2016-08 Urban Habitat WE 2019-12-07PAYROLL
(For Contractor's Optional Use; See instructions, Form WH-347 Inst.)
NAME OF CONTRACTOR O OR SUBCONTRACTOR Wage CA-SC-UH
ADDRESS P0Box1177
Det:
Urban Habitat
La Quinta, CA 92247
PAYROLL NO.
FOR WEEK ENDING
PROJECT AND LOCATION
PROJECT OR CONTRACT NO.
8.1
12/07/2019
La Quinta SilverRock Park Venue
La Quinta SilverRock Resort
2016-48I2016-OS
(1)
(2)
(3)
r- (4) DAY AND OATS
(5)
(6)
(7)
(8) "Other Deductions - 1) Local Tax 1
(9)
z m
z
DEDUCTIONS 2) Local Tax 2
°
o SUN
MO
TUE
WE
THtI
FRI
8ATMET
NAME. ADDRESS, AND
n O
4�Is
WORK
3) Other Deductions
WAGES
1
2
3
4
5
fi
7
Identification Number
CLASSIFICATION
to
TOTAL
RATE
GRSS
AMOO NT
PAID
FOR WEEK(
HOURS WOR}4E0 EACH DAY
OF EMPLOYEE
z 3 w
HOURS
OF PAY
EARNED
FICA 1
HOLDING
TAX
SWH
Medicare
OTHER'
7o11-
DEDUCTIONS
Check No.
Sex Race
Daniel J. Carver
Landscape Irrigation
D o
o
o
c
C
o
❑
0.00
oca Doc
534.88
1) 0.00
20715 Stoddard Wells Rd.
3
Labor
2) 0.00
Apple Valley, CA 92307
o 0
0
o
a
o
o
a
O.DD
o.❑o o.cc
64.11
57.DD
7.31
14.99
3) 10.34
147.75
886.33
270717343
1034.08
61665
S a
o
a
o
8.❑o
soa
a
16.00
93.43 o.ao
Male Caucasian
Fringe Detail: Health & Welfare: $119.521$7,47, Pension: $134.401$8.40, Annuity7 $8.001S0.50, Vacation: $77.921$4,87, Training Fund: $11.04/$0.69, Contract Compliance: $4.80/$0.30, Administrative Fund: $0.96/$0.06, Indust.
Stab _Fund :$1.921$0.12
Other Deduction Detail: SDI: 10.34
Luis M. Castaneda
Cement Mason
It
-
Fringe
Cameron D. Cleland
20250 Itasca Rd.
Apple Valley, CA 92308
2
Landscape Irrigation
Labor
D o
0
o
a
❑
o
❑
0.00
000 a.Do
263.44
97.62
123.00
39.49
22.83
1) O.OD
a�
298.68
1275.32
0 c
o
o
o
a
o
❑
0.00
o.oe C.Do
565931366
1574.0()
15.74
615626181
S a
0
o
0
0
8.9a
❑
8.00
35.43 a.De
Male Caucasian
Fringe Detail: Indust. Stab.Fund: $0.961W.12, Vacation: $38.961$4.87, Annuity: $4.001$0.50, Training Fund: $5.52!$0.69, Health & Weltare: $59.76/$7.47, Contract Compliance: $2.401$0.30, Pension: $67.201$8.40,
Administrative Fund: $0,48/$D.06
Other Deduction Detall: SDI: 15.74
Cameron D, Cleland
Itasca Rd.
Valley, CA 9230$
2
Landscape Irrigation
abor
0 c
❑
❑
❑
❑
o
c
O.OD
aw o.o0;267.44
97,62
123.00
39.99
22,83
1) 0.0020250
2) o 0DApple
15.74
295.68
1275,32
0 a
o
a
❑
❑
o
o
0.00
oao P-0o
565931366
3)
61662618,
S o
coo
0
o
n
❑
o
S.Ofl
33a3 0.❑❑574.00
Male Caucasian
F rige �e%S i. niuua,, a,ci,.ruua. 9W.a�,9U, 14, VaCUL10 . �oo.avey4.or, rmnwry: a4.uufyu.au, training runs: tio.s21$U.b9. Health a Welfare: $59.76/$7.47, Contract Compliance: $2.40/$0,30, Pension: $67.2af$8.40,
Admirtistratfve Fund: $0.481$0.06
Other Deduction Detail: SDI 15.74
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 to 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 G.F.R. § 5.5(a){3}{it) require contradors 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" indiaafing that the payrops are correct and complete and that each laborer or mechaNc 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
(Fear Contractor's Optional Use; See Instructions, Form WH-347 Inst.)
