2016-08 Urban Habitat WE 2019-12-14PAYROLL
(For Contractor's Optional Use; See Instructions, Form WH-347 Inst.)
NAME OF CONTRACTOR ne OR SUBCONTRACTOR Wage CA-SC-UH
ADDRESS POBOx1177
Urban Habitat Det:
La Quinta, CA 92247
PAYROLL NO. FOR WEEK ENDING
PROJECT AND LOCATION
PROJECTOR CONTRACT NO.
9.1 12114/2019
La Quint@ SllverRock Park Venue
2016-0812016-08
La Quinta SilverRock Resort
(1)
(2)
(3)
(4) DAY AND DATE
(6)
(6)
(7)
(8) 'Other Deductions - 1) Locai Tax 1
(9)
L9 ,a
z ao
DEDUCTIONS 2) Local Tax 2
3) Other Deductons
NETwTR
°
r
M
U
SAT
NAME. ADDRESS. AND
°xa
WORK
GROSS
WAGES
PAID
g
`�'
g
jp
11 i2
13
14
Wirt+
HOLDING
TOTAL
Identification Number
0o u
6
CLASSfFICATION
TOTAL
RATE
AMOUNT
FOR WEEKf
HOURS VlK)RKED EACH DAY
OF EMPLOYEE
3 ur
HOURS
OF PAY
EARNED
FICA
TAX
SWH
Medicare
OTHER'
DEDUCTIONS
Check No,
Sex Race
Josue Arce
ement Mason
D o
0
0
0
0
a
a
0.00
Duo
000 o w7740.00
1) 0.00
4046 Dwight Ave.
3
2) 0.00
Riverside, CA 92507
O ❑
❑
0
0
0
❑
❑
0.00
0.0o- ono45.B8
47.00
11.86
10.73
3) 7.44
122.$7
617.13
S o
s.oa
Boo
soo
s.ao
a.00
0
40.00
1000
611506098
renticeLevel l
61738
Male HisoanicAmerican
Fringe ue(an:lulnuity: $zu.uuratr.tu, t raining Funo: TW.Wf$0.69, Pension. $164.0044.10, Contract Compliance: $12.001$0.30, Indust. Stab.Fund: $3.201$0.08, Administrative Fund: $2.401$0.06, Health & Welfare: $176.
001$4.40, Vacation: $49.601$1.24
Other Deduction Detail: SDI: 7.40
Daniel J. Carver
20715 Stoddard Wells Rd.
Apple Valley, CA 92307
4
Landscape Irrigation
Labor
D 0
0
0
0
0
0
o
0,00
❑,w c.00X1309.68
a4.ao
2z.43
18.99
1) O.OG
2) 0.00
3) 13.10
zis.72
1089.98
p o
a
❑
-:
a
❑
a
0
p.o0
❑.0a o 0081.20
S ❑
o
0
o
a.00
s.ao
0
13.00
3s.a3 o ao
270717343
61717
Male Caucasian
Fringe uetaa: Hearim 4 welfare: wvi imi 41, Pension: $109.ZU1$8.40, Anrluity: $6.501$0.50, Vacation: $63,311$4.67, Training Fund: $8,971$0.69, Contract Compliance: $3.90/$0.30, Administrative Fund: $0.78/$0.136, Indust.
Steb.Fund: $1.56/$0.12
Other Deduction Detail: SDI: 13.10
Daniel J. Carver
20715 Stoddard Wells Rd.
Apple Valley, CA 92307
4
andscapa irrigation
Labor
0.00
0.00 0 oo
1❑0.29
81,20
84.00
22.43
18.99
2) p00
3)13.10219.72
1089.96
ts'
❑
o
o
.1.
o0
0.00
o.o0 0.00
o
0
0
❑
so❑
0
3,p0
3saa a.0❑
270717343
1309-68
61717
Male Caucasian
Fringe Detaii: Hearin a welfare: W;eAlaf.41, tension: $25011$8.40, Annuity: $1.501$0.50, Vacation: $14.611$4.87, Training Fund: $2.071$0.69, Contract Compliance: $0.901$0.30, Administrative Fund: $0.1a/$0.06, Indust.
Stab.Fund: $0.361$0.12
Other Deduction Detail: SDI: 13.10
Luis M. Castaneda
5 Running H
Palm Desert, CA 92260
2
Cement Mason
D o
0
0
❑
o
0
0
0.00
0.00 aocX1480.00
124,00
33.71
21.46
1) 0.00
2) 0.00
3) 139.37
410.30
1069.70
0 0
0
0
❑
a
o
❑
0,00
a,0o 0.❑091.76
$ c
s.oa
a.00
a.❑a
a.00
e.ao
0
40.00
37.0❑ a.dd
547439373
61743
Male
Fringe Detail: Vacation: $329.20r$8.23, Health & welfare: $298.801$7.47, Pension: $336.001$8.40, Annuity: $20.001$0.50, Training Fund: $27.60/$0.69, Contract Compliance: $12.001$0.30, Indust. Stab.Fund: $3.201$0,08,
Other: $2.80/$0.07. Administrative Fund: $2.401$0.06
Other Deduction Detail: SDI: 14.80, Child Support; 23.07, Child Support Fee: 1.50, State Tax Lien: 100.00
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 collection contained in 29 C.F.R.
