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Urban_Habitat__47.1_9-5-2038.51 621.20 Coachella, CA 92236 84711 Ave 51 C101 Fringe Detail: Health & Welfare: $106.00/$2.65, Pension: $40.00/$1.00, Annuity: $14.00/$0.35, Vacation/ Holiday: $41.20/$1.03 0 0Landscape Irr. Tender 3 E Aguayo JR Alejandro S D 0 8.00 00000 8.00 8.008.00 8.00 0 15.5340.00 0.00 0.00 0.000.00 32.00 5.05 9.01 0.00 90.78 530.42 616926918 0.00 6.21 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 621.20 63718 Other Deduction Detail: SDI: 6.21 145.91 2200.00 La Quinta, CA 92253 79925 Westward Ho Fringe Detail: Training Fund: $8.16/$0.51 0 0Roofer: sdsubtrades 4 Brett M. Brennan S D 0 0 00000 0 08.00 8.00 0 41.2716.00 0.00 17.56 0.000.00 199.00 145.91 31.90 0.00 544.72 1655.28 566515654 0.00 22.00 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 941.28 63721 Other Deduction Detail: SDI: 22.00 Male Caucasian 100.39 1619.27 Apple Valley, CA 92308 20250 Itasca Rd Fringe Detail: Other: $3.375/$0.15, Pension: $239.625/$10.65, Vacation/ Holiday: $79.875/$3.55, Health & Welfare: $257.625/$11.45, Training Fund: $22.50/$1.00 0 0Landscape Oper. Eng 2 D Cleland Cameron S D 0 8.00 00000 6.50 8.0000 0 38.4522.50 0.00 0.00 0.000.00 139.00 49.61 23.48 0.00 328.67 1290.60 565931366 0.00 16.19 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 865.12 63722 Other Deduction Detail: SDI: 16.19 38.51 621.20 Mecca, CA 92254 91889 Montenegro Dr Fringe Detail: Annuity: $14.00/$0.35, Pension: $40.00/$1.00, Health & Welfare: $106.00/$2.65, Vacation/ Holiday: $41.20/$1.03 0 0Landscape Irr. Tender 0 Torres Cesar S D 0 8.00 00000 8.00 8.008.00 8.00 0 15.5340.00 0.00 0.00 0.000.00 4.00 10.21 9.00 0.00 67.93 553.27 604246965 0.00 6.21 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 621.20 63723 Other Deduction Detail: SDI: 6.21 2) Local Tax 2 * Other Deductions - 1) Local Tax 1 3) Other Deductions TOTAL DEDUCTIONS PAYROLL (For Contractor's Optional Use; See Instructions, Form WH-347 Inst.) OR SUBCONTRACTORNAME OF CONTRACTOR ADDRESS PROJECT AND LOCATION PROJECT OR CONTRACT NO.FOR WEEK ENDINGPAYROLL NO. (1)(2)(3) DEDUCTIONS (5)(6)(7)(8)(9)(4) DAY AND DATE Identification Number NAME, ADDRESS, AND OF EMPLOYEE WORK CLASSIFICATION HOURS WORKED EACH DAY TOTAL HOURS RATE OF PAY GROSS AMOUNT EARNED FICA WITH- HOLDING TAX SWH OTHER* NET WAGES PAID FOR WEEK/NO. OF WITHHOLDING EXEMPTIONSST, OT or DTUrban Habitat PO Box 1177 La Quinta, CA 92247 47.1 La Quinta SilverRock Park Venue La Quinta SilverRock Resort09/05/2020 2016-08/2016-08 30 31 1 2 3 4 5 Medicare SUN MON TUE WED THU FRI SAT CA-SC-UHWage Det: Check No. Sex Race 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. This document was created using an EVALUATION version of ActiveReports. Only a licensed user may legally create reports for use in production. Please report infractions or address questions to sales@grapecity.us.com. Copyright © 2002-2009 GrapeCity, inc. All rights reserved. 77.00 1241.96 Apple Valley, CA 92308 9527 Navajo Fringe Detail: Annuity: $20.02/$0.91, Contract Compliance: $6.60/$0.30, Administrative Fund: $1.32/$0.06, Indust. Stab.Fund: $2.64/$0.12, Vacation/ Holiday: $107.14/$4.87, Training Fund: $15.40/$0.70, Pension: $184. 