2016-08 Urban Habitat WE 2019-12-21PAYROLL
(For Contractor's Optional Use; See Instructions, Form WH-347 Inst.)
NAME OF CONTRACTOR OR SUBCONTRACTOR ❑ Wage CA -Si
ADDRESS PO Box 1177
Urban Habitat Det:
La Quinta, CA 92247
PAYROLL NO.
FOR WEEK ENDING
PROJECT AND LOCATION
PROJECT OR CONTRACT NO.
10.1
12/21/2019
La Quinta SilverRock Park Venue
La Quinta SilverRock Resort
2016-08/2016-08
(1)
(2)
(3)
(4) DAY AND DATE
15)
(6)
(7)
(8) 'Other Deductions - 1) Local Tax 1
(9)
O m
Uzo
DEDUCTION5 2) Local Tax 2
3) Other Deductions
NET
°
SUN
F
MON
TUE
WEB
7HU
nRl
SAT
NAME, ADDRESS. AND
= a
WORK
AGES
15
16
17
18
19
20
21
WITH -
HOLDING
TOTAL
Identification Number
o
CLASSIFICATION
N
1
1
1
1
TOTAL
RATE
GROSS
AMOUNT
PAID
FOR WEEKf
HOl1R5 WORKED EACH DAY
OF EMPLOYEE
z w
HOURS
OF PAY
EARNED
FICA
TAX
SWH
Medicare
OTHER"
DEDUCTIONS
Check No.
Sex Race
Josue Arce
Cement Mason
D o
0
a
c
o
a
0
0.00
o no o.00;7/4111
1) 0.I
4046 Dwight Ave.
3
2)
Riverside, CA 92507
0 0
0
0
0
0
c
o
0.00
000 ho0
45.88
47.00
11.86
10.73
t2287
617,13
S a
&.00
eqn
n,00
6.00
8.04
0
40.00
1850 om.
611506098
prenfieeLevel 1
61789
Male HISDanic American
range DvialI $2u.00r$0.50, Training Fund: $21.61 Pension: $164.001$4,10, Contract Compliance: $12.00/$0.30, Indust. Stab. Fund: $3.20/$0.08, Administrative Fund: $2.401$0.06, Health & Welfare: $176.
001$4.40, Vacation: $49.61
Other Deduction Detail: SDI, 7,40
Daniel J. Carver
20715 Stoddard Wells Rd.
Apple Valley, CA 92307
4
Landscape Irrigation
abor
D 0
0
0
o
0
0
0
0,00
om o.00X1417.20
87.00
24.25
20.55
1) 0.00
2) 0.00
3)14.17
25439
1162.81
O o
o
o
0
0
o
a
0,00
1 0,oc10842
S 0
800
Boo
B.0c
aoo
a_oo
0
40,00
35.43 0,00
270717343
81768619E
Male Caucasian
n ange tseran: Heattn & vvenare: $4w,130i$7.47, Pension: $336.01.)1$B.40, Annuity: $20.0040.50, Vacation: $194.80/$4.87, Training Fund: $27.601$0.69, Contract Compliance: $12.001$0.30, Administrative Fund: $2.401$0.06,
Indust. Stab.Fund:$4.801$0.12
Other Deduction Detail: SDI: 14.17
Luis M. Castaneda
5 Running H
Palm Desert, CA 92260
2
Cement Mason
D o
c
e
o
o
0
0
0.00
o 0n c.00
1480.00
91.76
124.00
33.71
21.46
1) 0 00
2) 0.00
3) 139,37
410.30
1069,70
D o
a
o
a
0
0
0
0.00
oa0 o_oa
5 0
8.0n
a 0o
a oo
n.00
s.a0
0
40.00
a7 a0 a uo
547439373
1480.00
61794
Male
Hinge it+erail: vacation: $32R201$8-23, Health a welfare: $Z98.80!$7.47, Pension: $330 00!$&4Q Annuity: $20.00/$0.50, Training Fund: $27.60)$0.69, Contract Compliance: $12.00)$0.30, Indust. S1ab.Fund: $3.211
Other: $2.81 Administrative Fund: $2.401$0.06
Other Deduction Detail: SD]- 14.80, Child Support Fee: 1.50, Child Support: 23.07. State Tax Lien: 100.00
Cameron D. Cleland
20250Itasca Rd.
Apple Valley, CA 92308
2
Landscape Oper. Eng
D o
otN8.
o
0
0
0,00
nDo oco
1538.00
9535
130.00
45.26
22.30
1) D.00
2) 0.00
308.29
1229.71
O o
0
0
0
0
0,00
o0o 0.oa
3) 15.38
S o
a.ao8,Da
a00
0
40.00
38.45 0.00
565937366
1538.00
61765
Male Caucasian
Fringe Detail: Health a vveirare: $394.svt$y.6r, Pension: $394.BU/$9.87, Vacation, $193.60/$4.84, Training Fund: $60.00/$1.50, Annuity: VD.001$0.25, Contract Compliance: $12.01 Administrative Fund: $2.401$0.06,
Indust. Stab.Fund: $4.801$0.12
Other Deduction Detail: Section 125: 15.38
While completion of Form VJH-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.G- § 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 aff 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 woTR performed.
