Loading...
Urban_Habitat__69.2_2-6-2123.81 384.00 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 16.0024.00 0.00 0.00 0.000.00 6.00 0.00 5.57 0.00 39.99 344.01 616926918 0.00 4.61 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 384.00 65000 Other Deduction Detail: SDI: 4.61 Male Hispanic American 36.44 587.73 Coachella, CA 92236 48522 Playa del Amor Fringe Detail: Annuity: $2.625/$0.35, Health & Welfare: $19.875/$2.65, Pension: $7.50/$1.00, Vacation: $7.725/$1.03 0 0Landscape Irr. Tender 0 Daniel Alfaro S D 0 0 00000 7.50 000 0 15.537.50 0.00 0.00 0.000.00 0.00 0.00 8.52 0.00 52.01 535.72 633876688 0.00 7.05 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 116.47 65006 Other Deduction Detail: SDI: 7.05 Male Hispanic American 35.50 57257.00 Moreno Valley, CA 92553 25938 Delphinium Ave. Fringe Detail: Health & Welfare: $124.00/$8.00, Pension: $144.305/$9.31, Training Fund: $10.85/$0.70, Vacation: $75.485/$4.87, Other: $9.455/$0.61 0 0Laborer: Group 2 0 Luis E. Barrera S D 0 0 00000 0 07.50 8.00 0 36.9415.50 0.00 0.00 0.000.00 7.00 0.00 8.30 0.00 57.67 57199.33 616935284 0.00 6.87 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 572.57 65033 Other Deduction Detail: SDI: 6.87 Male Hispanic American 35.50 572.57 Moreno Valley, CA 92553 25938 Delphinium Ave. Fringe Detail: Training Fund: $10.85/$0.70, Health & Welfare: $124.00/$8.00, Pension: $144.305/$9.31, Vacation: $75.485/$4.87, Other: $9.455/$0.61 0 0Laborer: Group 2 0 Luis E. Barrera, Jr. S D 0 0 00000 0 07.50 8.00 0 36.9415.50 0.00 0.00 0.000.00 7.00 2.58 8.30 0.00 60.25 512.32 627569056 0.00 6.87 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 572.57 65034 Other Deduction Detail: SDI: 6.87 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 69.2 La Quinta SilverRock Park Venue La Quinta SilverRock Resort02/06/2021 2016-08/2016-08 31 1 2 3 4 5 6 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. 50.92 821.28 Ontario, CA 91762 1015 W. Flora St. Fringe Detail: Annuity: $14.56/$0.91, Training Fund: $11.20/$0.70, Health & Welfare: $128.00/$8.00, Pension: $134.40/$8.40, Vacation: $77.92/$4.87, Contract Compliance: $4.80/$0.30, Administrative Fund: $0.96/$0.06, Indust. Stab.Fund: $1.92/$0.12 0 0Landscape Irrigation Labor 0 Espiridion Bautista S D 0 8.00 00000 0 8.0000 0 34.5816.00 0.00 0.00 0.000.00 56.00 20.75 11.91 0.00 149.43 671.85 673039037 0.00 9.85 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 553.28 65011 Other Deduction Detail: SDI: 9.85 Male Hispanic American 16.61 267.75 Corona, CA 92879 4143 Moody Fringe Detail: Annuity: $2.712/$0.35, Health & Welfare: $20.46/$2.64, Pension: $7.75/$1.00, Vacation: $7.982/$1.03 0 0Landscape Irr. Tender 2 Nabor Cruz S D 0 0 00000 7.75 000 0 16.007.75 0.00 0.00 0.000.00 0.00 0.00 3.88 0.00 23.70 244.05 555291126 0.00 3.21 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 124.00 65044 Other Deduction Detail: SDI: 3.21 Male 85.22 1374.56 Temecula, CA 92592 30240 Miraloma Dr. Fringe Detail: Annuity: $36.172/$0.91, Training Fund: $27.825/$0.70, Administrative Fund: $2.385/$0.06, Indust. Stab.Fund: $4.77/$0.12, Contract Compliance: $11.925/$0.30, Vacation: $193.583/$4.87, Health & Welfare: $333.90/$8.40, Pension: $318.00/$8.00 0 0Landscape Irrigation Labor 0 Oscar Diaz S D 0 8.00 00000 7.75 8.008.00 8.00 0 34.5839.75 0.00 0.00 0.000.00 51.00 65.58 19.93 0.00 238.23 1136.33 615121373 0.00 16.50 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 1374.55 65047 Other Deduction Detail: SDI: 16.50 Male Hispanic American 36.04 581.22 Coachella, CA 92236 84711 Ave. 51 Fringe Detail: Annuity: $8.19/$0.91, Health & Welfare: $72.00/$8.00, Pension: $75.60/$8.40, Vacation/ Holiday: $43.83/$4.87, Administrative Fund: $0.54/$0.06, Contract Compliance: $2.70/$0.30, Training Fund: $6.30/$0.70, Indust. Stab.Fund: $1.08/$0.12 0 0Landscape Irrigation Labor 2 Marco A. Garcia Alonso S D 0 1.00 00000 8.00 000 0 34.589.00 0.00 0.00 0.000.00 18.00 0.00 8.42 0.00 69.43 511.79 641513170 0.00 6.97 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 311.22 65000037 Other Deduction Detail: SDI: 6.97 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 69.2 La Quinta SilverRock Park Venue La Quinta SilverRock Resort02/06/2021 2016-08/2016-08 31 1 2 3 4 5 6 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. 63.59 1025.68 Indio, CA 92203 41345 Noyes Crt. Fringe Detail: Vacation: $122.08/$7.63, Health & Welfare: $128.00/$8.00, Pension: $134.40/$8.40, Annuity: $14.56/$0.91, Training Fund: $11.20/$0.70, Contract Compliance: $4.80/$0.30, Indust. Stab.Fund: $1.28/$0.08, Other: $1.12/$0.07, Administrative Fund: $0.96/$0.06 0 0Cement Mason 0 Ruben Gonzalez S D 0 8.00 00000 8.00 000 0 38.5016.00 0.00 0.00 0.000.00 0.00 0.28 14.88 0.00 91.06 934.62 608268512 0.00 12.31 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 616.00 65054 Other Deduction Detail: SDI: 12.31 Male Hispanic American 52.99 854.67 San Jacinto, CA 92583 258 W. 7th St., Spc. 80 Fringe Detail: Annuity: $8.00/$0.25, Training Fund: $53.12/$1.66, Pension: $143.04/$4.47, Health & Welfare: $144.00/$4.50, Administrative Fund: $1.92/$0.06, Indust. Stab.Fund: $2.56/$0.08, Contract Compliance: $9. 60/$0.30, Vacation: $40.32/$1.26 0 0Landscape Irrigation Labor 0 Jose Gutierrez S D 0 8.00 00000 0 8.008.00 8.00 0 21.3032.00 0.00 0.00 0.000.00 0.00 0.64 12.39 0.00 76.28 778.39 571210268 0.00 10.26 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 681.60 Apprentice Level 2 6500027 Other Deduction Detail: SDI: 10.26 Male Hispanic American 91.72 1479.44 Coachella, CA 92236 85687 Guadalupana Ct. Fringe Detail: Health & Welfare: $264.64/$8.27, Pension: $315.52/$9.86, Vacation: $228.608/$7.144, Training Fund: $20.48/$0.64, Other: $7.68/$0.24 0 0Cement Mason 0 Jose A. Lagunes Medina S D 0 8.00 00000 8.00 08.00 8.00 0 38.5032.00 0.00 0.00 0.000.00 0.00 30.74 21.45 0.00 161.66 1317.78 805817125 0.00 17.75 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 1232.00 65023 Other Deduction Detail: SDI: 17.75 Male Hispanic American 41.69 672.38 Cathedral City, CA 92234 68805 Cedar Rd. Fringe Detail: Annuity: $0.875/$0.35, Health & Welfare: $6.625/$2.65, Vacation: $2.575/$1.03, Pension: $2.50/$1.00 0 0Landscape Irr. Tender 0 Saul Linares S D 0 0 00000 2.50 000 0 16.502.50 0.00 0.00 0.000.00 0.00 0.00 9.75 0.00 59.50 612.88 602043293 0.00 8.06 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 41.25 65056 Other Deduction Detail: SDI: 8.06 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 69.2 La Quinta SilverRock Park Venue La Quinta SilverRock Resort02/06/2021 2016-08/2016-08 31 1 2 3 4 5 6 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. 