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2016-08 Urban Habitat WE 2019-11-23PAYROLL (For Contractor's Optional Use; See Instructions, Form WH-347 Inst.) NAME OF CONTRACTOR tJ OR SUBCONTRACTOR Wage CA-SC-U H I ADDRESS PO Box 1177 Urban Habitat Det: La Quinta, CA 92247 PAYROLL NO. FOR WEEK ENDING PROJECT AND LOCATION PROJECT OR CONTRACT NO. 6.0 11/23/2019 La Quinta SilverRock Park Venue La Quinta SilverRock Resort 2016-08/2016-08 (1) (2) (3) (4) DAY AND DATE n (5) (6) (7) (8) ' Other Deductions- 1) Local Tax 1 (9) NAME. ADDRESS. AND Identification Number OF EMPLOYEE try ? z o O o o ~a O w z WORK CLASSIFICATION TOTAL HOURS RATE OF PAY GROSS AMOUNT EARNED DEDUCTIONS 2) Local Tax 2 3) Other Deductions NET WAGES PAID FOR WEEK/ Check No. `o SUN MON TUE I WED THU FRI I SAT 17 18 19 20 21122 23 FICA WITH- HOLDING TAX SWH Medicare OTHER' TOTAL DEDUCTIONS HOURS WORKED EACH DAY Sex Race Daniel J. Carver Landscape Irrigation D 0 0 0 0 0 0 0 0.00 o.00 o.00X1230�56 1) 0.00 20715 Stoddard Wells Rd. Apple Valley, CA 92307 4 abor 74.00 17.21 17.84 2) 0.00 3) 12.31 197.65 1032.91 0 0 0 0 o 0 0 0 0.00 a.00 0.a076.29 S 0 o 8.00 o 8.00 8.00 o 24.00 35.43 0.00 270717343 61572 Male Caucasian Fringe Detail: Health & Welfare: $179.281$7.47, Pension: $201.60/$8.40, Annuity: $12.00/$0.50, Vacation: $116.88/$4.87, Training Fund: $16.56/$0.69, Contract Compliance: $7.20/$0.30, Administrative Fund: $1.44/$0.06, Indust. Stab.Fund: $2.88/$0.12 Other Deduction Detail: SDI: 12.31 Daniel J. Carver 20715 Stoddard Wells Rd. Apple Valley, CA 92307 4 andscape Irrigation abor D o a o 0 0 0 0 0.00 o.00 o.00 267.44 76.29 74.00 17.21 17.84 1) 0.00 00 2) 2.31 3) 12.3t 197.65 1032.91 0 0 0 0 0 0 0 0 0.00 0.00 0.00 S o e.00 0 0 0 0 0 8.00 33.43 0.00 270717343 1230.56 61572 Male Caucasian Fringe Detail: Health & Welfare: $59.76/$7.47, Pension: $67.20/$8.40, Annuity: $4.00/$0.50, Vacation: $38.96/$4.87, Training Fund: $5.52/$0.69, Contract Compliance: $2.40/$0.30, Administrative Fund: $0.48/$0.06, Indust. Stab.Fund: $0.96/$0.12 Other Deduction Detail: SDI: 12.31 Luis M. Castaneda 5 Running H Desert, CA 92260 2 ement Mason D o o o 0 0 0 0 0.00 o.00 o.00X1184.00 88.00 18.90 17.16 1) 0.00 2) 0.00Palm 3) 36.41233.88 950.12 0 0 0 0 0 o 0 o D.00 0.00 0.0073.41 S o o s.ao s.00 s.00 a.00 0 3200 37oa o.o0 547439373 61595 Male Fringe Detail: Vacation: $263.36/$8.23, Health & Welfare: $239.04/$7.47, Pension: $268.801$8.40, Annuity: $16.00/$0.50, Training Fund: $22.08/$0.69, Contract Compliance: $9.601$0.30, Indust. Stab.Fund: $2.56/$0.08, Other: $2.24/$0.07, Administrative Fund: $1.921$0.06 Other Deduction Detail: SDI: 11.84, Child Support 24.57 Cameron D. Cleland 20250 Itasca Rd. Apple Valley, CA 92308 2abor Landscape Irrigation D 0 0 0 0 0 0 0 0.00 0.00 o.00Y283.44 106.00 28.23 19.30 1) 0.00 2) 0.00 3) 13.31 249.37 1081.67 0 0 0 0 0 0 0 0 0.00 0.00 0-0082.53 S o s.000o a o 0 8.00 35.43 0.00 565931366 61569 Male Caucasian Fringe Detail: Indust. Stab.Fund: $0.96/$0.12, Vacation: $38.96/$4.87, Annuity: $4-00/$0.50, Training Fund: $5.52/$0.69, Health & Welfare: $59.76/$7.47, Contract Compliance: $2.40/$0.30, Pension: $67.20/$8.40, Administrative Fund: $0.48/$0.06 Other Deduction Detail: SDI: 13.31 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 FI/I 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 PROJECT OR CONTRACT NO. La Quinta SilverRock Park Venue 6.0 11/23/2019 2016-08/2016-08 La Quinta SilverRock Resort (1) (2) (3) (4) DAY AND DATE (5) (6) (7) (8) * Other Deductions- 1) Loral Tax 1 (9) (9 DEDUCTIONS 2) Local Tax 2 `o SUN MON TUE WED THU FRI SAT 0 3) Other Deductions NET 0 o WAGES NAME, ADDRESS. AND oiL O WORK GROSS PAID F 17 18 19 20 21 22 23 WITH - Identification Number F w CLASSIFICATION TOTAL RATE AMOUNT HOLDING TOTAL FOR WEEK/ HOURS WORKED EACH DAY OF EMPLOYEE z 3 w HOURS OF PAY EARNED FICA TAX SWH Medicare OTHER* DEDUCTIONS Check No. Sex Race Cameron D. Cleland andscape Oper. Eng D 0 0 0 0 0 0 0 0.00 0.00 0.00X2810 1) 0.00 20250 Itasca Rd. 2 2) 0.00 Apple Valley, CA 92308 0 0 0 0 0 0 0 0 0.00 o.00 o.o082.53 106.00 28.23 19.30 3) 13.31 249.37 1081.67 S 0 0 8.00 0 8.co 8.00 0 24.00 3a.a5 0,00 565931366 61569 Male Caucasian Fringe Detail: Health & Welfare: $236.88/$9.87, Pension: $236.88/$9.87, Vacation: $116.16/$4.84, Training Fund: $36.00/$1.50, Annuity: $6.00/$0.25, Contract Compliance: $7.20/$0.30, Administrative Fund: $1.44/$0.06, Indust. Stab.Fund: $2.88/$0.12 Other Deduction Detail: SDI: 13.31 Pedro J. Clemente 68990 Harrison St. Space #101 Thermal, CA 92274 5 Landscape Irr. Tender D 0 0 0 0 0 0 0 0.00 0.00 0,007616..60 D.QO 0.00 g gq 1) 0.00 2) 0.00 3) 6.17 53.34 563.26 0 0 0 0 0 0 0 0 0.00 0.00 0.0038.23 S o 7.7s 8.00 0 26.42 75.3o o.o0 657090571 61605 Male IT Fringe Detail: Health & Welfare: $64.729/$2.45, Pension: $26.42/$1.00, Vacation: $27.2131$1.03, Annuity: $6.605/$0.25 Other Deduction Detail: SDI: 6.17 Enrique Corrales Alcantar 1278 Bernis Blvd. Thermal, CA 92274 2 Landscape Irrigation Labor D o 0 0 0 o s o 0.00 o,00 o.00 419.66 34.19 16.00 0,00 7.99 1) 0.00 2) 0.00 3) 5.52 63.70 487.80 0 o 0 0 0 0 0 0 0.00 0.00 0.00 S o a o 8.00 775 8o0 0 2375 17,67 0.00 767333187 ApprenticeLevel1 551.50 4224 Male 1 Fringe Detail: Administrative Fund: $1.425/$0.06, Training Fund: $31.825/$1.34, Contract Compliance: $7.125/$0.30, Pension: $101.175/$4.26, Health & Welfare: $104.50/$4.40, Indust. Stab -Fund: $1.90/$0.08, Annuity: $5.938/$0.25, Vacation/ Holiday: $29.925/$1.26 Other Deduction Detail: SDI: 5.52 Maurilio P. Cortez 55550 Tyler St. Thermal, CA 92274 5 Landscape Irrigation Labor D o o o o o o o 0.00 0.00 0.00 480.00 49.60 17.00 0.00 11.60 11 0.00 2) 0.00 3) 8.00 g6.20 713.80 0 0 0 0 0 0 0 0 0.00 0.00 0.00 S o 0 or oo e.00 s.00 0 24.00 20.00 0.00 604521749 Apprentice Level 1 800.00 61599 Male Hispanic American Fringe Detail: Training Fund: $16.56/$0.69, Annuity: $12.00/$0.50, Pension: $98.40/$4.10, Contract Compliance: $7.20/$0.30, Indust. Stab -Fund: $1.92/$0.08, Administrative Fund: $1.44/$0.06, Health & Welfare: $105. 