80/$8.40, Health & Welfare: $176.00/$8.00 0 0Landscape Irrigation Labor 4 JA Carver Daniel S D 0 7.50 00000 6.50 8.0000 0 34.5822.00 0.00 0.00 0.000.00 74.00 15.95 18.01 0.00 197.38 1044.58 270717343 0.00 12.42 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 760.76 63727 Other Deduction Detail: SDI: 12.42 90.72 1463.20 Desert Hot Springs, CA 92240 66886 Camino Idilio Fringe Detail: Annuity: $36.40/$0.91, Administrative Fund: $2.40/$0.06, Indust. Stab.Fund: $4.80/$0.12, Contract Compliance: $12.00/$0.30, Training Fund: $28.00/$0.70, Health & Welfare: $336.00/$8.40, Pension: $320. 00/$8.00, Vacation/ Holiday: $194.80/$4.87 0 0Landscape Irrigation Labor 5 Lopez Felipe S D 0 8.00 00000 8.00 8.008.00 8.00 0 36.5840.00 0.00 0.00 0.000.00 91.00 28.13 21.22 0.00 245.70 1217.50 604137146 0.00 14.63 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 1463.20 63730 Other Deduction Detail: SDI: 14.63 85.75 1383.20 Indio, CA 92201 81-921 Victoria St. Fringe Detail: Annuity: $7.28/$0.91, Training Fund: $5.60/$0.70, Administrative Fund: $0.48/$0.06, Indust. Stab.Fund: $0.96/$0.12, Health & Welfare: $67.20/$8.40, Pension: $64.00/$8.00, Vacation/ Holiday: $38.96/$4.87, Contract Compliance: $2.40/$0.30 0 0Landscape Irrigation Labor 0 Saldivar Mejia Gerardo S D 0 0 00000 0 08.00 0 0 34.588.00 0.00 0.00 0.000.00 131.00 35.59 20.06 0.00 286.24 1096.96 607068060 0.00 13.84 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 276.64 63733 Other Deduction Detail: SDI: 13.84 80.27 1294.74 Thermal, CA 92274 69455 Pierce St. Fringe Detail: Training Fund: $17.85/$0.85 0 0Painter: Industrial 9 Juan Guitron Gonzalez S D 0 4.00 00000 5.00 6.0006.00 0 61.6521.00 0.00 0.00 0.000.00 0.00 40.40 18.77 0.00 152.39 1142.35 655290807 0.00 12.95 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 1294.73 4270 Other Deduction Detail: SDI: 12.95 Male Hispanic American 2) Local Tax 2 * Other Deductions - 1) Local Tax 1 3) Other Deductions TOTAL DEDUCTIONS PAYROLL (For Contractor's Optional Use; See Instructions, Form WH-347 Inst.) OR SUBCONTRACTORNAME OF CONTRACTOR ADDRESS PROJECT AND LOCATION PROJECT OR CONTRACT NO.FOR WEEK ENDINGPAYROLL NO. (1)(2)(3) DEDUCTIONS (5)(6)(7)(8)(9)(4) DAY AND DATE Identification Number NAME, ADDRESS, AND OF EMPLOYEE WORK CLASSIFICATION HOURS WORKED EACH DAY TOTAL HOURS RATE OF PAY GROSS AMOUNT EARNED FICA WITH- HOLDING TAX SWH OTHER* NET WAGES PAID FOR WEEK/NO. OF WITHHOLDING EXEMPTIONSST, OT or DTUrban Habitat PO Box 1177 La Quinta, CA 92247 47.1 La Quinta SilverRock Park Venue La Quinta SilverRock Resort09/05/2020 2016-08/2016-08 30 31 1 2 3 4 5 Medicare SUN MON TUE WED THU FRI SAT CA-SC-UHWage Det: Check No. Sex Race 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. This document was created using an EVALUATION version of ActiveReports. Only a licensed user may legally create reports for use in production. Please report infractions or address questions to sales@grapecity.us.com. Copyright © 2002-2009 GrapeCity, inc. All rights reserved. 