§§ 3.3, 55(o). 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. Departrnertt 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 orfinancing 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•Bacorf 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 SUBCONTRACTOR Wage CA-SC-UH
ADDRESS PO BOX 1177
Det:
La Quinta, CA 92247
Urban Habitat
PAYROLL NO.
FOR WEEK ENDING
PROJECT AND LOCATION
OR CONTRACT NO.
9.1
12/14/2019
=POROJECT
La Quinta SilverRock Park Venue
16-08/2018-08
La Quinta Siivet-Rock Resort
(1)
(2)
(3)
(4) DAY AND DATE
n
(5)
(6)
(7)
(8) 'Other Deductions - 1) Local Tax 1
(9)
r7
DEDUCTIONS 2) Local Tax 2
NET
SUN
9 O
F
MON
TUE
WE
TH
FRI
SAT
3)Other Deductions
WAGES
NAME. ADDRESS. AND
°x
WORK
GROSS
PAID
S
�'
1 9
1 10
1 i
12
13
14
Identification Number
o w
CLASSIFICATION
TOTAL
RATE
AMOUNT
HOLIo G
TOTAL
FOR WEEK!
HOURS WORKED EACH DAY
OF EMPLOYEE
HOURS
OF PAY
EARNED
FICA
TAX
SWH
Medicare
OTHER'
pE13UCTIONS
Check No.
Sex Race
Cameron D. Cleland
Landscape Oper Fng
D 0
0
0
0
c
o
0
0.00
oco ou❑X
1) 0.00
20250 Itasca Rd.
2
2) 0.00
Apple Valley, CA 92308
0 0
o
a
o
c
c
o
0.00
0,00 0,00104.56
148.00
59.02
24.45
3) 16.a7
352.90
1333.48
S 0
❑
0
o
a-o0
B,aD
o
13.00
38.45 0,00
565931366
61714
Male Caucasian
Fringe Detail: Health & Welfare: $128.311$9.87, Pension: $12B.311$9.87, Vacation: $62.9244.84, Training Fund: $19.50!$1.5p, Annuity: $3.251$0.25, Contract Compliance: $3.90/$0.30, Administrative Fund: $0.78/$0.06,
Indust. Stab.Fund: $1.5640.12
Other Deduction Detail: SDI: 16.87
Cameron D. Cleland
202501tasca Rd.
Apple Valley, CA92308
2
Landscape Irrigation
Labor
O o
o
❑
a
❑
❑
a
O.Op
o00 0.00
106.29
104.56
148.00
59.02
24.45
11 0.06
3) 16.87
352.90
1333.48
O o
0
❑
0
0
0
a
0.00
aoo o.0a
5 0
0
❑
0
0
3❑a
o
3.00
ss43 0.00
565931366
1686.38
61714
Male Caucasian
Fringe Detail: Indust. Stab, Fund: $0.361$0.12, Vacation: $14.61/$4,87, Annuity: $1.501$0.50, Training Fund: $2.071$0.69, Health & Welfare: $22.411$7.47, Contract Compliance: $0.90/$0.30, Pension: $25,201$8.40,
Administrative Fund: $0.181$0-06
Other Deduction Detail: SDI: 16.87
Maurilto P. Cortez
55550 Tyler St.
Thermal,
Thermal, CA92274
4
LandscapeIrrigation
Labor
D o
o
0
o
0
0
0
0.00
000 o0D
160.00
0.69
54.00
948
16,53
1) 0.00
0.00
311.40
0
978.10o
O
..
0c
..
.
.
604521749
Apprentice Level 1
1140.20
61747
Male HisoanicAmerican
Fringe Detail: Training Fund: $5.521$0.69, Annuity: $4.001$0.50, Pension: $32.801$4.10, Contract Compliance: $2.401$0.30, Indust, Stab. Fund: $0.641$0.08, Administrative Fund: $0.481$0.06, Health & Welfare: $35.2olS4.4C,
Vacation: $9.92/$1.24
Other Deduction Detail: STAN: 11.40
Luis F. Lopez Quintero
66886 Camino Idilio
Desert Hot Springs, CA 92240
4
andscape Irrigation
Labor
D a
0
D
D
0
0
0
0.00
o oo ow
271.49
66.52
77.00
41.79
15.55
1) 0.00
3) 10,72
211.58
861.31
0 0
0
0
0
0
0
o
0.00
a oo ❑ ac
S a
a.0o
7.63
0
0
0
0
15.63
i7s� 000
164777350
pprentice Level 1
1072.89
61742
Male
Fringe Detail: Health & Welfare: $116,756/$7.47, Pension: $146.9221$9.40, Training Fund: $10.7851$0.69, Annuity: $7.8151$0.50, Vacation: $76.118/$4.87. Contract Compliance: $4.6891$0.30, Administrative Fund: $0.
