2016-08 Urban Habitat WE 2019-11-30PAYROLL
(For Contractor's Optional Use; See Instructions, Form WH-347 Inst.)
NAME OF CONTRACTOR 0 OR SUBCONTRACTOR Wage CA-SC-UH I ADDRESS PO Box 1177
Urban Habitat Det: La Quinta, CA 92247
PAYROLL NO.
FOR WEEK ENDING
PROJECT AND LOCATION
PROJECT OR CONTRACT NO.
7.1
11/30/2019
La Quinta SilverRock Park Venue
La Quinta SilverRock Resort
2016-08/2016-08
(1)
(2)
(3)
(4) DAY AND DATE
°
(5)
(6)
(7)
(8) * Other Deductions - 1) Local Tax 1
(9)
NAME. ADDRESS. AND
Identification Number
OF EMPLOYEE
O
0 o
a o a
O F w
z 3 w
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.
6 SUN
I MON
TUE
I WED
THU
FRI
SAT
24
ti
25
26
27
28
29
30
FICA
WITH-
HOLDING
TAX
SWH
Medicare
OTHER*
TOTAL
DEDUCTIONS
HOURS WORKED EACH DAY
Sax Race
Luis M. Castaneda
Cement Mason
D o
0
0
0
0
0
0
0.00t
0.00 0.00
518.00
1) 0.00
5 Running H
Palm Desert, CA 92260
2
32.12
13.00
0.00
7.52
2) 0.00
3) 29.75
82.39
435.61
p 0
0
0
o
a
o
0
0.000.00
0.00
s 0
0
7.00
7.00
0
0
0
14.007.00
0.00
547439373
518.00
61640
Male
Fringe Detail: Vacation: $115.22/$8.23, Health & Welfare: $104.58/$7.47, Pension: $117.601$8.40, Annuity: $7.00/$0.50, Training Fund: $9.66/$0.69, Contract Compliance: $4.20/$0.30, Indust. Stab.Fund: $1.12/$0.08, Other:
$0.98/$0.07, Administrative Fund: $0.84/$0.06
Other Deduction Detail: SDI: 5.18, Child Support: 24.57
Pedro J. Clemente
68990 Harrison St. Space #101
Thermal, CA 92274
5
Landscape Irrigation
Labor
D o
0
0
0
0
0
0
0.00
o.00 o.o0
723.76
44.87
9.00
0.00
10.50
1) 0.00
2) 0.00
3) 7.24
71.61
652.15
0 o
o
o
0
0
0
0E21
0
0.00 0.00
S 0
8.00
8.00��r5
33A3 0.00
657090571
723.76
61650
Male
Fringe Detail: Annuity: $10.825/$0.50, Training Fund: $14.938/$0.69, Pension: $181.86/$8.40, Health & Welfare: $161.725/$7.47, Vacation: $105.435/$4.87, Contract Compliance: $6.495/$0.30, Administrative Fund: $1.
299/$0.06, Indust. Stab.Fund: $2.5981$0.12
Other Deduction Detail: SDI: 7.24
Maurilio P. Cortez
55550 Tyler St.
Thermal, CA 92274
1
andscape Irrigation
Labor
D o
o
o
o
o
o
o
0.00
o.00 o.00
3.00
;433.001
26.85
0.00
0.00
6.28
1) 0.00
2) 0.00
3) 4.33
37.46
395.54
0 0
0
0
0
0
0
0
0.00
0.00 0.00
S o
o
s.ss
o
c
o
5.65
20.00 0.00
604521749
prentice Level 1
61644
Male Hispanic American
T
Fringe Detail: Training Fund: $3.898/$0.69, Annuity: $2.825/$0.50, Pension: $23.165/$4.10, Contract Compliance: $1.695/$0.30, Indust. Stab.Fund: $0.452/$0.08, Administrative Fund: $0.3391$0.06, Health & Welfare: $24.
86/$4.40, Vacation: $7.006/$1.24
Other Deduction Detail: SDI: 4.33
Ernesto Gonzalez Torres
61101 Grapefruit Blvd. #6
Thermal, CA 92274
2Labor
Landscape Irrigation
D o
0
o
o
o
o
0
0.00
o.00 o.00
376.06
23.32
14.00
0.00
5.45
1) 0.00
2) 0.00
3) 3.76
46.53
329.53
0 0
0
0
0
0
0
0.00
o.ao o.o0
S o
s.00
s.00
s.ss
o
0
0
21.65
17.37 om
617157389
Apprentice Level 1
376.06
61622
Male
I
1
Fringe Detail: Health & Welfare: $95.2644.40, Cooperation Comm.: $6.495/$0.30, Training Fund: $29.011/$1.34, Indust. Stab.Fund: $1.732/$0.08, Vacation: $27.279/$1.26, Pension: $92.229/$4.26, Annuity: $5.412/$0.25,
Administrative Fund: $1.299/$0.06
Other Deduction Detail: SDI: 3.76
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 0 OR SUBCONTRACTOR Wage CA-SC-UH
ADDRESS PCIBox 1177
Urban Habitat Det:
La Quinta, CA 92247
PAYROLL NO.