68.61 1106.56 San Bernardino, CA 92404 1659 McKinley Ave. Fringe Detail: Annuity: $29.12/$0.91, Training Fund: $22.40/$0.70, Administrative Fund: $1.92/$0.06, Indust. Stab.Fund: $3.84/$0.12, Contract Compliance: $9.60/$0.30, Vacation/ Holiday: $155.84/$4.87, Health & Welfare: $268.80/$8.40, Pension: $256.00/$8.00 0 0Landscape Irrigation Labor 2 Torres Gustavo S D 0 8.00 00000 8.00 8.008.00 0 0 34.5832.00 0.00 0.00 0.000.00 27.00 37.96 16.04 0.00 160.68 945.88 604924822 0.00 11.07 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 1106.56 63735 Other Deduction Detail: SDI: 11.07 87.68 1414.16 Riverside, CA 92509 9247 52nd St Fringe Detail: Health & Welfare: $91.60/$11.45, Training Fund: $8.00/$1.00, Pension: $85.20/$10.65, Other: $1.20/$0.15, Vacation/ Holiday: $28.40/$3.55 0 0Landscape Oper. Eng 4 Rincon Garcia Israel S D 0 0 00000 0 08.00 0 0 38.458.00 0.00 0.00 0.000.00 95.00 22.83 20.51 0.00 240.16 1174.00 610134793 0.00 14.14 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 307.60 63736 Other Deduction Detail: SDI: 14.14 68.60 1106.56 Desert Hot Springs, CA 92240 66834 Estrella Ave Fringe Detail: Annuity: $29.12/$0.91, Training Fund: $22.40/$0.70, Administrative Fund: $1.92/$0.06, Indust. Stab.Fund: $3.84/$0.12, Contract Compliance: $9.60/$0.30, Vacation/ Holiday: $155.84/$4.87, Health & Welfare: $268.80/$8.40, Pension: $256.00/$8.00 0 0Landscape Irrigation Labor 0 A Varela Jesus S D 0 8.00 00000 8.00 8.0008.00 0 34.5832.00 0.00 0.00 0.000.00 110.00 45.70 16.04 0.00 251.41 855.15 605083377 0.00 11.07 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 1106.56 63742 Other Deduction Detail: SDI: 11.07 39.68 640.00 Hemet, CA 92545 1660 Wrentree Way Fringe Detail: Health & Welfare: $106.00/$2.65, Pension: $40.00/$1.00, Vacation/ Holiday: $41.20/$1.03, Annuity: $14.00/$0.35 0 0Landscape Irr. Tender 2 Diaz Jorge S D 0 8.00 00000 8.00 8.008.00 8.00 0 16.0040.00 0.00 0.00 0.000.00 50.00 8.46 9.28 0.00 113.82 526.18 615221282 0.00 6.40 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 640.00 63743 Other Deduction Detail: SDI: 6.40 2) Local Tax 2 * Other Deductions - 1) Local Tax 1 3) Other Deductions TOTAL DEDUCTIONS PAYROLL (For Contractor's Optional Use; See Instructions, Form WH-347 Inst.) OR SUBCONTRACTORNAME OF CONTRACTOR ADDRESS PROJECT AND LOCATION PROJECT OR CONTRACT NO.FOR WEEK ENDINGPAYROLL NO. (1)(2)(3) DEDUCTIONS (5)(6)(7)(8)(9)(4) DAY AND DATE Identification Number NAME, ADDRESS, AND OF EMPLOYEE WORK CLASSIFICATION HOURS WORKED EACH DAY TOTAL HOURS RATE OF PAY GROSS AMOUNT EARNED FICA WITH- HOLDING TAX SWH OTHER* NET WAGES PAID FOR WEEK/NO. OF WITHHOLDING EXEMPTIONSST, OT or DTUrban Habitat PO Box 1177 La Quinta, CA 92247 47.1 La Quinta SilverRock Park Venue La Quinta SilverRock Resort09/05/2020 2016-08/2016-08 30 31 1 2 3 4 5 Medicare SUN MON TUE WED THU FRI SAT CA-SC-UHWage Det: Check No. Sex Race 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. This document was created using an EVALUATION version of ActiveReports. Only a licensed user may legally create reports for use in production. Please report infractions or address questions to sales@grapecity.us.com. Copyright © 2002-2009 GrapeCity, inc. All rights reserved. 