 703.27
15643 Canterbury Ct
Fontana, CA 92337
Tax ID 46-4757502
License # 1066389
Hours Worked by Day
260 Glider Circle Avenue 52 & Jefferson St.Payroll Number 1
For Week Ending 9/12/2020La Quinta, CA 92253Corona, CA 92878
Certified Payroll Report
Contractor Falcon Striping SilverRock Park Venue Project Project/Contract #27944
Date: Sep-16, 2020
p
p
THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEMENTS MAY SUBJECT THE CONTRACTOR OR SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION. SEE SECTION 1001 OF TITLE 18 AND
SECTION 231 OF TITLE 31 OF THE UNITED STATES CODE.
Remarks:
Name and Title
Norma Cuellar, Office Manager
Signature
(3) That any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with a State apprenticeship agency recognized by the Bureau of Apprenticeship and Training, United States Department of Labor, of if no such
recognized agency exists in a State, are registered with the Bureau of Apprenticeship and Training, United States Department of Labor.
(4) That:
(a) WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, FUNDS, OR PROGRAMS
in addition to the basic hourly wage rates paid to each laborer or mechanic listed in the above referenced payroll, payments of fringe benefits as listed in the contract have been or will be made to appropriate programs for the benefit of such employees,
except as noted in Section 4(c) below.
(b) WHERE FRINGE BENEFITS ARE PAID IN CASH
Each laborer or mechanic listed in the above referenced payroll has been paid, as indicated on the payroll, an amount not less than the sum of the applicable basic hourly wage rate plus the amount of the required fringe benefits as listed in the contract,
except as noted in Section 4(c) below.
(c) EXCEPTIONS
Exception (Craft) Explanation
(2) That any payrolls otherwise under this contract required to be submitted for the above period are correct and complete; that the wage rates for laborers and mechanics contained therein are not less than the applicable wage rates contained in any wage determination
Incorporated into the contract; that the classifications set forth therein for each laborer or mechanic conform with the work he performed.
I, Norma Cuellar, Office Manager do hereby state:
(1) That I pay or supervise the payment of the persons employed by Falcon Striping on the project SilverRock Park Venue Project; that during the payroll period commencing on Sep-06, 2020 and ending on Sep-12, 2020 all persons employed on the said project have been
paid the full weekly wages earned, that no rebates have been or will be made either directly or indirectly to or on behalf of said Falcon Striping from the full weekly wages earned by any person, other than permissible deductions as defined in Regulations, Part 3 (29 CFR
Subtitle A), issued by the Secretary of Labor under the Copeland Act, as amended (48 Stat. 948, 63 Stat. 108, 72 Stat. 967; 76 Stat 357; 40 U.S.C. 276c), and described below:
Employee Ttl Hours Avg Rate Gross Pay Fringe Amt Accrued Sick Hrs Accrued Vac Hrs
Cubillas, Valentin 48.75 29.63 1,444.61 153.63 0.00 0.00
Fringe Item Fringe Amt
Fringe Benefit - PW 153.63
Classification Hours Rate Gross Pay Fringe Amt Accrued Sick Hrs Accrued Vac Hrs Accrued Sick Accrued Vac Ttl Fringe Fringe Rate Total Rate
