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2016-08 Urban Habitat WE 2020-01-04PAYROLL (For Contractor's Optional Use; See instructions, Form WH-347 Inst.) NAME OF CONTRACTOR n OR SUBCONTRACTOR Wage CA-SC-UH ADDRESS PO Box 1 177 Urban Habitat Det: I -a Quinta, CA 92247 PAYROLL NO. FOR WEEK ENDING PROJ ECT AND LOCATION PROJECTOR CONTRACT NO. 12.1 01/04/2020 La Quinta SilverRock Park Venue 2016-0812016-08 La Quints SiIVerROCk Resort {1} (2) (3) (4) DAY AND DATE (5) (6) (7) (8) 'Other Deductions - 1) Local Tax 1 (9) 3 2 Local Tax 2 DEDUCTIONS ) 0 a SUN MON TUE WE THU FRIF4T Z z is o Other Deductions NET NAME. ADDRESS, AND O a WORK WAGES PAID 03) 29 30 31 1 2 3 WITH _ FOTAX Idenlificatien Number a g CLASSIFICATION r �' - TOTAL RATE GROSS AMOUNT FOR WEEKI HOURS WORKED EACH DAY OF EMPLOYEE z 3 6 HOURS OF PAY EARNED FICA SWµ lvedi re OTHER' CEDUCTIONS Check No. Sex Race Josue Arce CementMason p o 0 0 r 0 0 0 0.00 ono am 296.00 1) 0.D0 Dwight Ave. 3 2) 00 Rive Riverside, CA 92507 O o 0 0 r 0 0 0 0.00 0,00 n.aa 18.35 0.00 0.00 4.30 2.96 3} 2_g6 25.61 270.39 S 0 0 e.aa a o e0o n 16.00 tia.so 000 611506098 Apprentice Level 1 296.00 61891 Male HisoantAmerican range ueta r Arpulty: $6.uu1$u.SU, 1 raining Fund: $11.04!$0.69, Pension: $65.601$4.1D, Contract Compliance: $4.80/$0.30, Indust. Stab.Fund: $1.28150.68, Administrative Fund: $0.961$0.06, Health & Welfare- $70.401$4.40, Vacation: $19.841$1.24 Other Deduction Detail; SDI: 2.96 Daniel J. Carver 20715 Stoddard Wells Rd. Apple Valley, CA 92307 4 Landscape Irrigation Labor D a 0 o 0 r o 0 O.OD 000 a.o0 267.44 26.50 0.00 0.00 6.20 1) O.UO z) D.DD s} a.z6 36.98 390,46 O c a a 0 0 a 0 0.00 0 oc o.00 5 0 a c 0 s.ao a 0 8.00 3341 0.00 270717343 427.44 61870 Male Caucasian Fringe uetau: Realm e, vvetrare: $59. (uist.47, Pension: $67.201$8.40, Annuity: $4.001$0.50, Vacation: $38.961$4.87, Training Fund: $5.521$0.69, Contract Compliance: $2.40/$0.30, Administrative Fund- $0.481W.06. Indust. Stab.Fund: $0.961$0.12 Other Deduction Detail: SDI: 4.28 Luis M. CaStaneda 5 Running H Palm Desert, CA 92260 2 ernent Mason D a o 0 0 0 0 a 0.00 c.00 roc 888.00 55,05 52.00 6.81 12.87 2) 3,45 a) 133,45 260.18 627.82 0 0 0 0 0 0 0 0 0.00 0.00 0.00 S 0 D Sao o a_Go E on o 24.00 s7.� a.00 547439373 888.00 61895 Male Fringe uetau: vacation: $197.521$8.23, Heat & Welfare: $179,281$7.47, Pension: $201.601$8.40, Annuity; $12,001$0.50. Training Fund: $16.561$0.69, Contract Compliance: $7.201$0.30, Indust. Stab.Fund: $1.921$0.08, Other. $1.684$0.07, Administrative Fund: $1.441$0,06 Other Deduction Detail: SDI: 8.88, Child Support Fee: 1,50, Child Support: 23.07, State Tax Lien: 100.00 Cameron D_ Cleland Apple Itasca Rd. Apple Valley, CA 92308 2 Landscape Oper. Frig p o o 0 0 o 00,00 c00 e.0o 307.60 50.54 43.00 5.20 11.82 1) 0.00 2} 0.00 a) 8.15 118.71 