39.68 640.00 Lake Elsinore, CA 92530 15212 Lincoln St A Fringe Detail: Annuity: $14.00/$0.35, Health & Welfare: $106.00/$2.65, Pension: $40.00/$1.00, Vacation/ Holiday: $41.20/$1.03 0 0Landscape Irr. Tender 0 A Sando Jose S D 0 8.00 00000 8.00 8.008.00 8.00 0 16.0040.00 0.00 0.00 0.000.00 44.00 13.62 9.28 0.00 112.98 527.02 603024821 0.00 6.40 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 640.00 4271 Other Deduction Detail: SDI: 6.40 85.76 1383.20 Lake Elsinore, CA 92530 15212 Lincoln St Apt. A Fringe Detail: Annuity: $36.40/$0.91, Training Fund: $28.00/$0.70, Contract Compliance: $12.00/$0.30, Administrative Fund: $2.40/$0.06, Indust. Stab.Fund: $4.80/$0.12, Vacation/ Holiday: $194.80/$4.87, Health & Welfare: $336.00/$8.40, Pension: $320.00/$8.00 0 0Landscape Irrigation Labor 4 D Sando Jose S D 0 8.00 00000 8.00 8.008.00 8.00 0 34.5840.00 0.00 0.00 0.000.00 15.00 24.04 20.05 0.00 158.68 1224.52 612336635 0.00 13.83 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 1383.20 63748 Other Deduction Detail: SDI: 13.83 85.76 1383.20 Hemet, CA 92543 1327 Palomino Court Fringe Detail: Annuity: $36.40/$0.91, Training Fund: $28.00/$0.70, Administrative Fund: $2.40/$0.06, Indust. Stab.Fund: $4.80/$0.12, Health & Welfare: $336.00/$8.40, Pension: $320.00/$8.00, Vacation/ Holiday: $194. 80/$4.87, Contract Compliance: $12.00/$0.30 0 0Landscape Irrigation Labor 1 F Ortiz Jose S D 0 8.00 00000 8.00 8.008.00 8.00 0 34.5840.00 0.00 0.00 0.000.00 121.00 70.09 20.05 0.00 310.73 1072.47 573495026 0.00 13.83 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 1383.20 63749 Other Deduction Detail: SDI: 13.83 85.76 1383.20 San Jacinto, CA 92583 258 W. 7th Street Spc. 80 Fringe Detail: Annuity: $36.40/$0.91, Training Fund: $28.00/$0.70, Administrative Fund: $2.40/$0.06, Indust. Stab.Fund: $4.80/$0.12, Contract Compliance: $12.00/$0.30, Vacation/ Holiday: $194.80/$4.87, Health & Welfare: $336.00/$8.40, Pension: $320.00/$8.00 0 0Landscape Irrigation Labor 1 Gutierrez Jose S D 0 8.00 00000 8.00 8.008.00 8.00 0 34.5840.00 0.00 0.00 0.000.00 0.00 21.46 20.06 0.00 141.11 1242.09 571210268 0.00 13.83 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 1383.20 63750 Other Deduction Detail: SDI: 13.83 2) Local Tax 2 * Other Deductions - 1) Local Tax 1 3) Other Deductions TOTAL DEDUCTIONS PAYROLL (For Contractor's Optional Use; See Instructions, Form WH-347 Inst.) OR SUBCONTRACTORNAME OF CONTRACTOR ADDRESS PROJECT AND LOCATION PROJECT OR CONTRACT NO.FOR WEEK ENDINGPAYROLL NO. (1)(2)(3) DEDUCTIONS (5)(6)(7)(8)(9)(4) DAY AND DATE Identification Number NAME, ADDRESS, AND OF EMPLOYEE WORK CLASSIFICATION HOURS WORKED EACH DAY TOTAL HOURS RATE OF PAY GROSS AMOUNT EARNED FICA WITH- HOLDING TAX SWH OTHER* NET WAGES PAID FOR WEEK/NO. OF WITHHOLDING EXEMPTIONSST, OT or DTUrban Habitat PO Box 1177 La Quinta, CA 92247 47.1 La Quinta SilverRock Park Venue La Quinta SilverRock Resort09/05/2020 2016-08/2016-08 30 31 1 2 3 4 5 Medicare SUN MON TUE WED THU FRI SAT CA-SC-UHWage Det: Check No. Sex Race 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. This document was created using an EVALUATION version of ActiveReports. Only a licensed user may legally create reports for use in production. Please report infractions or address questions to sales@grapecity.us.com. Copyright © 2002-2009 GrapeCity, inc. All rights reserved. 