Striping PW Grp 2 5.75 40.36 232.07 24.68 0.00 0.00 0.00 0.00 24.68 21.19 61.55
Employee Ttl Hours Avg Rate Gross Pay Fringe Amt Accrued Sick Hrs Accrued Vac Hrs
Lopez, Pavel 43.50 23.49 1,021.89 153.63 0.00 0.00
Fringe Item Fringe Amt
Fringe Benefit - PW 153.63
Classification Hours Rate Gross Pay Fringe Amt Accrued Sick Hrs Accrued Vac Hrs Accrued Sick Accrued Vac Ttl Fringe Fringe Rate Total Rate
Striping PW Grp 1 5.75 39.06 224.60 33.77 0.00 0.00 0.00 0.00 33.77 21.19 60.25
Employee Ttl Hours Avg Rate Gross Pay Fringe Amt Accrued Sick Hrs Accrued Vac Hrs
Trujillo, Jose De Jesus 47.00 37.79 1,776.32 434.40 0.00 0.00
Fringe Item Fringe Amt
Fringe Benefit - PW 434.40
Classification Hours Rate Gross Pay Fringe Amt Accrued Sick Hrs Accrued Vac Hrs Accrued Sick Accrued Vac Ttl Fringe Fringe Rate Total Rate
Striping PW Grp 3 5.75 42.37 243.63 59.58 0.00 0.00 0.00 0.00 59.58 21.19 63.56
Employee Ttl Hours Avg Rate Gross Pay Fringe Amt Accrued Sick Hrs Accrued Vac Hrs
Vasquez Cortes, Jhair E 30.00 30.05 901.62 254.28 0.00 0.00
Fringe Item Fringe Amt
Fringe Benefit - PW 254.28
Classification Hours Rate Gross Pay Fringe Amt Accrued Sick Hrs Accrued Vac Hrs Accrued Sick Accrued Vac Ttl Fringe Fringe Rate Total Rate
Striping PW Grp 1 5.75 39.06 224.60 63.34 0.00 0.00 0.00 0.00 63.34 21.19 60.25
Employee Ttl Hours Avg Rate Gross Pay Fringe Amt Accrued Sick Hrs Accrued Vac Hrs
Zamora, Joshua 33.00 26.10 861.15 370.59 0.00 0.00
Fringe Item Fringe Amt
Fringe Benefit - Apprentice 370.59
Classification Hours Rate Gross Pay Fringe Amt Accrued Sick Hrs Accrued Vac Hrs Accrued Sick Accrued Vac Ttl Fringe Fringe Rate Total Rate
Striping Apprentice Prd 1 5.75 24.87 143.00 61.54 0.00 0.00 0.00 0.00 61.54 11.23 36.10
Falcon Striping, Inc. 260 Glider Circle, Corona, CA 92878 Tel: 951-737-7748 Fax: 951-737-7781
STATEMENT OF NON-PERFORMANCE
PAYROLL FORM
Payroll Report No. ___________
I, _________________________, hereby certify under penalty of perjury no person(s)
employed by Falcon Striping, Inc. performed work on the construction project
known as __________________________________________ for the payroll period
commencing on the _________ day of ______________, 2020 and ending on the
_______ day of __________, 2020.
Office Manager
SIGNATURE OF AUTHORIZED PERSON TITLE / POSITION
Norma Cuellar
NAME OF AUTHORIZED PERSON DATE
Falcon Striping, Inc. 260 Glider Circle, Corona, CA 92878 Tel: 951-737-7748 Fax: 951-737-7781
STATEMENT OF NON-PERFORMANCE
PAYROLL FORM
Payroll Report No. ___________
I, _________________________, hereby certify under penalty of perjury no person(s)
employed by Falcon Striping, Inc. performed work on the construction project
known as __________________________________________ for the payroll period
commencing on the _________ day of ______________, 2020 and ending on the
_______ day of __________, 2020.
Office Manager
SIGNATURE OF AUTHORIZED PERSON TITLE / POSITION
Norma Cuellar
NAME OF AUTHORIZED PERSON DATE
Falcon Striping, Inc. 260 Glider Circle, Corona, CA 92878 Tel: 951-737-7748 Fax: 951-737-7781
STATEMENT OF NON-PERFORMANCE
PAYROLL FORM
Payroll Report No. ___________
I, _________________________, hereby certify under penalty of perjury no person(s)