696.49 O 0 0 0 a a a.00 000 0.00 S o o a 0 s.aa o018 ,00 3e,as 0,a0 565931366 815.20 61867 Male Caucasian Fringe lletali: Health & vVeltare: $78.961$9.87, Pension: $78.961$9.87, Vacation: $38.721$4.84, Training Fund: $12.001$1.50, Annuity: $2.DOI$0.25, Contract Compliance: $2.401$0,30, Administrative Fund: $0.481$0.06, Indust Stab. Fund: $0.961$0.12 Other Deduction DetatL- SDI: 8.15 While completion of Form WH-347 is optional, it is mandatory for covered contractors and subcontractors performing work on Federally financed or assisted construction contracts to respond to the information collection contained in 29 C.F.R. §§ 3.3, 5.5(a). The Copeland Act (40 U.S.C. § 3145) contractors and subcontractors performing work on Federafly financed or assisted construction contracts to "furnish weekly a statement with respect to the wages paid each employee during the preceding week." U.S. Department of Labor (DOL) regulations at 29 G.F.R. g 5,5(a)(3)(ii) require contractors to submit weekly a copy of all payrolls to the Federal agency contracting for or financing the construction project, accompanied by a signed "Statement of Compliance" indicating that the payrolls are correct and complete and that each laborer or mechanic has been paid not less than the proper Davis•Bacon prevailing wage rate for the work performed. DOL and federal contracting agencies receiving this information review the information to determine that employees have received legally required wages and fringe benefits. PAYROLL (For Contractor's Optional Use; See Instructions, Form WH-347 Inst.) NAME OF CONTRACTOR OR SUDCONTRAcTOR Wage CA-SC-(1H ADDRESS PO BOX 1177 Urban Habitat Det La Quinta, CA 92247 PAYROLL NO. FOR WEEK ENDING PROJECT AND LOCATION PROJECTOR CONTRACT NO. 12.1 01/04/2020 La Quinta SilverRock Park Venue 2p16-08124t6-0$ La Quinta SilverRock Resort {7) (2) (3) F (4) DAY AND DATE ° (5) (6) (>) (a) 'Other Deductions - 1) Local Tax 1 (9) 01 ? go DEDUCTIONS 2) Loral Tex 2 3) Other Deductions NET SUN MO TUE I WPI THi1 FRI 5AT NAME_ ADDRESS. AND 00 d a WORK WAGES PAID ° 29 3D 31 1 2 3 4 WITH- HOLDING TOTAL Identification Number ° L w o - CLASSIFICAPON �' TOTAL RATE GROSS AMOUNT FOR WEEK1 FOURS WORKED EACH DAY OF EMPLOYEE zi HOURS OF PAY EARNED FICA TAX SWH Medicare OTHER" DEOUCTICN5 Check Nc. Sex Race Pedro J. Clemente Landscape Irr. Tender D a 0 ❑ ❑ 0 o a 0.00 000 oa3 285.80 t) 0.00 68990 Harrison 5t. Space #101 2) 0.00 0 ❑ a o ❑ o c 0.00 0,00 a ❑❑ Thermal, CA 92274 5 23.39 0.00 0.00 5.47 32.63 344.65 3} 3.77 S 0 8.00 ❑ 0 649 423 0 18.68 r5.3❑ CAD 657090571 377.28 61906 Male Fringe Detail: Health & Welfare: $45.7661$2.45, Pension: $18.681$1.00, Vacation: $19.241$1.03, Annuity: $4.671$0.25 Other Deduction Detaii: SDI: 3.77 Maurilio P. Cortez 55550 Tyler St. Thermal, CA 92274 5 Landscape Irrigation Labor