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Urban_Habitat__48.1_9-12-2023.11 372.72 Coachella, CA 92236 84711 Ave 51 Fringe Detail: Health & Welfare: $63.60/$2.65, Pension: $24.00/$1.00, Annuity: $8.40/$0.35, Vacation: $24.72/$1.03 0 0Landscape Irr. Tender 3 Alejandro Aguayo S D 0 8.00 00000 8.00 8.0000 0 15.5324.00 0.00 0.00 0.000.00 5.00 0.00 5.40 0.00 101.24 271.48 616926918 0.00 67.73 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 372.72 63784 Other Deduction Detail: SDI: 3.73, Supplemental Dues: 64.00 Male Hispanic American 52.16 841.28San Bernardino, CA 92405 3429 North E. Street Fringe Detail: Annuity: $14.56/$0.91, Training Fund: $11.20/$0.70, Administrative Fund: $0.96/$0.06, Indust. Stab.Fund: $1.92/$0.12, Pension: $134.40/$8.40, Health & Welfare: $128.00/$8.00, Contract Compliance: $4. 80/$0.30, Vacation/ Holiday: $77.92/$4.87 0 0Landscape Irrigation Labor 3 Manuel de Jesus Alvarado Alvarado S D 0 0 00000 8.00 8.0000 0 34.5816.00 0.00 0.00 0.000.00 36.00 3.20 12.20 0.00 111.97 729.31 613161995 0.00 8.41 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 553.28 63820 Other Deduction Detail: SDI: 8.41 Male Hispanic American 52.16 841.28San Bernardino, CA 92405 3429 North E. Street Fringe Detail: Annuity: $5.60/$0.35, Pension: $16.00/$1.00, Health & Welfare: $42.40/$2.65, Vacation: $16.48/$1.03 0 0Landscape Irr. Tender 3 Manuel de Jesus Alvarado Alvarado S D 0 8.00 00000 0 008.00 0 18.0016.00 0.00 0.00 0.000.00 36.00 3.20 12.20 0.00 111.97 729.31 613161995 0.00 8.41 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 288.00 63820 Other Deduction Detail: SDI: 8.41 Male Hispanic American 30.81 496.96 Thermal, CA 92274 68990 Harrison St. Space #101 Fringe Detail: Health & Welfare: $21.20/$2.65, Pension: $8.00/$1.00, Vacation: $8.24/$1.03, Annuity: $2.80/$0.35 0 0Landscape Irr. Tender 5 Pedro J. Clemente S D 0 0 00000 0 008.00 0 15.538.00 0.00 0.00 0.000.00 0.00 0.00 7.20 0.00 42.98 453.98 657090571 0.00 4.97 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 124.24 63834 Other Deduction Detail: SDI: 4.97 Male 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 48.1 La Quinta SilverRock Park Venue La Quinta SilverRock Resort09/12/2020 2016-08/2016-08 6 7 8 9 10 11 12 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. 47.93 773.12 Thermal, CA 92274 55550 Tyler St. Fringe Detail: Training Fund: $22.72/$1.42, Annuity: $8.16/$0.51, Pension: $134.40/$8.40, Contract Compliance: $4.80/$0.30, Indust. Stab.Fund: $1.28/$0.08, Administrative Fund: $0.96/$0.06, Health & Welfare: $119. 52/$7.47, Vacation: $21.28/$1.33 0 0Landscape Irrigation Labor 5 Maurilio P. Cortez S D 0 0 00000 8.00 008.00 0 24.1616.00 0.00 0.00 0.000.00 13.00 0.00 11.21 0.00 79.87 693.25 604521749 0.00 7.73 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 386.56 Apprentice Level 3 63824 Other Deduction Detail: SDI: 7.73 Male Hispanic American 15.87 256.00 Hemet, CA 92545 1660 Wrentree Way Fringe Detail: Annuity: $5.60/$0.35, Health & Welfare: $42.40/$2.65, Pension: $16.00/$1.00, Vacation: $16.48/$1.03 0 0Landscape Irr. Tender 0 Jorge Diaz S D 0 0 00000 8.00 008.00 0 16.0016.00 0.00 0.00 0.000.00 50.00 0.00 3.71 0.00 136.14 119.86 615221282 0.00 66.56 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 256.00 63807 Other Deduction Detail: SDI: 2.56, Supplemental Dues: 64.00 Male Hispanic American 17.15 276.64 Temecula, CA 92592 30240 Miraloma Dr. 