employed by Falcon Striping, Inc. performed work on the construction project
known as __________________________________________ for the payroll period
commencing on the _________ day of ______________, 2020 and ending on the
_______ day of __________, 2020.
Office Manager
SIGNATURE OF AUTHORIZED PERSON TITLE / POSITION
Norma Cuellar
NAME OF AUTHORIZED PERSON DATE
Project
Work Pay Sun Mon Tue Wed Thu Fri Sat Timesheet Paid Pay Job Fringe Check Total Social Medi-Federal State Total
Employee Name SSN Classification Type 4 5 6 7 8 9 10 Hours Hours Rate Gross Pay Rate Number Gross Pay Security care Tax Tax SDI Deduct Net Pay
Alcocer, Gerardo 564-27-6002 Striping PW Grp 1 RT 4.00 4.00 4.00 39.06 156.24 21.19 27165 1,122.95 69.62 16.29 50.00 21.59 11.23 168.73 954.22
13471 Leda Lane Apt 14
Garden Grove, CA 92843
Castillo, Guillermo A 637-86-4321 Striping PW Grp 1 RT 4.00 4.00 4.00 39.06 156.24 21.19 27173 1,268.59 78.65 18.40 87.00 19.00 12.68 215.73 1,052.86
3741 Harvill Lane Apt 3
Riverside, CA 92503
Hernandez, Alfred F 549-08-7314 Striping PW Grp 1 RT 4.00 4.00 4.00 39.06 156.24 21.19 27182 688.32 42.67 9.98 60.00 13.17 6.88 132.70 555.62
7625 Hillside St
Corona, CA 92881
Higa, Ryan C 607-01-3999 Striping Apprentice Prd 1 RT 4.00 6.50 6.50 24.87 99.48 11.23 27183 1,168.95 72.48 16.95 142.00 48.61 11.69 291.73 877.22
187 S. Hollenbeck Ave
Covina, CA 91723
Santos, Juan M 622-06-2489 Striping PW Grp 3 RT 4.00 4.00 4.00 42.37 169.48 21.19 27199 1,967.14 121.96 28.53 236.00 132.41 19.67 538.57 1,428.57
3996 Stotts St
Riverside, CA 92503
Certified Payroll Report
Contractor Falcon Striping SilverRock Park Venue Project Project/Contract #27944
260 Glider Circle Avenue 52 & Jefferson St.Payroll Number 5
For Week Ending 10/10/2020La Quinta, CA 92253Corona, CA 92878
Tax ID 46-4757502
License # 1066389
Hours Worked by Day
Date: Oct-14, 2020
p
p
4 0
(2) That any payrolls otherwise under this contract required to be submitted for the above period are correct and complete; that the wage rates for laborers and mechanics contained therein are not less than the applicable wage rates contained in any wage determination
Incorporated into the contract; that the classifications set forth therein for each laborer or mechanic conform with the work he performed.
I, Norma Cuellar, Office Manager, do hereby state:
(1) That I pay or supervise the payment of the persons employed by Falcon Striping on the project SilverRock Park Venue Project; that during the payroll period commencing on Oct-04, 2020 and ending on Oct-10, 2020 all persons employed on the said project have been
paid the full weekly wages earned, that no rebates have been or will be made either directly or indirectly to or on behalf of said Falcon Striping from the full weekly wages earned by any person, other than permissible deductions as defined in Regulations, Part 3 (29 CFR
Subtitle A), issued by the Secretary of Labor under the Copeland Act, as amended (48 Stat. 948, 63 Stat. 108, 72 Stat. 967; 76 Stat 357; 40 U.S.C. 276c), and described below:
(3) That any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with a State apprenticeship agency recognized by the Bureau of Apprenticeship and Training, United States Department of Labor, of if no such
recognized agency exists in a State, are registered with the Bureau of Apprenticeship and Training, United States Department of Labor.
(4) That:
(a) WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, FUNDS, OR PROGRAMS
in addition to the basic hourly wage rates paid to each laborer or mechanic listed in the above referenced payroll, payments of fringe benefits as listed in the contract have been or will be made to appropriate programs for the benefit of such employees,
except as noted in Section 4(c) below.
(b) WHERE FRINGE BENEFITS ARE PAID IN CASH
Each laborer or mechanic listed in the above referenced payroll has been paid, as indicated on the payroll, an amount not less than the sum of the applicable basic hourly wage rate plus the amount of the required fringe benefits as listed in the contract,
except as noted in Section 4(c) below.
THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEMENTS MAY SUBJECT THE CONTRACTOR OR SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION. SEE SECTION 1001 OF TITLE 18 AND
SECTION 231 OF TITLE 31 OF THE UNITED STATES CODE.