NAME OF CONTRACTOR ❑� 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
8.1
1207MIS
2016-0812016-08
La Quinta SilverRock Resort
(1)
{2}
(3)
(4) DAY AND DARE
(5)
(a)
(7)
(8) • Other Deductions -1) Local Tax 1
(9)
DEDUCTIONS 2) Local Tax 2
b SUN
MON
TUE WE
THII FRI
SAT
Z
3) Other Deductions
NET
o
WAGES
1
'
2
3 4
5 6
7
NAME. ADDRESS. AND
k 0 a
°
WORK
GROSS
PAID
ldenritieation Number
w
CLASSIFICATION
TOTAL
RATE
AMOUNT
HOLDING
TOTAL
FOR WEEKf
HOURS WORKED EACH DAY
OF EMPLOYEE
z 3 w
HOURS
OF PAY
EARNED
FICA
TAX
SWH
Medicare
OTHER'
DEMO-PONS
Check No.
Sex Race
Cameron D. Cleland
andscape Oper. Eng
D 0
a
0
0
a
0
a
0.00
❑ 0o 0.00
307.60
1) 0•00
20250 Itasca Rd.
2) 0.00
p 0
0
0
❑
❑
o
0
0.00
Doc 0 w
Apple Valley, CA 92308
2
97.62
123.00
39.49
22.83
3) 15.74
298.68
1275.32
5 a
0
0
o
e.00
0
0
g.Op
3s4s 0.❑0
565931366
1574100
616626181
Male Caucasian
Fringe Detail: Health & Welfare: $78.961$9.87, Pension: $78.961$9.67, Vacation: $38.721$4.84, Training Fund: $12.001$1.50, Annuity: $2.001$0.25, Contract Compliance: $2.40!$0.30, Administrative Fund: $0.481$0.06, Indust.
Stab.Fund� $0.961$0.12
Other Deduction Detail: SDI: 15.74
Pedro J. Clemente
68990 Harrison St. Space #101
Thermal, CA 92274
5
Landscape Irr_ Tender
p 0
❑
a
o
0
0
0.00
0.00 0.00
489.60
30.36
0.00
0.00
7.10
1) aDO
2) 0.00
3) 4.89
42.35
447.25
O ❑
❑
0
0
0
0
0
0.00
0.00 0.00
S 0
e,a❑
0.00
0
0 ❑0
s,00
0
32.00
15,30 0.00
657090571
489.60
51702
Male
Fringe Detail; Health & Welfare: $78.401$2.45, Pension: $32.00f$1.00, Vacation: $32.961$1.03, Annuity: $8,001$0.25
Other Deduction Detail: SDI: 4.89
Maurilio P. Cortez
55550 Tyler St.
Thermal, CA 92274
5
Landscape Irrigation
Sher
D 0
0
0
0
0
0
0
0.00
❑.❑❑ 0a0;640.00
0.00
39.8$
1.00
0.00
9.28
1) 0.00
z) 009
3) 6.4p
56.36
583.64
O 0
❑
0
0
0
D
0
0.00
0❑❑ a-w
S 0
8.00
awl
0
a.00
Boo
0
32,00
20.w coo
604521749
Apprentice Level 1
61695
Male Hispanic American
Fringe Detail: Training Fund: $22.081$0.69, Annuity: $16.00/$0.50, Pension: $131.201$4.10, Contract Compliance: $9.e01$0.30, Indust. Stab.Fund: $2.561$0.08, Administrative Fund: $1.921$0.05, Health & Welfare: $140.