FOR WEEK ENDING
PROJECT AND LOCATION
PROJECT OR CONTRACT NO.
7.1
11/30/2019
La Quinta SiiverRock Park Venue
La Quinta SiiverRock Resort
2016-08/2016-08
(1)
(2)
(3)
(4) DAY AND DATE
o
(5)
(6)
(7)
(8) • Other Deductions - 1) Local Tax 1
(9)
NAME. ADDRESS. AND
Identification Number
OF EMPLOYEE
0.
a o
O a
_
O = 2
w
°z 3 u6
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.
6 SUN
MO
TUE
WE
THU
FRI
SAT
0 24
'�
25
26
27
28129
30
FICA
WITH-
HOLDING
TAX
SWH
Medicare
OTHER`
TOTAL
DEDUCTIONS
HOURS WORKED EACH DAY
Sex Race
Luis F. Lopez Quintero
Landscape Irrigation
p o
o
0
o
o
0
0
0.00
o.00 o.co
376.06
1) 0.00
66886 Camino Idilio
Desert Hot Springs, CA 92240
1
abor
23.32
0.00
2.11
5.46
2) 0.00
3) 3.76
34.65
341.41
0 0
0
0
0
0
0
0
0.00
0.00 0.00
S 0
8.00
8.00
5.65
0
0
0
21.65
17.37 o.o0
164777350
prentice Level 1
376.06
61639
Male
Fringe Detail: Health & Welfare: $161.725/$7.47, Pension: $203.51/$9.40, Training Fund: $14.938/$0.69, Annuity: $10.825/$0.50, Vacation: $105.4351$4.87, Contract Compliance: $6.495/$0.30, Administrative Fund: $1.
299/$0.06,Indust. Stab.Fund: $2.598/$0.12
Other Deduction Detail: SDI: 3.76
Felipe Lopez
66886 Camino Idilio
Desert Hot Springs, CA 92240
5
Landscape Irrigation
Labor
D o
0
0
0
0
0
0
0.00
0.00 0.00Z
59.00
11.45
17.13
1) 0.00
2) 0.00
3> 11.81
172.62
1008.52
0 0
0
0
0
0
0
0
0.00
0.00 0.0073.23
S o
e.00
s.o0
s.ss
o
0
0
21.65
33.43 0.00
604137146
61623
Male
Fringe Detail: Health & Welfare: $161.725/$7.47, Pension: $181.86/$8.40, Annuity: $10.825!$0.50, Vacation: $105.4351$4.87, Training Fund: $14.938/$0.69, Contract Compliance: $6.495/$0.30, Administrative Fund: $1.
299/$0.06, Indust. Stab.Fund: $2.598/$0.12
Other Deduction Detail: SDI: 11.81
Miguel L. Sanchez
55550 Tyler St. Space #3
Thermal, CA 92274
4
Landscape Irrigation
Labor
D o
0
0
0
0
0
0
0.00
o.00 o.00
7458..43
6.00
0.00
6.65
1) 0.00
2) 0.00
3) 4 58
45.65
412.78
0 0
0
0
0
0
0
0.00
0.00 0.0028A2
S o
0
0
5.65
0
0
0
5.65
33.43 0.00
622987861
61645
Male
Fringe Detail: Health & Welfare: $42.206/$7.47, Pension: $47.46/$8.40, Vacation: $27.516/$4.87, Training Fund: $3.898/$0.69, Annuity: $2.825/$0.50, Contract Compliance: $1.695/$0.30, Administrative Fund: $0.339/$0.06,
Indust. Stab.Fund: $0.678/$0.12
Other Deduction Detail: SDI: 4.58
Howard A. Turnbow
81797 Avenida Estuco
Indio, CA 92203
1
ement Mason
D o
0
0
0
0
0
0
0.00
0.00 0.00
888.00
55.06
84.00
26.62
12.87
1) 0.00
2) 0.00
3) 9.88
187.43
700.57
0 0
0
0
0
o
o
0.00
0.00 0.00
S o
8.00
8.00
8.00
0
0
0
24.00
37.Do 0.00
529802418
888.00
61626
Male
Fringe Detail: Vacation: $197.52/$8.23, Health & Welfare: $179.28/$7.47, Pension: $201.60/$8.40, Annuity: $12.00/$0.50, Training Fund: $16.56/$0.69, Contract Compliance: $7.20/$0.30. Indust. Stab.Fund: $1.92/$0.08,
Administrative Fund: $1.44/$0.06, Other: $1.68/$0.07
Other Deduction Detail: SDI: 8.88
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.
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)
24th day of November , 2019 , and ending the 30th 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, 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 10/01/19,Revised Payroll #7.1,
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 1S 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: 2019-11-30
Payroll Number: 7
Amendment Number: 0
8 employee payroll record(s) processed
Your Transaction ID is: 7226982
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