38.52 621.20 Thermal, CA 92274 55550 Tyler St. Space #3 Fringe Detail: Annuity: $14.00/$0.35, Pension: $40.00/$1.00, Vacation/ Holiday: $41.20/$1.03, Health & Welfare: $106.00/$2.65 0 0Landscape Irr. Tender 5 LopezMendez Juan S D 0 8.00 00000 8.00 8.008.00 8.00 0 15.5340.00 0.00 0.00 0.000.00 0.00 0.00 9.01 0.00 53.74 567.46 620099088 0.00 6.21 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 621.20 63753 Other Deduction Detail: SDI: 6.21 12.04 830.40 Desert Hot Springs, CA 92240 66886 Camino Idilio Fringe Detail: Health & Welfare: $176.00/$4.40, Pension: $170.40/$4.26, Vacation/ Holiday: $50.40/$1.26, Annuity: $10.00/$0.25, Training Fund: $56.40/$1.41, Contract Compliance: $12.00/$0.30, Indust. Stab.Fund: $3. 20/$0.08, Administrative Fund: $2.40/$0.06 0 0Landscape Irrigation Labor 4 Felipe Lopez Luis S D 0 8.00 00000 8.00 8.008.00 8.00 0 20.7640.00 0.00 0.00 0.000.00 47.00 21.82 51.48 0.00 140.64 689.76 164777350 0.00 8.30 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 830.40 Apprentice Level 2 63756 Other Deduction Detail: SDI: 8.30 44.64 720.00 San Bernardino, CA 92404 1455 E. Date Street Apt. 77 Fringe Detail: Annuity: $14.00/$0.35, Health & Welfare: $106.00/$2.65, Pension: $40.00/$1.00, Vacation/ Holiday: $41.20/$1.03 0 0Landscape Irr. Tender 3 De Jesus A Manuel S D 0 8.00 00000 8.00 8.008.00 8.00 0 18.0040.00 0.00 0.00 0.000.00 24.00 0.53 10.44 0.00 86.81 633.19 613161995 0.00 7.20 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 720.00 63757 Other Deduction Detail: SDI: 7.20 44.64 720.00 Coachella, CA 92236 84711 Ave 51 Apt G104 Fringe Detail: Annuity: $14.00/$0.35, Pension: $40.00/$1.00, Vacation/ Holiday: $41.20/$1.03, Health & Welfare: $106.00/$2.65 0 0Landscape Irr. Tender 2 Antonio Garcia Marco S D 0 8.00 00000 8.00 8.008.00 8.00 0 18.0040.00 0.00 0.00 0.000.00 33.00 3.11 10.44 0.00 98.39 621.61 641513170 0.00 7.20 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 720.00 63758 Other Deduction Detail: SDI: 7.20 2) Local Tax 2 * Other Deductions - 1) Local Tax 1 3) Other Deductions TOTAL DEDUCTIONS PAYROLL (For Contractor's Optional Use; See Instructions, Form WH-347 Inst.) OR SUBCONTRACTORNAME OF CONTRACTOR ADDRESS PROJECT AND LOCATION PROJECT OR CONTRACT NO.FOR WEEK ENDINGPAYROLL NO. (1)(2)(3) DEDUCTIONS (5)(6)(7)(8)(9)(4) DAY AND DATE Identification Number NAME, ADDRESS, AND OF EMPLOYEE WORK CLASSIFICATION HOURS WORKED EACH DAY TOTAL HOURS RATE OF PAY GROSS AMOUNT EARNED FICA WITH- HOLDING TAX SWH OTHER* NET WAGES PAID FOR WEEK/NO. OF WITHHOLDING EXEMPTIONSST, OT or DTUrban Habitat PO Box 1177 La Quinta, CA 92247 47.1 La Quinta SilverRock Park Venue La Quinta SilverRock Resort09/05/2020 2016-08/2016-08 30 31 1 2 3 4 5 Medicare SUN MON TUE WED THU FRI SAT CA-SC-UHWage Det: Check No. Sex Race 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. This document was created using an EVALUATION version of ActiveReports. Only a licensed user may legally create reports for use in production. Please report infractions or address questions to sales@grapecity.us.com. Copyright © 2002-2009 GrapeCity, inc. All rights reserved. 