D o o o ❑ o 0 0 0.00 o.00 000 326.90 34.60 0.00 0.00 6.09 1) 0.D0 2) D 00 3) 5.58 48.27 509,73 O ❑ 0 0 0 ❑ o.z3 0 0.23 30.0❑ ❑,oc S 0 e 00 0 0 o a 00 0 16.00 20.w ❑,cc 604521749 Male Hisoanic.American Apprentice Level 1 558.OD 61899 Fringe Detail: Training Fund: $11.1991$0.69, Annuity: $8.115/$0.50, Pension: $66.54344.10, Contract Compliance: $4.8691$0.30, lndusl. Stab.Fund: $1.298f$0.08, Administrative Fund: $0.974)$0.06, Health & Welfare: $71 Al2/$4.40, Vacation: $20.125($1.24 Other Deduction Detail: SDI: 5.58 Ernesto Gonzalez Torres 61101 Grapefruit Blvd. #6 Thermal, CA 92274 617157389 Male 2 Landscape Irrigation Labor Apprentice Lever 1 D ❑ o 0 0 0 0 0,00 000 em Y77M 277.92 17.23 4.00 0.00 4.03 1) 0.00 2) 0.00 3) 2.78 28.04 249.88 61875 0 0 0 0 ❑ 0 3 0 0.00 aw ❑.❑❑ S 0 e.00 a o e 0❑ o 0 16,00 17,37 0.00 Fringe Detail: Health a WeIare: $70.40r$4.40, cooperation Gomm.: $4.801$0.30, Training Fund: $21.441$1.34, Indust. Stab.Fund: $1.281$o.W, Vacation: $20.161$1.26, Pension: $68.161$4.26, Annuity: $4.001$0.25, Administrative Fund: $0.96M.06 Other Deduction Detail: SDI: 2.78 Luis F. Lopez Quintero 66886 Camino ldilio Desert Hot Springs, CA 92240 4 andscape Irrigation abor D o ❑ a ❑ 0 o 0 0.00 c.00 oco 324.47 26.55 2.00 3.06 6.21 1) 0.00 2) 0.00 3t 429 42.11 386.20 0 0 0 0 0 ❑ 0 ❑ 0.00 0.00 0,00 S ❑ 9.❑❑ a a 6.45 423 0 18.68 1737 Boo 164777350 pprentice Level 1 428.31 61894 Male Fringe Detail: Health & Welfare: $139.541$7.47, Pension: $175.5921$9.40, Training Fund: $12.8891$0.69, Annuity: $9.341$0.50, Vacation: $90.972t$4.87, Contract Compliance: $5.6041$0.30, Administrative Fund: $1.1211$0.06, Indust- Stab.Fund: $2.242d$0.12 Other Deduction Detail: SDI: 4.29 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 V.S.C. § 3145) contractors and subcontractors performing work on Federatly rmanced 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 alf payrolls to the Fedoras 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 prevailing wage rate far the work performed. DOL and federal contracting agencies receiving this information review the information l0 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-L)H ADDRESS PD Box 1177 Urban Habitat Det: La Quints, CA 92247 PAYROLL NO, FOR WEEK ENDING PROJECT AND LOCATION PROJECTOR CONTRACT NO. 12.1 01/04/2020 La Quinta SilverRock Park Venue 2016-0812016 OS La Quinta SilverRock Resort (1) (2) {3) (4) DAY AND DATE ° (5) (6) (7) (8) • Other Deductions - 1) Local Tax 1 (9) 0, DEDUCTIONS 2) Local Ten 2 * SUN MO - WE THU Frei $A7 500 3)Other Deductions NET NAME. ADDRESS, AND `f WORK WAGES PAID ° 29 30 3f 1 2 3 4 TH HOLa NG TOTAL ideniifcatPon Number o � k CLASSIFICATION TOTAL ROTE GROSS AMOUNT FOR Wi'Fur HOURS WORKED EACH DAY OF EMPLOYEE z 3 m HOURS OF PAY EARNED FICA TAX SV H Medicare OTHER` DEDJC nONS Check No, Sex Race Felipe Lopez Landscape oper. Eng D 0 0 0 a o a a 0.00 o.00 aua 365.27 1) 0.00 66886 Camino Idillo 5 2} 0.00 Desert Hot Springs, CA 92240 0 0 q o o o 0 0 0.00 o.a0 0.00 60,78 34.00 1.15 14.21 3) 9.80 119.94 860.29 S a e.ao o a m so 0 a 9.50 38,45 a.aa 604137146 980.23 B1870 Male Fnnge Detail: Health & Welfare: $93.765!