2016-08 Urban Habitat WE 2019-11-09PAYROLL
(For Contractor's Optional Use; See Instructions, Form WH-347 Inst.)
NAME OF CONTRACTOR F,11 OR SUBCONTRACTOR ❑ Wage CA-SC-UH
ADDRESS PO Box 1177
Det:
La Quinta, CA 92247
Urban Habitat
PAYROLL NO.
FOR WEEK ENDING
PROJECT AND LOCATION
PROJECTOR CONTRACT NO.
La Quinta SilverRock Park Venue
4.1
11/09/2019
2016-08/2016-08
La Quinta SilverRock Resort
(1)
(2)
(3)
(4) DAY AND DATE
(5)
(6)
(7)
(8) * Other Deductions - 1) Local Tax 1
(9)
O
DEDUCTIONS 2) Local Tax 2
ti SUN
MON
TUE
I WED
THU
FRI
SAT
a O
3) Other Deductions
yyNET
AGES
NAME. ADDRESS. AND
�. 0 a
WORK
GROSS
PAID
3
°'
4
5
6
7
8
9
WITH -
Identification Number
O F w
CLASSIFICATION
TOTAL
RATE
AMOUNT
HOLDING
TOTAL
FOR WEEK!
HOURS WORKED EACH DAY
OF EMPLOYEE
° 3 w
HOURS
OF PAY
EARNED
FICA
TAX
SWH
Medicare
OTHER*
DEDUCTIONS
Check No.
Sex Race
Daniel J. Carver
Landscape Irrigation
D o
0
0
0
0
0
0
0.00
o.00 o.o0
1103.19
1) 0.00
20715 Stoddard Wells Rd.
4
Labor
2> 0.00
Apple Valley, CA 92307
0 0
0±..o
o
0
0.00
0do 0.00
87.00
95.00
28.60
20.35
3) 14.04
244.99
1158.21
S0
4.50
4.50
8.00
a
33.00
33.43 o.00
270717343
1403.20
61476
Male Caucasian
Fringe Detail: Health & Welfare: $246.51/$7.47, Pension: $277.20/$8.40, Annuity: $16.50/$0.50, Vacation: $160.71/$4.87, Training Fund: $22.77/$0.69, Contract Compliance: $9.90/$0.30, Administrative Fund: $1.98/$0.06,
Indust. Stab.Fund: $3.96/$0.12
Other Deduction Detail: SDI: 14.04
Daniel J. Carver
20715 Stoddard Wells Rd.
Apple Valley, CA 92307L.
4
Landscape Irrigation
P 9
Labor
D o
0
0
0
0
0
0
0.00
0.00 0.00X1403.20
95.00
28.60
20.35
1) 0.00
2) 0.00
3) 14.04
244.99
115521
0±031.
0
0
0
0
0
0.00
0.00 0.0087.00
S
o
a
350
0
0
7.00
35.43 0,00
270717343
61476
Male Caucasian
Fringe Detail: Health & Welfare: $52.29/$7.47, Pension: $58.80/$8.40, Annuity: $3.50/$0.50, Vacation: $34.09/$4.87, Training Fund: $4.83/$0.69, Contract Compliance: $2.10/$0.30, Administrative Fund: $0.42/$0.06, Indust.
Stab.Fund: $0.84/$0.12
Other Deduction Detail: SDI: 14.04
Cameron D. Cleland
20250 Itasca Rd.
Apple Valley, CA 92308
2
Landscape Oper. Eng
D o
0
0
0
0
0
0
0.00
o oo o oo
1268.85
94.05
128.00
43.40
22.00
1) 0.00
2) 0.00
3) 15.17
302.62
1214.24
0 o
0
o
c
0
0
0
0.00
0.00 0.00
S 0
4.50
8.00
8.00
4.50
e.0o
0
33.00
3845 o.00
565931366
1516.86
61473
Male Caucasian
Fringe Detail: Health & Welfare: $325.71/$9.87, Pension: $325.71/$9.87, Vacation: $159.72/$4.84, Training Fund: $49.50/$1.50, Annuity: $8.25/$0.25, Contract Compliance: $9.90/$0.30, Administrative Fund: $1.98/$0.06,