DOL and federal contracting agencies receiving this information review the informabon to determine that employees have received fegalfy 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
Urban Habitat pet:
La Quints, CA 92247
PAYROLL NO
FOR WEEK ENDING
PROJECT AND LOCATION
PROJECT OR CONTRACT NO,
10.1
12121/2019
La Quinta SilverRock Park Venue
2016-0812016-08
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
o
o SUN
p
MO
TUE
WEII
THU
FRI
SAT
o z
O
3) Other Deductions
NET
NAME -ADDRESS. AND
=A
WORK
GROSS
WAGES
PAID
r 15
w
16
17
18
19
20
21
WITH,
HOLDING
TOTAL
Identifoa{ion Number
O = �y�
°z
CLASSIFICATION
TOTAL
RATE
AMOUNT
FOR WEEK/
HOURS WORKED EACH DAY
OF EMPLOYEE
3
HOURS
OF pAY
EARNED
FICA
Tax
SWH
Medicare
OTHER'
OEORICTIONS
Check No.
Sex Race
Ernesto Gonzalez Torres
Landscape Irrigatfon
D a
0
0
0
o
G
o
❑.0C
aac coo
4X41&18
1) 0.00
61101 Grapefruit Blvd. #6
Labor
0 0
0
9
P
o
G
a
0.00
0 00 o.po
Thermal, CA 92274
2
25,85
18.00
0.51
6 05
3) 4.17
54.58
562,30
S a
p
aoo
aoG
a_Go
0
0
24,00
11.37 060
617157389
pprenticeLevel l
61773
Male
Fringe Detail Health & Welfare: $105.601$4.40, Cooperation Comm.: $7.201$0.30, Training Fund: $32.1&$1.34, Indust. Stab.Fund: $1;.5)W$0.08, Vacation: $30.241$126, Pension: $102.241$4.26, Annuity: $6.0040.25,
Administrative Fund: $1.441$0.06
Other Deduction Detail: SDI: 4.17
Kenneth P. Ocean
15214 Mission St.
Hesperia, CA92345
0
andscapeIrrigation
Labor
D o
0
0
0
0
0
0
0.00
1 om c.op
1337220
82.90
126.00
34.23
19.39
1) 0.00
3) 13.37
275,89
1061.31
0 0
o
o
o
a
o
o
D.OD
o.po coo
5 o
e.0o
8.90
a.co
9,Oa
8.00
0
40.40
33G3 a.DD
559657836
1337.20
61792
Male
Fringe Detail: Health & Welfare: $298.801$7.47, Pension: $336.00/$8.40, Annuity: $20.001$0.50, Vacation: $194.801$4.87, Training Fund: $27.60/$0.69, Contract Compliance: $12.001$0.30, Administrative Fund: $2.401$0.46,
Indust. Stab.Fund: $4.801$0.12
Other Deduct#on Detail: SDI: 13,37
Howard A. Turnbow
81797 Avenida Estuco
Indio, CA 92203
1
Cement Mason
o
0
o
o
o
o
0.00
c.n o oo
1415.25
69.39
133.00
45.87
16.23
1) 0.00
2)000
3) 11.19
275.68
10843.57
tDo
o
0
0
0
0
0
0.00
0.0c 000
e.0a
a aG
s_op
s qo
s zs
o
38.25
37.o0 o.OD
529802418
11119. 55
61778
Male
Fringe Detail: Vacation: $314.7981$8.23, Health & Welfare: $285.7271$7.47, Pension: $321,$01$8,40, Annuity: $19.1251$0,50, Training Fund: $26.3921$0.69, Contract Compliance: $11.4751$0.30, Indust. Stab.Fund: $3.
06/$0.08, Administrative Fund: $22951$0.06, Other: $2.6781$0.07
Other Deduction Detail: SDI: 11.19
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, 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)(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 labarer or mechanic has been paid not less than the proper Davis -Bacon prevailing wage rate for the work performed.
DOL and fedora) 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
Habitat on the
(Contractor or Subcontractor)
La Quanta SilverRock Park Venue a Public Works Project commencing on the
(Building or Work)
15th day of December , 2019 , and ending the 21st 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 Habitat
(Contractor or Subcontractor)
from any person and that no deductions have been trade 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, Child Support Fee, SDI, Section
125, 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 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 10I01I19,Revised Payroll #10A.
Contractor License # 963744, Workers Compensation Policy # URWC004126
NAME AND TITLE:
Theresa Brennan, President
SIGNATURE:
Signed Electronically
THE WILLFUL FAL&FICATION OF ANY OF THE AaOVE STATEMENTS MAY SUBJECT THE CONTRACTOR OR
SUBCONTRACTOR TO CIVIL OR CRIWNAL PROSECUTION. SEE SLCT}ON 1001 OF TITLE 18 AND SECTION 231 OF TITLE
a1 OF THE UNITED STATES CODE.
U5. G.P.O.. 1M7519.W
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: 2019-12-21
Payroll Number: 10
Amendment Number: 0
7 employee payroll record(s) processed
Your Transaction ID is: 7444147
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