$9.87, Pension: $93-7651$9.87, Vacation: $45.961$4.84, Annuity: $2.3751$0.25, Training Fund: $14.2531.50, Contract Compliance: $2.851$0.30, Administrative Fund: $0.571$0.f)6, Indust. Stab.Fund: $114.001$12.00 Other Deduction Detail: SDI: 9.80 Felipe Lopez 66886 Camino Idilfo Desert Hot 5plings, CA $2240 andscape Irrigation abor D 0 a4.jt4. 0 0.00 0,00 0.007104 34.00 1.15 14.21 9.80 119.94 BS0.29 0 o o 00.23 5am4 0.0060.78 S a a 0 10.50 33.43 0.oa 604137146 61870 Male Fringe Detail: Health & welfare: $80.1531$7.47, Pension: $90.1321$8.40, Annuity; $5.3651$0.50, Vacation: $52.2551$4.87, Training Fund: $7.4041$0.69, Contract Compliance: $3.2191$0.30, Administrative Fund: $0.6441$0.06, Indust. Stab.Fund: $1.288!$0.12 Other Deduction retail: SDI: 9,80 Kenneth P. Ocean 15214 Mission St. Hesperia, CA 92345 0 Landscape Irrigation Labor D o 0 0 0 0 o o 0.00 1 a.00 ooa 534.88 32.09 46.00 7.37 9.84 1) 0.00 2) 0.00 3) 6.70 102.00 776.88 O o o a o a o 0.00 0.00 0 00 S 0 e,00- 0 a 8.00 a a 16.00 33.43 0.0o- 559657836 678.88 61893 Male Fringe Detail: Health & Welfare: $119.521$7.47, Pension; $134.40/$8,40, Annuity: $8.001$0.50, Vacation: $77.9244.87, 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: 6.70 Gerardo Saldivar Mejia Victoria St. Indio, CA 92201 0 Landscape Irrigation abor D o c o o o o o 0.00 c.c0 0.00Z 100.00 20.48 16.34 3) 0.0081921 2) 0.00 3) 11.27 217 92 908.46 0 0 0 0 0 0 0 0 0.00 0 ao 0,0089.83 $ a 2 a2 a a 0 a 9 2.02 333 aoo 607068060 61878 Male Hispanic American Fringe Delatl; Administrative Fund: $0.1211$0.06, Pension: $16.9681$8.40, Annuity: $L011$0.50, Vacation: $9.8371$4.87, Contract Compliance: $0.6061$0.30, Indust. Stab.Fund: $0.2421$0.12. Health & Welfare: $15.0891$747. Training Fund: $1.3941$0,69 Other Deduction Detail, SDI: 11.27 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 OR SUBCONTRACTOR Wage CA-SC-UH ADDRESS PO Box 1177 Urban Habitat Det: La Quinta, CA 92247 PAYROLL NO. FOR WEEK ENDING PROJECT AND LOCATION PROJ EC7 OR CONTRACT NO. 121 01/04/2020 La Quinta SilvesRock Park Venue La Quinta SilverRock Resort 2016-0812016-08 (f} (2) (3) (4) DAY AND DATE (5) (6) (7) (8) ' Other Deductions - 1) Local Tax 1 (9) NAME. ADDRESS. AND IdentiFeatien Numbar OF EMPLOYEE C �'o O _ O °z 3 WORK CLASSIFICATION TOTAL HOURS RATE OF PAY GROSS AMOUNT EARNED DEDUCTIONS 2) Loral Tax 2 3) Other Deduction s NET WAGES PAID FOR WEEK/ Check No. r 5UN MON TUE WED THU FRf SAT 29 30 31 1 2 3 4 FICA TH- Holl❑ NG TAX 8WH Medicare OTHER' TOTAL OEDUCTIONS HOURS WORKED