89.72 1447.20 Hemet, CA 92544 40400 Newport Rd Fringe Detail: Annuity: $7.28/$0.91, Training Fund: $5.60/$0.70, Administrative Fund: $0.48/$0.06, Indust. Stab.Fund: $0.96/$0.12, Pension: $64.00/$8.00, Health & Welfare: $67.20/$8.40, Contract Compliance: $2.40/$0.30, Vacation/ Holiday: $38.96/$4.87 0 0Landscape Irrigation Labor 1 Mercado Martin S D 0 0 00000 0 08.00 0 0 34.588.00 0.00 0.00 0.000.00 129.00 76.64 20.99 0.00 330.83 1116.37 621104173 0.00 14.48 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 276.64 63760 Other Deduction Detail: SDI: 14.48 12.04 830.40 Thermal, CA 92274 55550 Tyler St Sp#3 Fringe Detail: Annuity: $10.00/$0.25, Health & Welfare: $176.00/$4.40, Pension: $170.40/$4.26, Vacation/ Holiday: $50.40/$1.26, Training Fund: $56.40/$1.41, Contract Compliance: $12.00/$0.30, Indust. Stab.Fund: $3. 20/$0.08, Administrative Fund: $2.40/$0.06 0 0Landscape Irrigation Labor 5 P Cortez Maurilio S D 0 8.00 00000 8.00 8.008.00 8.00 0 20.7640.00 0.00 0.00 0.000.00 19.00 0.00 51.49 0.00 90.83 739.57 604521749 0.00 8.30 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 830.40 Apprentice Level 2 63761 Other Deduction Detail: SDI: 8.30 85.76 1383.20 Thermal, CA 92274 55550 Tyler St Space #3 Fringe Detail: Annuity: $36.40/$0.91, Training Fund: $28.00/$0.70, Administrative Fund: $2.40/$0.06, Indust. Stab.Fund: $4.80/$0.12, Vacation/ Holiday: $194.80/$4.87, Health & Welfare: $336.00/$8.40, Pension: $320. 00/$8.00, Contract Compliance: $12.00/$0.30 0 0Landscape Irrigation Labor 4 L Sanchez Miguel S D 0 8.00 00000 8.00 8.008.00 8.00 0 34.5840.00 0.00 0.00 0.000.00 135.00 62.35 20.05 0.00 317.00 1066.20 622987861 0.00 13.84 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 1383.20 63762 Other Deduction Detail: SDI: 13.84 47.97 773.60 Corona, CA 92879 4143 Moody Fringe Detail: Annuity: $11.20/$0.35, Health & Welfare: $84.80/$2.65, Vacation/ Holiday: $32.96/$1.03, Pension: $32.00/$1.00 0 0Landscape Irr. Tender 2 Cruz Nabor S D 0 8.00 00000 8.00 8.008.00 0 0 15.5332.00 0.00 0.00 0.000.00 38.00 15.49 11.22 0.00 120.42 653.18 555291126 0.00 7.74 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 496.96 63765 Other Deduction Detail: SDI: 7.74 2) Local Tax 2 * Other Deductions - 1) Local Tax 1 3) Other Deductions TOTAL DEDUCTIONS PAYROLL (For Contractor's Optional Use; See Instructions, Form WH-347 Inst.) OR SUBCONTRACTORNAME OF CONTRACTOR ADDRESS PROJECT AND LOCATION PROJECT OR CONTRACT NO.FOR WEEK ENDINGPAYROLL NO. (1)(2)(3) DEDUCTIONS (5)(6)(7)(8)(9)(4) DAY AND DATE Identification Number NAME, ADDRESS, AND OF EMPLOYEE WORK CLASSIFICATION HOURS WORKED EACH DAY TOTAL HOURS RATE OF PAY GROSS AMOUNT EARNED FICA WITH- HOLDING TAX SWH OTHER* NET WAGES PAID FOR WEEK/NO. OF WITHHOLDING EXEMPTIONSST, OT or DTUrban Habitat PO Box 1177 La Quinta, CA 92247 47.1 La Quinta SilverRock Park Venue La Quinta SilverRock Resort09/05/2020 2016-08/2016-08 30 31 1 2 3 4 5 Medicare SUN MON TUE WED THU FRI SAT CA-SC-UHWage Det: Check No. Sex Race 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. This document was created using an EVALUATION version of ActiveReports. Only a licensed user may legally create reports for use in production. Please report infractions or address questions to sales@grapecity.us.com. Copyright © 2002-2009 GrapeCity, inc. All rights reserved. 