Name and Title
Norma Cuellar, Office Manager
Signature
Employee Ttl Hours Avg Rate Gross Pay Fringe Amt Accrued Sick Hrs Accrued Vac Hrs
Alcocer, Gerardo 51.00 22.02 1,122.95 174.82 0.00 0.00
Fringe Item Fringe Amt
Fringe Benefit - PW 174.82
Classification Hours Rate Gross Pay Fringe Amt Accrued Sick Hrs Accrued Vac Hrs Accrued Sick Accrued Vac Ttl Fringe Fringe Rate Total Rate
Striping PW Grp 1 4.00 39.06 156.24 24.32 0.00 0.00 0.00 0.00 24.32 21.19 60.25
Employee Ttl Hours Avg Rate Gross Pay Fringe Amt Accrued Sick Hrs Accrued Vac Hrs
Castillo, Guillermo A 55.00 23.07 1,268.59 174.82 0.00 0.00
Fringe Item Fringe Amt
Fringe Benefit - PW 174.82
Classification Hours Rate Gross Pay Fringe Amt Accrued Sick Hrs Accrued Vac Hrs Accrued Sick Accrued Vac Ttl Fringe Fringe Rate Total Rate
Striping PW Grp 1 4.00 39.06 156.24 21.53 0.00 0.00 0.00 0.00 21.53 21.19 60.25
Employee Ttl Hours Avg Rate Gross Pay Fringe Amt Accrued Sick Hrs Accrued Vac Hrs
Hernandez, Alfred F 26.25 26.22 688.32 206.60 0.00 0.00
Fringe Item Fringe Amt
Fringe Benefit - PW 206.60
Classification Hours Rate Gross Pay Fringe Amt Accrued Sick Hrs Accrued Vac Hrs Accrued Sick Accrued Vac Ttl Fringe Fringe Rate Total Rate
Striping PW Grp 1 4.00 39.06 156.24 46.90 0.00 0.00 0.00 0.00 46.90 21.19 60.25
Employee Ttl Hours Avg Rate Gross Pay Fringe Amt Accrued Sick Hrs Accrued Vac Hrs
Higa, Ryan C 45.00 25.98 1,168.95 505.35 0.00 0.00
Fringe Item Fringe Amt
Fringe Benefit - Apprentice 505.35
Classification Hours Rate Gross Pay Fringe Amt Accrued Sick Hrs Accrued Vac Hrs Accrued Sick Accrued Vac Ttl Fringe Fringe Rate Total Rate
Striping Apprentice Prd 1 4.00 24.87 161.66 69.89 0.00 0.00 0.00 0.00 69.89 11.23 36.10
Employee Ttl Hours Avg Rate Gross Pay Fringe Amt Accrued Sick Hrs Accrued Vac Hrs
Santos, Juan M 47.50 41.41 1,967.14 752.25 0.00 0.00
Fringe Item Fringe Amt
Fringe Benefit - PW 752.25
Classification Hours Rate Gross Pay Fringe Amt Accrued Sick Hrs Accrued Vac Hrs Accrued Sick Accrued Vac Ttl Fringe Fringe Rate Total Rate
Striping PW Grp 3 4.00 42.37 169.48 64.81 0.00 0.00 0.00 0.00 64.81 21.19 63.56
Falcon Striping, Inc. 260 Glider Circle, Corona, CA 92878 Tel: 951-737-7748 Fax: 951-737-7781
STATEMENT OF NON-PERFORMANCE
PAYROLL FORM
Payroll Report No. ___________
I, _________________________, hereby certify under penalty of perjury no person(s)
employed by Falcon Striping, Inc. performed work on the construction project
known as __________________________________________ for the payroll period
commencing on the _________ day of ______________, 2020 and ending on the
_______ day of __________, 2020.
Office Manager
SIGNATURE OF AUTHORIZED PERSON TITLE / POSITION
Norma Cuellar
NAME OF AUTHORIZED PERSON DATE
STATEMENT OF NON-PERFORMANCE
PAYROLL FORM
Payroll Report No. ___________
I, _________________________, hereby certify under penalty of perjury no person(s)
employed by Falcon Striping, Inc. performed work on the construction project
known as __________________________________________ for the payroll period
commencing on the _________ day of ______________, 2020 and ending on the
_______ day of __________, 2020.
Office Manager
SIGNATURE OF AUTHORIZED PERSON TITLE / POSITION
Norma Cuellar
NAME OF AUTHORIZED PERSON DATE
Falcon Striping, Inc. 260 Glider Circle, Corona, CA 92878 Tel: 951-737-7748 Fax: 951-737-7781
Project
Work Pay Sun Mon Tue Wed Thu Fri Sat Timesheet Paid Pay Job Fringe Check Total Social Medi-Federal State Total
Employee Name SSN Classification Type 25 26 27 28 29 30 31 Hours Hours Rate Gross Pay Rate Number Gross Pay Security care Tax Tax SDI Deduct Net Pay
Delgado, Jose A 614-14-6618 Striping PW Grp 3 RT 1.25 3.25 3.25 42.37 52.96 21.19 27350 1,663.11 103.11 24.12 125.00 48.30 62.63 363.16 1,299.95
15199 Jeraldo Dr.
Victorville, CA 92394
Gonzalez Rosas, Juan Manuel 672-20-3421 Striping PW Grp 1 RT 1.25 1.25 1.25 39.06 48.83 21.19 27353 836.84 51.89 12.14 78.00 22.25 54.37 218.65 618.19
713 Mt. Whitney Circle
Corona, CA 92879
Higa, Ryan C 607-01-3999 Striping Apprentice Prd 1 RT 1.25 3.25 3.25 24.87 31.09 11.23 27357 1,007.27 62.45 14.61 106.00 34.38 56.07 273.51 733.76
187 S. Hollenbeck Ave
Covina, CA 91723
Certified Payroll Report
Contractor Falcon Striping SilverRock Park Venue Project Project/Contract #27944
260 Glider Circle Avenue 52 & Jefferson St.Payroll Number 8-FINAL
For Week Ending 10/31/2020La Quinta, CA 92253Corona, CA 92878
Tax ID 46-4757502
License # 1066389
Hours Worked by Day
Date: Nov-04, 2020
p
p
(2) That any payrolls otherwise under this contract required to be submitted for the above period are correct and complete; that the wage rates for laborers and mechanics contained therein are not less than the applicable wage rates contained in any wage determination
Incorporated into the contract; that the classifications set forth therein for each laborer or mechanic conform with the work he performed.