EACH DAY Sex Race Rafael Sanchez Garcia 56125 Harrison St. Thermal, CA 92274 0 Landscape Irrigation Labor D o 0 0 0 0 a o 0,00 coo auA91434 75.00 12.55 13.26 t) 0.00 2) D.00 3) 9 14 66.64 747.70 0 o a 0 0 0 0 o p.00 a.u0 0,0056.69 S o 2.02 0 a C 0 0 2.02 33a3 0.00 614126878 61908 Male Hispanic American Fringe Detail: Annuity: $1.01/$0.50, Pension: $16-9681$8.40, Contract Compliance: $0.606/$0.39, Vacation: $9.8371$4.87, Administrative Fund: $0.1211$0.06, Training Fund: $1.394/$0.69, Indust. Stab Fund: $0.242J$0.12, Health & Welfare: $15.0891$7.47 Other Deduction Detail: SDI: 9.14 Miguel I_- Sanchez 55550 Tyler St. Space #3 Thermal, CA92274 4 Landscape Irrigation Labor0.00 D n o 0 0 0 0 0 0.00 0.00 a 0o WAII 58.82 62.00 21.89 13.76 t) 0.00 s} 949 165.96 762.74 p o 0 0 0 0 o.za o 0.23 50,14 000 $ 0 Boo 0 C 0 s,00 0 16.00 33.43 0.0a 622987861 948,70 61900 Male Fringe Detail: Health & Welfare: $121.2381$7.47, Pension: $136.3321$8.40, Vacation: $79.041$4.87, Training Fund: $11.199/$0.69, Annuity: $8.115/$0.50, Contract Compliance: $4.8691$0.30, Administrative Fund: $0.974/$0.06, fndust. Stab. Fund: $1.9481$0.12 Other Deduction Detail: SDI: 9.49 Howard A. Turnbow 81797 Avenida Estuco Indio, CA 92203 1 [ement Mason D 0 0 0 C 0 0 0 0.00 o oo 0.00 592.00 36.70 49.00 8.93 g 58 2) 0.00 3) 5.92 109.13 482.87 0 0 0 0 0 0 a a 0.00 00D 0.00 S n o 0 o Boo 8.00 0 16.00 1700 0 0a 529802418 592.00 61880 Male Fringe Detail: Vacation: $131.681$8.23, Health & Welfare: $119.52/$7.47, Pension: $134.40/$8.40, Annuity: $8.001$0.50, Training Fund: $11.041$0.6% Contract Compliance: $4,801$0.30, Indust. Stab.Fund: $1.281$0.08, Administrative Fund: $0.961$0.06, Other. $1.121$0.07 Other Deduction Detail: SDI: 5.92 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 C.F.R. § 5,6(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 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 SiiverRock Park Venue a Public Works Project commencing on the (Building or Work) 29th day of December , 2019 , and ending the 4th day of January 2020 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, Child Support Fee, SDI, 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 1010t119,13evised Payroll #12.1, Contractor License # 963744, Workers Compensation Policy # URWC004126 NAME AND TITLE' SIGNATURE Theresa Brennan, President Signed Electronically THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEMENTS MAY SUBJECT THE CONTRACTOR OR SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION, SEE SECTION 1001 OF TITLE i8 AND SECTION 231 OF TfTL1~ 31 OF THE UNITED STATES CODE. ' 11.5 G.P 0.'. 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: 2020-01-04 Payroll Number: 12 Amendment Number: 0 15 employee payroll record(s) processed Your Transaction ID is: 7444191 Print this Page View your submission Ate