Indust. Stab.Fund: $3.96/$0.12
Other Deduction Detail: SDI: 15.17
Cameron D. Cleland
20250 Itasca Rd.
Apple Valley, CA 92308
2
andscape Irrigation
Labor
D o
0
0
0
0
0
0
0.00
o.00 o.00
248,01
94.05
128.00
43.40
22.00
1) 0.00
2) 0.00
3) 15.17
302.62
1214.24
0 0
0
0
0
0
0
0
0.00
0.00 0.00
S o
3.50
0
0
3.50
0
0
7.00
3543 0.0D
565931366
1516.86
61473
Male Caucasian
Fringe Detail: Indust. Stab.Fund: $0.84/$0.12, Vacation: $34.091$4.87, Annuity: $3.50/$0.50, Training Fund: $4.83/$0.69, Health & Welfare: $52.29/$7.47, Contract Compliance: $2.10/$0.30, Pension: $58.80/$8.40,
Administrative Fund: $0.42/$0.06
Other Deduction Detail: SDI: 15.17
While completion of Form WH-347 is optional, it is mandatory for covered contractors and subcontractors performing work on Federally financed or assisted construction contracts to respond to the information collection contained in 29 C.F.R.
§§ 3.3, 5.5(a). The Copeland Act (40 U.S.C. § 3145) contractors and subcontractors performing work on Federally financed or assisted construction contracts to "furnish weekly a statement with respect to the wages paid each employee
during the preceding week" U.S. Department of Labor (DOL) regulations at 29 C.F.R. § 5.5(a)(3)(ii) require contractors to submit weekly a copy of all payrolls to the Federal agency contracting for or financing the construction project,
accompanied by a signed "Statement of Compliance" indicating that the payrolls are correct and complete and that each laborer or mechanic has been paid not less than the proper Davis -Bacon prevailing wage rate for the work performed.
DOL and federal contracting agencies receiving this information review the information to determine that employees have received legally required wages and fringe benefits.
PAYROLL
(For Contractor's Optional Use; See Instructions, Form WH-347 Inst.)
NAME OF CONTRACTOR (`/I OR SUBCONTRACTOR n Wage CA-SC-UH
Urban Habitat
Det:
ADDRESS PO Box 1177
La Quinta, CA 92247
PAYROLL NO.
FOR WEEK ENDING
PROJECT AND LOCATION
PROJECT OR CONTRACT NO.
La Quinta SilverRock Park Venue
4.1
11 /09/2019
2016-08/2016-08
La Quinta SilverRock Resort
(1)
(2)
(3)
(4) DAY AND DATE
(5)
(6)
(7)
(8) ` Other Deductions - 1) Local Tax 1
(9)
O
DEDUCTIONS 2) Local Tax 2
F SUN
MON
TUE
WED
THU
FRI
SAT
o O
3) Other Deductions
NET
WAGES
NAME, ADDRESS, AND
LL 01
°
WORK
GROSS
PAID
3
'�
4
5
6
7
8
9
WITH-
Identification Number
_
r w
°z
CLASSIFICATION
TOTAL
RATE
AMOUNT
HOLDING
TOTAL
FOR WEEK/
HOURS WORKED EACH DAY
OF EMPLOYEE
3 w
HOURS
OF PAY
EARNED
FICA
TAX
SWH
Medicare
OTHER`
DEDUCTIONS
Check No.