47.97 773.60 Corona, CA 92879 4143 Moody Fringe Detail: Annuity: $7.28/$0.91, Training Fund: $5.60/$0.70, Administrative Fund: $0.48/$0.06, Indust. Stab.Fund: $0.96/$0.12, Vacation/ Holiday: $38.96/$4.87, Health & Welfare: $67.20/$8.40, Pension: $64.00/$8.00, Contract Compliance: $2.40/$0.30 0 0Landscape Irrigation Labor 2 Cruz Nabor S D 0 0 00000 0 008.00 0 34.588.00 0.00 0.00 0.000.00 38.00 15.49 11.22 0.00 120.42 653.18 555291126 0.00 7.74 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 276.64 63765 Other Deduction Detail: SDI: 7.74 85.76 1383.20 Temecula, CA 92592 30240 Miraloma Dr Fringe Detail: Annuity: $36.40/$0.91, Training Fund: $28.00/$0.70, Administrative Fund: $2.40/$0.06, Indust. Stab.Fund: $4.80/$0.12, Vacation/ Holiday: $194.80/$4.87, Health & Welfare: $336.00/$8.40, Pension: $320. 00/$8.00, Contract Compliance: $12.00/$0.30 0 0Landscape Irrigation Labor 2 Diaz Oscar S D 0 8.00 00000 8.00 8.008.00 8.00 0 34.5840.00 0.00 0.00 0.000.00 53.00 67.51 20.05 0.00 240.16 1143.04 615121373 0.00 13.84 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 1383.20 63767 Other Deduction Detail: SDI: 13.84 42.16 680.00 Coachella, CA 92236 51285 Fredrick St. Apt. G-104 Fringe Detail: Annuity: $14.00/$0.35, Health & Welfare: $106.00/$2.65, Pension: $40.00/$1.00, Vacation/ Holiday: $41.20/$1.03 0 0Landscape Irr. Tender 3 Arias Penalosa Otoniel S D 0 8.00 00000 8.00 8.008.00 8.00 0 17.0040.00 0.00 0.00 0.000.00 20.00 0.00 9.86 0.00 78.82 601.18 621666061 0.00 6.80 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 680.00 63768 Other Deduction Detail: SDI: 6.80 38.52 621.20 Thermal, CA 92274 68990 Harrison St. Space #101 Fringe Detail: Annuity: $14.00/$0.35, Health & Welfare: $106.00/$2.65, Vacation/ Holiday: $41.20/$1.03, Pension: $40.00/$1.00 0 0Landscape Irr. Tender 5 J Clemen Pedro S D 0 8.00 00000 8.00 8.008.00 8.00 0 15.5340.00 0.00 0.00 0.000.00 0.00 0.00 9.01 0.00 53.74 567.46 657090571 0.00 6.21 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 621.20 63769 Other Deduction Detail: SDI: 6.21 2) Local Tax 2 * Other Deductions - 1) Local Tax 1 3) Other Deductions TOTAL DEDUCTIONS PAYROLL (For Contractor's Optional Use; See Instructions, Form WH-347 Inst.) OR SUBCONTRACTORNAME OF CONTRACTOR ADDRESS PROJECT AND LOCATION PROJECT OR CONTRACT NO.FOR WEEK ENDINGPAYROLL NO. (1)(2)(3) DEDUCTIONS (5)(6)(7)(8)(9)(4) DAY AND DATE Identification Number NAME, ADDRESS, AND OF EMPLOYEE WORK CLASSIFICATION HOURS WORKED EACH DAY TOTAL HOURS RATE OF PAY GROSS AMOUNT EARNED FICA WITH- HOLDING TAX SWH OTHER* NET WAGES PAID FOR WEEK/NO. OF WITHHOLDING EXEMPTIONSST, OT or DTUrban Habitat PO Box 1177 La Quinta, CA 92247 47.1 La Quinta SilverRock Park Venue La Quinta SilverRock Resort09/05/2020 2016-08/2016-08 30 31 1 2 3 4 5 Medicare SUN MON TUE WED THU FRI SAT CA-SC-UHWage Det: Check No. Sex Race 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. This document was created using an EVALUATION version of ActiveReports. Only a licensed user may legally create reports for use in production. Please report infractions or address questions to sales@grapecity.us.com. Copyright © 2002-2009 GrapeCity, inc. All rights reserved. 42.16 680.00 Thermal, CA 92274 56725 Harrison St. Fringe Detail: Annuity: $2.80/$0.35, Vacation/ Holiday: $8.24/$1.03, Pension: $8.00/$1.00, Health & Welfare: $21.20/$2.65 0 0Landscape Irr. Tender 0 Sanchez Garcia Rafael S D 0 0 00000 0 08.00 0 0 17.008.00 0.00 0.00 0.000.00 47.00 7.39 9.86 0.00 113.21 566.79 614126878 0.00 6.80 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 136.00 63771 Other Deduction Detail: SDI: 6.80 85.76 1383.20 San Jacinto, CA 92583 258 W 7th Street Spc 80 Fringe Detail: Annuity: $36.40/$0.91, Training Fund: $28.00/$0.70, Health & Welfare: $336.00/$8.40, Pension: $320.00/$8.00, Vacation/ Holiday: $194.80/$4.87, Contract Compliance: $12.00/$0.30, Administrative Fund: $2. 