601$4.40, Vacation: $39.681$1.24
Other Deduction Detail: SDI: 6.40
Ernesto Gonzalez Torres
61101 Grapefruit Blvd. #6
Thermal, CA 92274
2Labor
Landscape Irrigation
p 0
0
0
0
0
a
0
0.00
0.00 0.00;138.96
34A6
35.00
5.36
B.06
1) 0.00
2) 0.00
3) 5.56
48741
O 0
a
a
❑
o
❑
0
0.00
0-00 0.00
S 0
s0o
❑
❑
0617157389
0
0
8.00
17-37 0.00555.85
pprentice Level 1
6167U
Male
Fringe Detail: Health & Welfare: $35.201$4.40, Cooperation Comm.: $2.401$0.30, Training Fund: $10.721$1.34, Indust. Stab.Fund: $0.64f$0.08, Vacation: $10.081$1.26, Pension: $34.081$4,26, Annuity: $2.001$0.25,
Administrative Fund: $0.48/$0.06
Other Deduction Detail: SDI: 5.56
While completion of Form VVH-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 coalection contained in 29 C.F.R.
§§ 3.3, 5.5(a). The Copeland Act (40 U.S.C. § 3145) contractors and subcontractors peAouning work on Federally financed or assisted construction contracts to "furnish weekly a statement with respect to the wages paid each employee
dulling the preceding week." U.S. Department Of Labor IDOL) regulations at 29 C.F.R. § 5.5(a}(3)(ii) require contractors to submit weekly a copy of all payrolls to the FedeW 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 OR SVBCONTRACTOR Wage CA-SC-UH
ADDRFSS PO Box 1177
Urban Habitat Det-
La Quints, CA 92247
PAYROLL NO.
FOR WEEK ENDING
PROJECT AND LOCATION
PROJECT OR CONTRACT NO.
8.1
12/07/2019
La Quints SilverRock Park Venue
2016-0812016-08
La Quints SilverRock Resort
(1)
(2)
(3)
F (4) DAY AND DATE
o
(5)
(6)
(7)
(8) 'Other Deductions - 1) Local Tax 1
{9)
0
zo
DEDUCTIONS 2) Local Tax 2
3) Other Deduclions
NET
o SUN
o
MON
TVE
WED
THU FRl
$A7
NAME. ADDRESS. AND
n. a
WORK
WAGES
PAID
y
2
3
4
$ 1 6
7
FKXpIHNG
TOTAL
rdertti5catian Number
O w
ClA55SFICATlON
�'
1
1
TOTAL
RATE
GROSS
AMOUNT
FOR YUEEK!
HOURS WORKED EACH DAY
OF EMPLOYEE
z 3 w
HOURS
OF PAY
EARNED
FICA
TAX
SWH
Medicare
OTHER'
DEDUCTIONS
Check No.
Sex Race
Luis F. Lopez Quintero
Landscape Irrigation
❑ 0
0
0
0
0
c
0A
0.00 0.00
555,84
1) 0.00
66886 Camino Idilio
Labor
0.00
o o
0
0
0
0
0
02)
Desert Hot Springs, CA 92240
4
34 46
16,00
7.86
8.06
71.94
483,90
3} 5.58
S o
e.ao
s.00
0
s.00
8.00
0
E---
164777350
rentice Level 1
555.84
61690
Male
range Detail: Heaim a Welfare: $239,04r$7.47, Pension: $300.801$8.40, Training Fund: $22.081$0.69, Annuity: $16.0040.50, Vacation: $155.84f$4.67, Contract Compliance: $9.60/$0.30, Administrative Fund: $1.921$0.06,
Indust- Stab.Fund: $3.84/$0.12
Other Deduction Detail: SDI: 5.56
JuanLopezMendez
55550 Tyler St. Space #3
Thermal, CA 92274
$
LandscapeIrr.Tender
D 0
0
0
o
a
0
a
0.00
0oo aw
436.05
34.61
D.00
o.00
6.14
1) O.OD
2) 0.00
3) 5.60
48.55
512.79
O o
0
0
❑
o
0
0
o.DD
0oo 0.op
ST�.