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, Contract Compliance: $2.40/$0.30, Vacation: $38.96/$4.87, Health & Welfare: $67.20/$8.40, Pension: $64.00/$8.00 0 0Landscape Irrigation Labor 2 Oscar Diaz S D 0 0 00000 0 008.00 0 34.588.00 0.00 0.00 0.000.00 0.00 0.00 4.01 0.00 23.92 252.72 615121373 0.00 2.76 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 276.64 63832 Other Deduction Detail: SDI: 2.76 Male Hispanic American 68.61 1106.5611122 Liverpool, CA 92503 3429 North E. Street 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, Vacation/ Holiday: $155.84/$4.87, Pension: $268.80/$8.40, Health & Welfare: $256. 00/$8.00, Contract Compliance: $9.60/$0.30 0 0Landscape Irrigation Labor 0 Miguel de Jesus Guillen Villanueva 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 0.00 251.42 855.14 549256183 0.00 11.07 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 1106.56 63826 Other Deduction Detail: SDI: 11.07 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 48.1 La Quinta SilverRock Park Venue La Quinta SilverRock Resort09/12/2020 2016-08/2016-08 6 7 8 9 10 11 12 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 Jacinto, CA 92583 258 W. 7th St., Spc. 80 Fringe Detail: Annuity: $29.12/$0.91, Training Fund: $22.40/$0.70, Pension: $268.80/$8.40, Health & Welfare: $256.00/$8.00, Administrative Fund: $1.92/$0.06, Indust. Stab.Fund: $3.84/$0.12, Contract Compliance: $9. 60/$0.30, Vacation: $155.84/$4.87 0 0Landscape Irrigation Labor 6 Jose Gutierrez S D 0 8.00 00000 8.00 8.0008.00 0 34.5832.00 0.00 0.00 0.000.00 0.00 9.29 16.04 0.00 105.00 1001.56 571210268 0.00 11.06 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 1106.56 63814 Other Deduction Detail: SDI: 11.06 Male Hispanic American 41.19 649.36 Desert Hot Springs, CA 92240 66886 Camino Idilio Fringe Detail: Health & Welfare: $91.60/$9.16, Pension: $3.80/$0.38, Training Fund: $14.10/$1.41, Other: $10.70/$1.07 0 0Landscape Irrigation Labor 5 Luis F. Lopez Quintero S D 0 0 00000 1.00 1.0008.00 0 20.7610.00 0.00 0.00 0.000.00 27.00 12.11 9.63 0.00 96.58 552.78 164777350 0.00 6.65 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 207.60 Apprentice Level 2 63817 Other Deduction Detail: SDI: 6.65 Male 40.26 649.36 Thermal, CA 92274 55550 Tyler St. Space #3 Fringe Detail: Health & Welfare: $21.20/$2.65, Pension: $8.00/$1.00, Annuity: $2.80/$0.35, Vacation: $8.24/$1.03 0 0Landscape Irr. Tender 5 Juan LopezMendez S D 0 0 00000 0 008.00 0 15.538.00 0.00 0.00 0.000.00 1.00 0.00 9.42 0.00 57.18 592.18 620099088 0.00 6.50 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 124.24 63817 Other Deduction Detail: SDI: 6.50 Male 72.57 1170.56 Desert Hot Springs, CA 92240 66886 Camino Idilio Fringe Detail: Health & Welfare: $64.00/$8.00, Pension: $67.20/$8.40, Annuity: $7.28/$0.91, Vacation: $38.96/$4.87, Training Fund: $5.60/$0.70, Contract Compliance: $2.40/$0.30, Administrative Fund: $0.48/$0.06, Indust. Stab.Fund: $0.96/$0.12 0 0Landscape Irrigation Labor 5 Felipe Lopez S D 0 0 00000 0 008.00 0 36.588.00 0.00 0.00 0.000.00 56.00 9.52 16.97 0.00 166.77 1003.79 604137146 0.00 11.71 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 292.64 63795 Other Deduction Detail: SDI: 11.71 Male 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 48.1 La Quinta SilverRock Park Venue La Quinta SilverRock Resort09/12/2020 2016-08/2016-08 6 7 8 9 10 11 12 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. 48.05 774.96 Coachella, CA 92236 84711 Ave 51 Apt G104 Fringe Detail: Annuity: $7.00/$0.35, Pension: $20.00/$1.00, Vacation/ Holiday: $20.60/$1.03, Health & Welfare: $53.00/$2.65 0 0Landscape Irr. Tender 2 Antonio Garcia Marco S D 0 0 00000 8.00 8.0004.00 0 18.0020.00 0.00 0.00 0.000.00 38.00 4.32 11.23 0.00 109.35 665.61 641513170 0.00 7.75 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 360.00 63821 Other Deduction Detail: SDI: 7.75 48.05 774.96 Coachella, CA 92236 84711 Ave 51 Apt G104 Fringe Detail: Health & Welfare: $64.00/$8.00, Pension: $67.20/$8.40, Annuity: $7.28/$0.91, Vacation/ Holiday: $38.96/$4.87, Training Fund: $5.60/$0.70, Contract Compliance: $2.40/$0.30, Administrative Fund: $0.48/$0.06, Indust. Stab.Fund: $0.96/$0.12 0 0Landscape Irrigation Labor 2 Antonio Garcia Marco S D 0 8.00 00000 0 000 0 34.588.00 0.00 0.00 0.000.00 38.00 4.32 11.23 0.00 109.35 665.61 641513170 0.00 7.75 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 276.64 63821 Other Deduction Detail: SDI: 7.75 68.61 1106.56 Thermal, CA 92274 55550 Tyler St Space #3 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, Vacation/ Holiday: $155.84/$4.87, Health & Welfare: $268.80/$8.40, Pension: $256. 00/$8.00, Contract Compliance: $9.60/$0.30 0 0Landscape Irrigation Labor 4 L Sanchez Miguel S D 0 8.00 00000 8.00 8.0008.00 0 34.5832.00 0.00 0.00 0.000.00 81.00 35.38 16.05 0.00 212.10 894.46 622987861 0.00 11.06 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 1106.56 63827 Other Deduction Detail: SDI: 11.06 42.00 677.52 Corona, CA 92879 4143 Moody Fringe Detail: Annuity: $14.56/$0.91, Training Fund: $11.20/$0.70, Administrative Fund: $0.96/$0.06, Indust. Stab.Fund: $1.92/$0.12, Vacation/ Holiday: $77.92/$4.87, Health & Welfare: $134.40/$8.40, Pension: $128.00/$8.00, Contract Compliance: $4.80/$0.30 0 0Landscape Irrigation Labor 2 Cruz Nabor S D 0 0 00000 8.00 8.0000 0 34.5816.00 0.00 0.00 0.000.00 28.00 10.11 9.82 0.00 96.70 580.82 555291126 0.00 6.77 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 553.28 63830 Other Deduction Detail: SDI: 6.77 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 48.1 La Quinta SilverRock Park Venue La Quinta SilverRock Resort09/12/2020 2016-08/2016-08 6 7 8 9 10 11 12 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. 