40/$0.06, Indust. Stab.Fund: $4.80/$0.12 0 0Landscape Irrigation Labor 0 Carrillo Sergio S D 0 8.00 00000 8.00 8.008.00 8.00 0 34.5840.00 0.00 0.00 0.000.00 92.00 33.67 20.05 0.00 245.31 1137.89 626545633 0.00 13.83 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 1383.20 63775 Other Deduction Detail: SDI: 13.83 2) Local Tax 2 * Other Deductions - 1) Local Tax 1 3) Other Deductions TOTAL DEDUCTIONS PAYROLL (For Contractor's Optional Use; See Instructions, Form WH-347 Inst.) OR SUBCONTRACTORNAME OF CONTRACTOR ADDRESS PROJECT AND LOCATION PROJECT OR CONTRACT NO.FOR WEEK ENDINGPAYROLL NO. (1)(2)(3) DEDUCTIONS (5)(6)(7)(8)(9)(4) DAY AND DATE Identification Number NAME, ADDRESS, AND OF EMPLOYEE WORK CLASSIFICATION HOURS WORKED EACH DAY TOTAL HOURS RATE OF PAY GROSS AMOUNT EARNED FICA WITH- HOLDING TAX SWH OTHER* NET WAGES PAID FOR WEEK/NO. OF WITHHOLDING EXEMPTIONSST, OT or DTUrban Habitat PO Box 1177 La Quinta, CA 92247 47.1 La Quinta SilverRock Park Venue La Quinta SilverRock Resort09/05/2020 2016-08/2016-08 30 31 1 2 3 4 5 Medicare SUN MON TUE WED THU FRI SAT CA-SC-UHWage Det: Check No. Sex Race 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. This document was created using an EVALUATION version of ActiveReports. Only a licensed user may legally create reports for use in production. Please report infractions or address questions to sales@grapecity.us.com. Copyright © 2002-2009 GrapeCity, inc. All rights reserved. Contract #2016-08, Wage Decision #CA-SC-UH Mod 0 10/01/19,Revised Payroll #47.1, Contractor License # 963744, Workers Compensation Policy # URWC004126 Urban Habitat 30th Other September 22nd, 2020 Urban Habitat 2020 2020SeptemberAugust5th - * U.S. G.P.O.: 1997 519.861 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. (a) WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, FUNDS, OR PROGRAMS 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 18 AND SECTION 231 OF TITLE 31 OF THE UNITED STATES CODE. NAME AND TITLE:SIGNATURE: REMARKS (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. on the (Contractor or Subcontractor) 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 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. (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: Signed ElectronicallyTheresa Brennan, Other Date I, under penalty of perjury, do hereby state: (1) That I pay or supervise the payment of the persons employed by a Public Works Project commencing on the (Building or Work) , and ending theday of ,day of , Theresa Brennan (Contractor or Subcontractor) La Quinta SilverRock Park Venue (Name of Signatory Party)(Title) (c) EXCEPTIONS FICA, FWH, Medicare, State Tax, SDI This document was created using an EVALUATION version of ActiveReports. Only a licensed user may legally create reports for use in production. Please report infractions or address questions to sales@grapecity.us.com. Copyright © 2002-2009 GrapeCity, inc. All rights reserved.