Sex Race
Emesto Gonzalez Torres
Landscape Irrigation
D 0
0
0
0
0
0
0
o.DD
0.00 0.00
694.80
1) 0.00
61101 Grapefruit Blvd. #6
Labor
2) 0.00
0 0
0
0
o
0
0
0
0.00
0.00 0.00
Thermal, CA 92274
2
43.08
51.00
11.48
10.08
3) 6.95
122.59
572.21
S o
8.00
8.00
Boo
8.00
& 0
0
40.00
17.37 0.00
617157389
Apprentice Level 1
694.80
61481
Male
Fringe Detail: Health & Welfare: $176.001$4.40, Cooperation Comm.: $12.00/$0.30, Training Fund: $53.60/$1.34, Indust. Stab.Fund: $3.20/$0.08, Vacation: $50.40/$1.26, Pension: $170.40/$4.26, Annuity: $10.00/$0.25,
Administrative Fund: $2.40/$0.06
Other Deduction Detail: SDI: 6.95
Kenneth P. Ocean
15214 Mission St
Hesperia, CA 92345
0
Landscape Irrigation
Labor
D o
0
0
0
0
0
0
0.00
o.00 o.00Z1337.20
126.00
34.23
19.39
1) 0.00
2) 0.00
3) 13.37
275.90
1061.30
0 0
0
0
0
0
0
0
0.00
0.00 00082.91
$ 0
B.00
B.DD
8.00
8.00
B.OD
0
40.00
33.43 o.00
559657836
61498
Male
Fringe Detail: Health & Welfare: $298.80/$7.47, Pension: $336.00/$8.40, Annuity: $20.00/$0.50, Vacation: $194.80/$4.87, Training Fund: $27.60/$0.69, Contract Compliance: $12.00/$0.30, Administrative Fund: $2.40/$0.06,
Indust. Stab.Fund: $4.80/$0.12
Other Deduction Detail: SDI: 13.37
While completion of Form WH-347 is optional, it is mandatory for covered contractors and subcontractors performing work on Federally financed or assisted construction contracts to respond to the information collection contained in 29 C.F.R.
§§ 3.3, 5.5(a). The Copeland Act (40 U.S.C. § 3145) contractors and subcontractors performing work on Federally financed or assisted construction contracts to "furnish weekly a statement with respect to the wages paid each employee
during the preceding week." U.S. Department of Labor (DOL) regulations at 29 C.F.R. § 5.5(a)(3)(ii) require contractors to submit weekly a copy of all payrolls to the Federal agency contracting for or financing the construction project,
accompanied by a signed "Statement of Compliance" indicating that the payrolls are correct and complete and that each laborer or mechanic has been paid not less than the proper Davis -Bacon prevailing wage rate for the work performed.
DOL and federal contracting agencies receiving this information review the information to determine that employees have received legally required wages and fringe benefits.
Date December 11th,
2019
I, Theresa Brennan President
(Name of Signatory Party) (Title)
under penalty of perjury, do hereby state:
(1) That I pay or supervise the payment of the persons employed by
Urban Habitat on the
(Contractor or Subcontractor)
La Quinta SilverRock Park Venue a Public Works Project commencing on the
(Building or Work)
3rd day of November , 2019 , and ending the 9th day of November 2019
all persons employed on 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 no behalf of said
Urban Habitat
(Contractor or Subcontractor)
from any person and that no deductions have been made either directly or indirectly from the full wages
earned by any person other than permissible deductions as defined in Regulations, California Labor
Code, Division 2, Chapter 7, Part 1 (Public Works Section 1720 thru 1861) and or described below.
FICA, FWH, Medicare, State Tax, SDI
(2) That the payrolls for the Public Works Project required to be submitted are true, 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 assigned to the contract, the classifications
assigned to each Laborer or Mechanic conform to the work performed.
(3) That any apprentices employed during the above period are duly registered in a bona fide program
registered with the State apprenticeship agency and that training contributions are or will be made pursuant
to California Labor Code 1777.5
(4) That:
(a) WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, FUNDS, OR PROGRAMS
0 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
REMARKS
Contract #2016-08, Wage Decision #CA-SC-UH Mod 0 10101/19,Revised Payroll #4.1,
Contractor License # 963744, Workers Compensation Policy # URWC004126
NAME AND TITLE:
SIGNATURE:
Theresa Brennan, President
Signed Electronically
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.
U.S. G.P.O._ 1997 5%861
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: URBAN HABITAT
Contractor Address: 36953 COOK ST., STE. 101 PALM DESERT CA 92211
Awarding Body: THE CITY OF LA QUINTA
Project ID: 300347
Contract With: THE CITY OF LA QUINTA
Week Ending Date: 2019-11-09
Payroll Number: 4
Amendment Number: 0
6 employee payroll record(s) processed
Your Transaction ID is: 7226580
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