I, Norma Cuellar, Office Manager, do hereby state:
(1) That I pay or supervise the payment of the persons employed by Falcon Striping on the project SilverRock Park Venue Project; that during the payroll period commencing on Oct-25, 2020 and ending on Oct-31, 2020 all persons employed on the said project have been
paid the full weekly wages earned, that no rebates have been or will be made either directly or indirectly to or on behalf of said Falcon Striping from the full weekly wages earned by any person, other than permissible deductions as defined in Regulations, Part 3 (29 CFR
Subtitle A), issued by the Secretary of Labor under the Copeland Act, as amended (48 Stat. 948, 63 Stat. 108, 72 Stat. 967; 76 Stat 357; 40 U.S.C. 276c), and described below:
(3) That any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with a State apprenticeship agency recognized by the Bureau of Apprenticeship and Training, United States Department of Labor, of if no such
recognized agency exists in a State, are registered with the Bureau of Apprenticeship and Training, United States Department of Labor.
(4) That:
(a) WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, FUNDS, OR PROGRAMS
in addition to the basic hourly wage rates paid to each laborer or mechanic listed in the above referenced payroll, payments of fringe benefits as listed in the contract have been or will be made to appropriate programs for the benefit of such employees,
except as noted in Section 4(c) below.
(b) WHERE FRINGE BENEFITS ARE PAID IN CASH
Each laborer or mechanic listed in the above referenced payroll has been paid, as indicated on the payroll, an amount not less than the sum of the applicable basic hourly wage rate plus the amount of the required fringe benefits as listed in the contract,
except as noted in Section 4(c) below.
(c) EXCEPTIONS
Exception (Craft) Explanation
THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEMENTS MAY SUBJECT THE CONTRACTOR OR SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION. SEE SECTION 1001 OF TITLE 18 AND
SECTION 231 OF TITLE 31 OF THE UNITED STATES CODE.
Remarks:
Name and Title
Norma Cuellar, Office Manager
Signature
Employee Ttl Hours Avg Rate Gross Pay Fringe Amt Accrued Sick Hrs Accrued Vac Hrs
Delgado, Jose A 45.75 36.35 1,663.11 566.83 0.00 0.00
Fringe Item Fringe Amt
Fringe Benefit - PW 566.83
Classification Hours Rate Gross Pay Fringe Amt Accrued Sick Hrs Accrued Vac Hrs Accrued Sick Accrued Vac Ttl Fringe Fringe Rate Total Rate
Striping PW Grp 3 1.25 42.37 137.70 46.93 0.00 0.00 0.00 0.00 46.93 21.19 63.56
Employee Ttl Hours Avg Rate Gross Pay Fringe Amt Accrued Sick Hrs Accrued Vac Hrs
Gonzalez Rosas, Juan Manuel 34.50 24.26 836.84 174.82 0.00 0.00
Fringe Item Fringe Amt
Fringe Benefit - PW 174.82
Classification Hours Rate Gross Pay Fringe Amt Accrued Sick Hrs Accrued Vac Hrs Accrued Sick Accrued Vac Ttl Fringe Fringe Rate Total Rate
Striping PW Grp 1 1.25 39.06 48.83 10.20 0.00 0.00 0.00 0.00 10.20 21.19 60.25
Employee Ttl Hours Avg Rate Gross Pay Fringe Amt Accrued Sick Hrs Accrued Vac Hrs
Higa, Ryan C 39.75 25.34 1,007.27 446.39 0.00 0.00
Fringe Item Fringe Amt
Fringe Benefit - Apprentice 446.39
Classification Hours Rate Gross Pay Fringe Amt Accrued Sick Hrs Accrued Vac Hrs Accrued Sick Accrued Vac Ttl Fringe Fringe Rate Total Rate
Striping Apprentice Prd 1 1.25 24.87 80.83 35.82 0.00 0.00 0.00 0.00 35.82 11.23 36.10