42.00 677.52 Corona, CA 92879 4143 Moody Fringe Detail: Annuity: $2.80/$0.35, Health & Welfare: $21.20/$2.65, Vacation/ Holiday: $8.24/$1.03, Pension: $8.00/$1.00 0 0Landscape Irr. Tender 2 Cruz Nabor S D 0 8.00 00000 0 000 0 15.538.00 0.00 0.00 0.000.00 28.00 10.11 9.82 0.00 96.70 580.82 555291126 0.00 6.77 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 124.24 63830 Other Deduction Detail: SDI: 6.77 52.44 845.92 Hemet, CA 92543 1327 Palomino Court Fringe Detail: Health & Welfare: $128.00/$8.00, Pension: $134.40/$8.40, Annuity: $14.56/$0.91, Vacation: $77.92/$4.87, Training Fund: $11.20/$0.70, Contract Compliance: $4.80/$0.30, Administrative Fund: $0.96/$0.06, Indust. Stab.Fund: $1.92/$0.12 0 0Landscape Irrigation Labor 1 Jose F. Ortiz S D 0 8.00 00000 8.00 000 0 34.5816.00 0.00 0.00 0.000.00 57.00 22.85 12.27 0.00 153.02 692.90 573495026 0.00 8.46 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 553.28 63813 Other Deduction Detail: SDI: 8.46 Male Hispanic American 52.44 845.92 Hemet, CA 92543 1327 Palomino Court Fringe Detail: Health & Welfare: $64.00/$8.00, Pension: $67.20/$8.40, Annuity: $7.28/$0.91, Vacation: $38.96/$4.87, Training Fund: $5.60/$0.70, Contract Compliance: $2.40/$0.30, Administrative Fund: $0.48/$0.06, Indust. Stab.Fund: $0.96/$0.12 0 0Landscape Irrigation Labor 1 Jose F. Ortiz S D 0 0 00000 0 8.0000 0 36.588.00 0.00 0.00 0.000.00 57.00 22.85 12.27 0.00 153.02 692.90 573495026 0.00 8.46 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 292.64 63813 Other Deduction Detail: SDI: 8.46 Male Hispanic American 33.72 544.00 Coachella, CA 92236 51285 Frederick St Fringe Detail: Annuity: $11.20/$0.35, Vacation: $32.96/$1.03, Pension: $32.00/$1.00, Health & Welfare: $84.80/$2.65 0 0Landscape Irr. Tender 3 Otoniel A. Penalosa S D 0 8.00 00000 8.00 8.0008.00 0 17.0032.00 0.00 0.00 0.000.00 7.00 0.00 7.89 0.00 54.05 489.95 621666061 0.00 5.44 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 544.00 63833 Other Deduction Detail: SDI: 5.44 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 48.1 La Quinta SilverRock Park Venue La Quinta SilverRock Resort09/12/2020 2016-08/2016-08 6 7 8 9 10 11 12 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. 71.09 1146.56 Indio, CA 92201 81921 Victoria St. Fringe Detail: Administrative Fund: $0.48/$0.06, Pension: $67.20/$8.40, Annuity: $7.28/$0.91, Vacation: $38.96/$4.87, Contract Compliance: $2.40/$0.30, Indust. Stab.Fund: $0.96/$0.12, Health & Welfare: $64.00/$8.00, Training Fund: $5.60/$0.70 0 0Landscape Irrigation Labor 0 Gerardo Saldivar Mejia S D 0 0 00000 0 4.0004.00 0 34.588.00 0.00 0.00 0.000.00 103.00 21.37 16.62 0.00 223.54 923.02 607068060 0.00 11.46 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 276.64 63798 Other Deduction Detail: SDI: 11.46 Male Hispanic American 71.09 1146.56 Indio, CA 92201 81921 Victoria St. Fringe Detail: Administrative Fund: $0.96/$0.06, Pension: $134.40/$8.40, Annuity: $14.56/$0.91, Vacation: $77.92/$4.87, Contract Compliance: $4.80/$0.30, Indust. Stab.Fund: $1.92/$0.12, Health & Welfare: $128.00/$8.00, Training Fund: $11.20/$0.70 0 0Landscape Irrigation Labor 0 Gerardo Saldivar Mejia S D 0 8.00 00000 8.00 000 0 36.5816.00 0.00 0.00 0.000.00 103.00 21.37 16.62 0.00 223.54 923.02 607068060 0.00 11.46 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 585.28 63798 Other Deduction Detail: SDI: 11.46 Male Hispanic American 76.29 1230.40 Lake Elsinore, CA 92530 