9381$0.06, Indust. Stab.Fund: $1,87640A2
Other Deduction Detail: 301: 10.72
While completion of Form VIM-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 preoeding 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 orfinancing 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 perfomred.
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 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
9.1
12/14/2019
2016-0812016-08
La Quinta SilverRock Resort
0)
(2)
43)
(4) DAY AND DATE
(5)
(6)
(7)
(8) • Other Deduc tons - 1) Local Tax 1
(9)
0
F
DEDUCTIONS 2) Local Tax 2
i5 SUN
MO N
TUE
WED
THU
FRt
$AT
?
3) Other Deduciions
NET
WAGES
$
9
10
11
12
13
14
NAME. ADDRESS. AND
Q;x,
p
WORK
GROSS
PAID
Identification Number
w
°z
CLASSIFICATION
TOTAL
RATE
AMOUNT
noLDiMc
TOTAL
FOR WEEK!
HOURS WORKER EACH DAY
OF EMPLOYEEtz
3 m
HOURS
OF PAY
EARNED
FICA
TAX
6WH
Medicare
OTHER"
DEDUCTYDNs
Check No.
Sex Race
Juan LopezMendez
LaboreriGnoulp 1
❑ 0
0
0
0
0
0
o
0.00
0.00 o.00
559.3s
1) 0.00
55550 Tyler St. Space#3
5
2) D.00
Thermal, CA 92274
O o
o
❑
0
0
0
a
0.00
oo0 0_00
78.44
69.00
16.9fi
18.33
3) 12,65
195.34
1069.23
S o
a,0o
re3
0
a
a
o
15.63
357e 000
62009908$
1264.57
61740
Mafe
Fringe Detail: Health & Welfare: $116.7561$7.47, Pension: $139.907!$8.90, Annuity: $0.875/$0.056, Vacation: $76.1181$4.87, Training Fund: $10.785/$0.69, fndust. Stab.Fund: $125.04/$8.00, Contract Compliance: $0.
2451$0.016
Other Deduction Detail: SDI: 12.65
Felipe Lopez
66886 Camino Idilio
Desert Hat Springs, CA 92240
1
andscape Irrigation
Labor
❑ 0
0
0
a
a
a
❑
D.00
o.00 o.00Z
137.OD
67.10
26.66
1) 0.00
2i 0.00
3y 18.39
363.14
1475.43
0 ❑
o
a
0
0
0
0
0.00
o.ao o 00113.99
S a
o
-r63
0
0
o
0
7,63
35.43 0,❑0
604137146
61723
Male
Fringe Detail: Health & Welfare: $56.996)$7.47, Pension: $64.0921$8.40, Annuity: $3.8151$0.50, Vacation: $37.1581$4.87, Training Fund: $5.2651$0.69, Contract Compliance: $2.28W$0 30, Administrative Fund: $0.4581$0.06,
Indust. Stab.Fund: $0.9161$0.12
Other Deduction Detail: SDI: 18.39
Felipe Lopez
66886 Camino Idilio
1p
andscape Oper. Eng
D D
0
0
0
0
0
0
0.00
ono 000;307/.60
113.99
13700
67.10
26.66
1) 0.00
2) 0.00363.14
1475.43
o
0
0
e
0
0
0
O.OD
❑0a aoa
Desert Hot Springs, CA 92240
3) 1&39604137146
S a
am
a
o
o
a
o
g.1H]
36.45 o,m838.57
61723
Male
Fringe Detail. Health & Welfare: $78.961$9.87, Pension: $78.96f$9.87, Vacation: $38.721$4.84, Annuity: $2.ODI$0.25, Training Fund: $12.001$1.50, Contract Compliance: $2.40/$0.30, Administrative Fund: $0.481$0.06, Indust.