50-0
B.Oa
8.00
0
28.50
15.30 n.en
620099088
Male
861.34
61688678"
hinge Geiaii: Hearth & Wenare: *bJ.N251$2.45, Pension: $28.501$1.O0,Annuity: $7.125/$0.25, Vacation: $29.3551$1.03
Other Deduction Detail: SDI; 5.60
Juan LopezMendez
55550 Tyler St. Space #f3
Thermal, CA 92274
5
Laborer/Group 1
D o
0
0
0
0
0
0
0.00
0.00 0.0a
125,26
34.81
0.00
0.00
8.14
1) 0.00
2) 0.00
3) 5.60
48,55
512.79
0 0
a
0
a
n
c
0
0.00
o,c0 0.00
S o
o
sso
0
a
a
c
3.50
0s,�0 a.0a
620099088
561.34
61688618'
Male
rnuige Daian: neaiih & vvenare: m2a. I4ar�r.4r, version: $31.t 5r$a.eo, Annuity: $0.875/$025, Vacation: $17.0451$4.87, Training Fund: $2.4151$0.69, Indust. Stab.Fund: $28,001$8.00, Contract Compliance: $0.2451$0.07
Other Deduction Detail: SDI: 5.6C
Felipe Lopez
66886 Camino Idilio
Desert Hot Springs, CA 9224D
5
Landscape Irrigation
Labor
D a
0
o
0
0
o
a
0.00
ouo aoo
726.31
89,78
91.00
29.85
20.99
1) 0.00
2) 0.00
3) 14A8
246,10
1201.90
0 a
0
o
a
0
a
0
0.00
0.00 0.00
5 0
asc
a.00
c
a_00
0
0
20.50
35A3 0.ao
604137146
1448.00
61671
Male
, y, -tau. neAlm a vve,idre: 41OJ. ioorar.4r, tension: $i rz 20$8.40, Annuity: ,01U.zwsu.5u, vacation; $99-635!$4.87, Training Fund: $14.1451$0.69, Contract Compliance: $6.15!$0.3p, Administrative Fund: $1.231$0.06,
Indust. Stab.Fund; $2.46/$0.12
Other Deduction Detail: SDI: 14.48
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 CT R.
§§ 32. 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 paymfls 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 21 OR SUBCONTRACTOR Wage CA-SC-LIH
ADDRESS P0gox1177
Det:
La Quinta, CA 92247
Urban Habitat
PAYROLL NO.
FOR WEEK ENDING
PROJECTAND LOCATION
PROJECT OR CONTRACT NO.
8.1
12/07/2019
La Quinta SilverRock Park Venue
2016-0812016-08
La Quinta SilverRock Resort
0)
(2)
(3)
(4) DAY AND DATE
8
(5)
(e)
(7)
(8) ' Other Deductions - 11 Local Tax 1
(a)
O
DEDUCTIONS 2) Local Tax 2
SUN
MQ
TUE
WE
THU
FRI
SAT
0 o
3) OtheT Deductions
tS-
WNET
AS
1
L0
2
1 3
4
5
6
7
NAME. ADDRESS, AND
u, O a
D
WORK
GROSS
PAID
Identification Number
w
CLASSIFICATION
TOTAL
RATE
AMOUNT
HOLMNG
YOTAL
FOR VVEEKI
HOURS WORKED EACH DAY
OF EMPLOYEE
_;
HOURS
OF PAY
EARNED
FICA
TAY
SWH
Medicare
OTHER"
DEDUCTIONS
Check No.
Sex Race
Felipe Lopez
andscape Oper. Eng
D o
D
o
D
0
o
D
0.00
0.00 o.o0
2.1
1) 0.00
Camino
2) 0.00
0.00
o_Da000
Desert Hot Springs, CA 92240
5
89.78
91.00
29.85
20.99
s) 14.48
246.10
1201.90
11.50
3a45 0,00
601137146
.