15212 Lincoln St. #A Fringe Detail: Training Fund: $32.00/$1.00, Pension: $340.80/$10.65, Health & Welfare: $366.40/$11.45, Vacation/ Holiday: $113.60/$3.55, Other: $4.80/$0.15 0 0Landscape Oper. Eng 4 Jose D. Sandoval Becerra S D 0 8.00 00000 8.00 8.0008.00 0 38.4532.00 0.00 0.00 0.000.00 0.00 17.32 17.85 0.00 123.76 1106.64 612336635 0.00 12.30 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 1230.40 63812 Other Deduction Detail: SDI: 12.30 Male Hispanic American 31.74 512.00 Lake Elsinore, CA 92530 15212 Lincoln St. #A Fringe Detail: Annuity: $11.20/$0.35, Pension: $32.00/$1.00, Vacation: $32.96/$1.03, Health & Welfare: $84.80/$2.65 0 0Landscape Irr. Tender 0 Jose A. Sandoval S D 0 8.00 00000 8.00 8.0008.00 0 16.0032.00 0.00 0.00 0.000.00 29.00 7.99 7.42 0.00 81.27 430.73 603024821 0.00 5.12 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 512.00 4272 Other Deduction Detail: SDI: 5.12 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 48.1 La Quinta SilverRock Park Venue La Quinta SilverRock Resort09/12/2020 2016-08/2016-08 6 7 8 9 10 11 12 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. 33.72 544.00 San Jacinto, CA 92583 258 W 7th Street Spc 80 Fringe Detail: Annuity: $11.20/$0.35, Pension: $32.00/$1.00, Health & Welfare: $84.80/$2.65, Vacation/ Holiday: $32.96/$1.03 0 0Landscape Irr. Tender 2 Carrillo Sergio S D 0 8.00 00000 8.00 8.0008.00 0 17.0032.00 0.00 0.00 0.000.00 0.00 3.74 7.89 0.00 50.79 493.21 626545633 0.00 5.44 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 544.00 63839 Other Deduction Detail: SDI: 5.44 26.96 434.84 Mecca, CA 92203 91889 Montenegro Dr. Fringe Detail: Pension: $28.00/$1.00, Vacation/ Holiday: $28.84/$1.03, Annuity: $9.80/$0.35, Health & Welfare: $74.20/$2.65 0 0Landscape Irr. Tender 0 Cesar Torres S D 0 4.00 00000 8.00 8.0008.00 0 15.5328.00 0.00 0.00 0.000.00 0.00 3.20 6.31 0.00 104.82 330.02 604246965 0.00 68.35 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 434.84 63789 Other Deduction Detail: SDI: 4.35, Supplemental Dues: 64.00 Male Hispanic American 51.46 829.92 San Bernardino, CA 92404 1659 McKinley Ave. Fringe Detail: Annuity: $21.84/$0.91, Training Fund: $16.80/$0.70, Health & Welfare: $192.00/$8.00, Pension: $201.60/$8.40, Contract Compliance: $7.20/$0.30, Administrative Fund: $1.44/$0.06, Vacation/ Holiday: $116. 88/$4.87, Indust. Stab.Fund: $2.88/$0.12 0 0Landscape Irrigation Labor 2 Gustavo Torres S D 0 8.00 00000 0 8.0008.00 0 34.5824.00 0.00 0.00 0.000.00 0.00 2.95 12.04 0.00 74.75 755.17 604924822 0.00 8.30 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 829.92 63800 Other Deduction Detail: SDI: 8.30 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 48.1 La Quinta SilverRock Park Venue La Quinta SilverRock Resort09/12/2020 2016-08/2016-08 6 7 8 9 10 11 12 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 #48.1, Contractor License # 963744, Workers Compensation Policy # URWC004126 Urban Habitat 6th Other October 4th, 2020 Urban Habitat 2020 2020SeptemberSeptember12th - * 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, Supplemental Dues 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.