Stab.Fund:$96.001$12.00
Other Deduction Detail: SDI: 18.39
Kenneth P.Ocean
15214 Mission SL
Hesperia, CA92346
0
Landscapelrrigation
Labor
D o
0
0
0
0
o
a
0.00
coo aoa
534.88
75.13
111.00
25.95
17.57
1) 0oo
3) .12
3} 1z.2
241.77
969.91
0 0
D
0
o
a
0
a
0.00
❑.oa o,00
S c
0
0
o
s-oo
sae
o
16.130
0.00
559667836
1211.68
61741
Male
133A3
Fringe Detail: Health & Welfare: $t 19.5257.417, Pension: $134.401$8.40, Annuity: $8.001$0.50, Vacation; $77.921$4.87, Training Fund: $11.041$0.69, Contract Compliance: $4.801$0.30, Administrative Fund: $0.961$0.06, Indust.
Stab. Fund: $1.921$0.12
Other Deduction Detail: SDI: 12.12
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 contalned in 29 G.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 7 OR SU8CONTRACTOR Wage CA-SC-UH
ADDRESS PO Box 1177
Urban Habitat Det:
La Quinta, CA 92247
PAYROLL NO.
FOR WEEK ENDING
PROJECT AND LOCATION
PROJECTOR CONTRACT NO.
9.1
12/1412019
La Quinta SilverRock Park Venue
La Quinta SilverRock Resort
2016-O 92016-08
(1)
(2)
(3)
(4) DAY AND DATE
(5)
(6)
(7)
(a) " Other Deductions - 1) Local Tax 1
(9)
NAME, ADDRESS. AND
Identification Number
OF EMPLOYEE
O ,�
o O
i i
O rz- w
z 3 w
WORK
CLASSIFICATION
TOTAL
HOURS
RATE
OF PAY
GROSS
AMOUNT
EARNED
DEDUCT70NS 2) Local Tax 2
3) Other Deductions
NET
WAGES
PAID
FOR WEEK!
Check No.
a
SUN
MO
Tue
WE
THU FR! SAT
$
9
10
11
12 13 14
F1Cq
wlTt+
HOLDING
TAX
SWH
Medicare
OTHER'
TOTAL
pEOUCTI0N5
HOURS WORKED EACH DAY
sex Race
Miguel L. Sanchez
55550 Tyler 5t. 5pace #3
CA 92274
4
andscape Irrigation
LaborThermal,
D a
0
0
0
v
0
a
0,00
a.00 o.o0Y267.44
98.00
46.54
17.48
1) 0.00
3) 1205248.79
956.37
O a
o
0
a
n
0
0
0.00
n.o❑ o.vo74,72
S o
6.00
0
0
0
0
0
B4O0
33.43 0.00
622987861
61748
Maie
range ueraa: norm e< vveirwe: *ZWJtvyr.41, Pension: $nr,zw v%,40, vacanon: $36.961$4.87, Training Fund: $5,521$0.59, Annuity: $4.001$0.50, Contract Compliance: $2.401$0.30, Administrative Fund: $0.481$0.06, Indust.
Siab,Fund: $0.961$0.12
Other Deduction Detail: SDI: 12.05
Howard A. TumboW
81797 C 92203 stuCO
Indio, CA 92203
1
Cement Mason
0
❑
0
0
0
0.00
0.00 00Z
212,00
82.15
21 4g
1) 0,40
2} 0.00
3> 1A.80
42217
1057.83
I
t—
n
0
❑
0
0
0.00
am 0.0o91.16
eDo
aflv
a.o0
e.0v
0
40.00
37.00 0.00
529802418
617217
Male
r6mje veran: vacannn: asce.Nfya.�s, tlealm a welrare: 412Ub.t1UfW.4r, Pension: $336,UVI$t1.40, Annuity: $Z0.0040.5U, Training Fund: $27.601$0.69, Contract Compliance: $12.001$0,30, Indust, S1ab.Fund: $3.201$0.08,
Administrative Fund: $2.4040,06, Other: $2,801$0.07
Other Deduction Detail: SDI: 14.80
While completion of Form VVH-347 is optional, it is mandatory for covered contractors and subcontractors perrorming 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) reguiations at 29 C.F.R. § 5.5(a)(3)(ii) require contractors to submit weekly a copy of all payrolls to the 1=ederal agency contracting for orfrnancing 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 prevailfng 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 January 16th, 2020
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
(But{ding or Work)
8th day of December , 2019 , and ending the 14th day of December 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
(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 1,361) and or described below.
FICA, FWH, Medicare, State Tax, Child Support, Child Support Fee, SDI, STAN,
State Tax Lien
(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 wdl 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 10I01119,Revised Payroll 0.1,
Contractor License # 963744, Workers Compensation Policy # URWC004126
NAME AND TITLE. SIGNATURE-,
Theresa Brennan, President Signed Electronically
THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE s7ATEMENTs 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.: 1097 510.601
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 LAQUINTA
Project ID: 300347
Contract With: THE CITY OF LA QUINTA
Week Ending Date: 2019-12-14
Payroll Number: 9
Amendment Number: 0
14 employee payroll record(s) processed
Your Transaction ID is: 7444128
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