44800
61671
Mae
Fringe Detail: Health & Welfare: $113.5051$9.87, Pension: $113.5051$9.87, Vacation: $55.661$4.84, Annuity: $2.B751$0.25, Training Fund: $17.25/$1.50, Contract Compliance: $3.45/$0.30, Administrative Fund: $0.691$0.06,
Indust. Stab.Fund: $138.001$12.00
Other Deduction Detail: SDI: 14.48
Kenneth P. Ocean
Mission St.
Hesperia,
Hesperia, CA 92345
0
Landscape Irrigation
Labor
D a
o
0
0
a
0
0
0.00
0.00 a.a0Z
116.00
28.71
18.17
1) 0.00
00
2) 2.53
31 12.53
253.13
1000.39
0 a
a
a
o
0
0
0
0.00
a.aa 0.0077.72
S 0
s,00
0
0
24.00
33.43 0.00
559657836
61689
Male
18.00r0j
Fringe Detail: Health & Welfare: $179.281$7.47, Pension: $201.601$6.40, Annuity: $12.001$0.50, Vacation: $116.Bal$4.87, Training Fund: $16.561$0,69, Contract Compliance: $7.201$0.30, Administrative Fund: $1.441$0.06,
Indust. Stab. Fund: $2.881$0.12
Other Deduction Detail: SDI: 12.53
Gerardo Saldivar Mejia
81921 Victoria St,
Indio, CA 92201
0
Landscape Irrigation I
Labor
D o
D
a
0
o
o
D
0.00
coo 0.00
/107511
94.00
19.10
15.59
1) 0.00
2) 0.0D
3) 10.75
206.10
869A1
O D
a
o
a
D
o
0
4.00
a.Do 0.0066.66
S 0
z.s0
a
n
o
a
o
2.50
33.43 DUO
607068060
61673
Male Hisoanic American
Fringe Detail; Administratve Fund: $0.151$0.06, Pension: $21.001$8.40, Annuity: $1.251$0.50, Vacation: $12.175/$4.87, Conlract Compliance: $0.75/$0.30, Indust. Stab.Fund: $0.301$0.12, Health & Welfare: $18.6751$7.47,
Training Fund: $1.7251$0.69
Other Deduction Detail: SDI:10.75
Miguel L. Sanchez
55550 Tyler St. Spam #3
Thermal, CA 92274
4
Landscape Irrigation
Labor
D a
0
a
0
a
0
0
0.00
o.a0 cm
124.00
66.76
75.00
32.14
15.61
1) 0.00
�2) 0.00
3) 10.78
20029
876.48
0 o
a
o
0
0
0
0
0.00
o.00 o-.o0
S n
3.50
0
0
D
0
0
3.50
3543 a.LO
622987861
1076.77
61696818'
Male
Fringe Detail: Health & Welfare: $26.1451$7.47, Pension: $29.401$8.40, Vacation; $17.04544,87, Training Fund: $2.4151$0.69, Annuity: $1.75/$D.$0, Contract Compliance: $1.051$0.30, Administrative Fund: $0.211$0.06,
Indust. Stab.Fund: $0.42/$0.12
Other Deduction Detail: SDI: 10,78
While completion or Form VVH-347 is optional, it is mandatary for covered contractors and subcontractors performing work on Federaly financed or assisted construction contracts to respond to the Information collection contained in 29 G.F.R.
§§ 3.3, 6.5(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 G.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-Beoon 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 beneCtts.
PAYROLL.
(For Contractor's Optional Use, See Instructions, Form WH-347 Inst.)
NAME OF CONTRACTOR OR SUBCONTRACTOR � Wage CA-SC-UH
ADDRESS PO Box 1177
Urban Habitat Det:
La Quints, CA 92247
PAYROLL NO. FOR WEEK ENDING
PROJECT AND LOCATION
PROJECT OR CONTRACT NO.