60/$4.40, Vacation: $29.76/$1.24 Other Deduction Detail: SDI: 8.00 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 "fumish 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 F/� 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 PROJECT OR CONTRACT NO. La Quinta SilverRock Park Venue 6.0 11/23/2019 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) L� N DEDUCTIONS 2) Local Tax 2 SUN MON TUE WED THU FRI SAT 3) Other Deductions NET a o r WAGES 17 `a 18 19 20 1 21 1 22 23 NAME, ADDRESS, AND oa WORK GROSS PAID Identification Number O ? w CLASSIFICATION TOTAL RATE AMOUNT WITH - 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 Ernesto Gonzalez Torres Landscape Irrigation p s61101 D o 0 0 0 0 0 0 0.00 o.00 0.00V555.814 1) 0.00 Grapefruit Blvd. #6 2 Labor 2)0.0088 Thermal, CA 92274 0 0 0 0 0 0 0 0 0.00 0.00 0.0034.47 35.00 5.36 8.06 3) 5.55617157389 44 467.40 S 0 8-00 800 08,0o s.00 0 32.00 17.37 0.00 pprentice Level 1 61577 Male Fringe Detail: Health & Welfare: $140.80/$4.40, Cooperation Comm.: $9.60/$0.30, Training Fund: $42.88/$1.34, Indust. Stab.Fund: $2.56/$0.08, Vacation: $40.32/$1.26, Pension: $136.32/$4.26, Annuity: $8.00/$0.25, Administrative Fund: $1.92/$0.06 Other Deduction Detail: SDI: 5.55 Luis F. Lopez Quintero 66886 Camino IdiliO Desert Hot Springs, CA 92240 1 Landscape Irrigation Labor D o 0 0 0 0 0 o 0.00 000 o.00 463.25 43.08 32.00 13.97 10.07 1) 0.00 2) 0.00 3) 6.95 106.07 588.73 0 0 0 0 0 o o o 0.00 0.00 0.00 S 0 0 2.67 8.00 8.00 8.00 0 26.67 17.37 0,00 164777350 Apprentice Level 1 694.80 61594 Male Fringe Detail: Health & Welfare: $199.225/$7.47, Pension: $250.698/$9.40, Training Fund: $18.402/$0.69, Annuity: $13.335/$0.50, Vacation: $129.883/$4.87, Contract Compliance: $8.001/$0.30, Administrative Fund: $1 _ 60/$0.06, Indust. Stab.Fund: $3.20/$0.12 Other Deduction Detail: SDI: 6.95 Felipe Lopez Desert Hot Springs, CA 92240 Deser Camino ngs, 5 Landscape Irrigation abor D o o 0 0 0 0 0 0.00 o.00 o.o0�883.22 84.04 80.00 22,96 19.66 1) 0.00 00 2) 3.5522021 3) 13.55604137146 1135.30 0 c 0 0 0 0 0 0 0.00 0.00 0.00 S o o zs7 s.00 z76 s.00 0 26.42 3a43 o.00355.51 61578 Male Fringe Detail: Health & Welfare: $197.357/$7.47, Pension: $221.928/$8.40, Annuity: $13.21/$0.50, Vacation: $128.665/$4.87, Training Fund: $18.23/$0.69, Contract Compliance: $7.926/$0.30, Administrative Fund: $1. 585/$0.06, Indust. Stab.Fund: $3.17/$0.12 Other Deduction Detail: SDI: 13.55 Kenneth P. Ocean 15214 MISSIOn St. Hesperia, CA 92345 0 Landscape Irrigation Labor D 0 0 0 0 0 0 o 0.00 000 o.00 1069.76 70.21 101.00 21.62 16.42 1) 0,00 00 2) 1.32 3> 11.32 220.57 911.85 0 0 0 0 0 0 0 0 0.00 0.00 D.00 S 0 8or) 8.00 0 8.00 8.00 0 32.00 33.43 0.00 559657836 1132.42 61593 Male Fringe Detail: Health & Welfare: $239.04/$7.47, Pension: $268.80/$8.40, Annuity: $16.00/$0.50, Vacation: $155.84/$4.87, Training Fund: $22.08/$0.69, Contract Compliance: $9.60/$0.30, Administrative Fund: $1.92/$0.06, Indust. Stab.Fund:$3.84/$0.12 Other Deduction Detail: SDI: 11.32 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. §§ 33, 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 Wage CA-SC-UH ADDRESS PO Box 1177 Det: La Quinta, CA 92247 Urban Habitat PAYROLL NO, FOR WEEK ENDING PROJECT AND LOCATION PROJECT OR CONTRACT NO. La Quinta SilverRock Park Venue 6.0 11/23/2019 2016-0812016-08 La Quinta SilverRock Resort (1) (2) (3) (4) DAY AND DATE (5) (6) (7) (S) ' Other Deductions - 1) Local Tax 1 (9) 13 DEDUCTIONS 2) Local Tax 2 F SUN I MON TUE WE THU FRI SAT 0 o 3) Other Deductions NET ° WAGES NAME, ADDRESS. AND ° a _ WORK GROSS PAID 17 m 18 19 20 21 22 23 Identification Number 0,2 CLASSIFICATION TOTAL RATE AMOUNT HOLDIN 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 Miguel L. Sanchez Landscape Irrigation D 0 0 0 0 0 0 0 0.00 0.00 0.00 793.9 11) 0.00 55550 Tyler St. Space #3 Labor 2) 0.00 O o 0 0 0 0 0 0 0.00 0.00 0.00 Thermal, CA 92274 4 74.34 97.00 45.91 17.38 3) 11.99 246.62 952.38 S o a o e.00 z7s s.00 0 23.75 33.43 0.00 622987861 1199.00 61600 Male Fringe Detail: Health & Welfare: $177.412/$7.47, Pension: $199.50/$8.40, Vacation: $115.663/$4.87, Training Fund: $16.387/$0.69, Annuity: $11.875/$0.50, Contract Compliance: $7.125/$0.30, Administrative Fund: $1. 425/$0 06, Indust. Stab.Fund: $2.85/$0.12 Other Deduction Detail: SDI: 11.99 Howard A. Turnbow Avenida Estuco1 CA 92203 ementMason D o 0 0 0 0 0 0 0.00 000 0-00 X9090. 188.00 70.79 1986 1) 0.0081797 23))13.6s 0.00Indio, 377.21 991.79 0 0 0 0 0 0 0 0 0.00 0.00 00084.87 S o 5.0o a.00 s.o0 a.0o a.00 0 37,00 37.o0 0.00 529802418 13600 61581 Male Fringe Detail: Vacation: $304.51/$8.23, Health & Welfare: $276-39/$7.47, Pension: $310.80/$8.40, Annuity: $18.50/$0.50, Training Fund: $25.53/$0.69, Contract Compliance: $11.101$0.30, Indust. Stab.Fund: $2.96/$0.08, Administrative Fund: $2.22/$0.06, Other: $2.59/$0.07 Other Deduction Detail: SDI: 13.69 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 constriction 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 15th, 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) 17th day of November , 2019 , and ending the 23rd 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 (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, Child Support, 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 ❑✓ 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 10101119,Payroll #6, Contractor License # 963744, Workers Compensation Policy # URWC004126 NAME AND TITLE: Theresa Brennan, President SIGNATURE: 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 519,861 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: 2019-11-23 Payroll Number: 6 Amendment Number: 0 14 employee payroll record(s) processed Your Transaction ID is: 7226980 Print this Page View your submission lie