8.1 12/0712019
La Quinta SilverRock Park Venue
7
La Quinta SilverRock Resort
2016-0812016-08
(1)
(2)
(3)
F (4) DAY AND DATE
(5)
(6)
(7)
(8) ' Other Deductions - 1) Local Tax 1
{9)
3z
DEDUCTIONS 2)Local Tax
o SUN
MON
TUE
WED
7HU
FRI
SAT
9 o
0
3) Other Deductions
j
2
3
4
5
6
7
NAME. ADDRESS. AND
,�
WORK
yyNET
GES
HOLDING
TOTAL
Identlficatian Number
o C z
CLASSIFICATION
F
m
TOTAL
RATE
GROSS
AMOUNT
PAID
FOR WEEKf
HOURS WORKED EACH DAY
OF EMPLOYEE
z $ L
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
o
0
0.00
a.00 moo;10761.77
1) 0-00
55550 Tyler St, Space #3
abor
2) 0.00
O o
0
o
a
o
0
0.00
0.00 ow
Thermal, CA92274
4
8876
75.00
32.14
15.61
200.29
876.48
622987861
3) 10.78
616966181
S 0
4.50
a.00
0
s.30
eao
a
28.50
ano
Male
133.43
�.,,y ,, -.. u...v�,� w,�,�..,�,,,,p,,w,, -,..con. ,ycoa.ww�a.wv, vawun u. �raa.I uo/4,4.o/, [raining runo: Y3`J.OtiD!$U.liB, Annuriy: $14.25!$U.bU, Contract Compliance:,58.551$0.30, Administrative Fund: $1.71 M0,06,
Indust. Stab. Fund: $3.4240.12
Other Deduction Detail: SDI: 10.78
Howard A.TumboW
81797 Avenida Estuco
Indio, CA 92203
1
CementMason
D o
0
0
o
0
o
o
0.00
j o0o ow
1184.00
73,41
147.00
51.87
17.17
1) 0.00
2) 0.00
301.29
862.71
O c
c
o
0
o
a
o
0.00
a.ao 0.00
529802418
1184.00
3) 11.84
61675
S 0
eoo
B.00
0
a.o0
s00
0
32.00
al.0o a,00
Male
•,••,,,...,.�.,.. „a•.,.,.,.,,,. . I , ,Qo,,., .: vvc„a,c..pc��,�wry r.wr , rension: �4a9.awyt5.4V, ,ynnutry: �To.uurau.oU, training rung: $'61.V8f$0.89, Contract Compliance: $9.601$0.30, Indust. Stab.Fund: $2.561$0.08,
Administrative Fund: $1.921$0.06, Other: $2.241$0,07
Other Deduction Detail: SDI: 11,84
While completion of Form WH-347 is optional, it is mandatory far 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 Copetand 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
du6ng 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 renew the information to determine that employees have received legally required wages and fringe benefits.
Date December 28th,
2019
1, Theresa Brennan
(Name of Signatory Party)
under penalty of perjury, do hereby state:
President
(Title)
(1) That 1 pay or supervise the payment of the persons employed by
Urban Habitat an the
(Contractor or Subcontractor)
La Quinta SilverRock Park Venue a Public Works Project commencing on the
(Building or Work)
1st day of December , 2019 , and ending the 7th day of December 2019
all persons employed on said project have been paid the full weekly wages eamed, 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, Pad 1 (Public Works Section 1720 thru 1881) and or described below.
FICA, FWH, Medicare, State Tax, Child Support, SDI, Tax Levy
(2) That the payrolls for the Public Works Project required to be submitted are true, correct and
complete, that the wage fates 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 taborer 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,Revised Payroll #8.1,
Contractor License # 963744, Workers Compensation Policy # URWC004126
NAME AND TITLE:
SIGNATURE:
Theresa Brennan, President
Signed Electronically
THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE S-rATEMEN7S MAY SUBJECT THE CONTRACTOR OR
SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION. SEE SECTION 1001 OF TITLE f8 AND SECTION 231 OF TITLE
31 OF THE UNITED STATES COPE.
' U. S. G.V.Q.: 1997 519.8ti1
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: 2019-12-07
Payroll Number: 8
Amendment Number: 0
18 employee payroll record(s) processed
Your Transaction ID is: 7444110
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