42.16 679.97 Hemet, CA 92544 40400 Newport Rd. Fringe Detail: Health & Welfare: $72.00/$8.00, Pension: $75.60/$8.40, Vacation: $43.83/$4.87, Annuity: $8.19/$0.91, Administrative Fund: $0.54/$0.06, Indust. Stab.Fund: $1.08/$0.12, Contract Compliance: $2.70/$0.30, Training Fund: $6.30/$0.70 0 0Landscape Irrigation Labor 1 Martin Mercado S D 0 1.25 00000 7.75 000 0 34.589.00 0.00 0.00 0.000.00 36.00 12.55 9.86 0.00 108.73 571.24 621104173 0.00 8.16 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 311.22 65039 Other Deduction Detail: SDI: 8.16 Male 72.03 1161.82 Coachella, CA 92236 49072 Brianne Lane Fringe Detail: Vacation: $181.213/$7.63, Health & Welfare: $190.00/$8.00, Pension: $199.50/$8.40, Annuity: $21.613/$0.91, Training Fund: $16.625/$0.70, Cooperation Comm.: $7.125/$0.30, Indust. Stab.Fund: $1.90/$0.08, Administrative Fund: $1.425/$0.06, Other: $1.663/$0.07 0 0Cement Mason 0 Daniel A. Ochoa S D 0 8.00 00000 7.75 008.00 0 38.5023.75 0.00 0.00 0.000.00 52.00 19.01 16.84 0.00 173.82 988.00 609984392 0.00 13.94 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 914.37 65007 Other Deduction Detail: SDI: 13.94 Male Hispanic American 36.79 593.47 Desert Hot Springs, CA 92240 15225 Palm Drive Space #11 Fringe Detail: Vacation: $2.575/$1.03, Pension: $2.50/$1.00, Annuity: $0.875/$0.35, Health & Welfare: $6.625/$2.65 0 0Landscape Irr. Tender 1 Guadalupe Pacheco S D 0 0 00000 2.50 000 0 15.532.50 0.00 0.00 0.000.00 28.00 4.71 8.60 0.00 85.22 508.25 579481023 0.00 7.12 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 38.82 65016 Other Deduction Detail: SDI: 7.12 Male 88.25 1423.43 Coachella, CA 92236 52821 Calle Joyce Fringe Detail: Vacation: $242.252/$7.63, Health & Welfare: $254.00/$8.00, Pension: $266.70/$8.40, Annuity: $28.893/$0.91, Training Fund: $22.225/$0.70, Contract Compliance: $9.525/$0.30, Indust. Stab.Fund: $2.54/$0.08, Other: $2.223/$0.07, Administrative Fund: $1.905/$0.06 0 0Cement Mason 0 Jesus J. Perez Vazquez S D 0 8.00 00000 7.75 08.00 8.00 0 38.5031.75 0.00 0.00 0.000.00 9.00 22.66 20.64 0.00 157.63 1265.80 607900677 0.00 17.08 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 1222.37 65022 Other Deduction Detail: SDI: 17.08 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 69.2 La Quinta SilverRock Park Venue La Quinta SilverRock Resort02/06/2021 2016-08/2016-08 31 1 2 3 4 5 6 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. 36.12 582.58 Indio, CA 92201 45903 Deglet Noor Fringe Detail: Pension: $2.50/$1.00, Vacation: $2.575/$1.03, Health & Welfare: $6.625/$2.65, Annuity: $0.875/$0.35 0 0Landscape Irr. Tender 0 Blanca Perez S D 0 0 00000 2.50 000 0 15.532.50 0.00 0.00 0.000.00 0.00 0.00 8.45 0.00 51.56 531.02 582192373 0.00 6.99 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 38.82 65002 Other Deduction Detail: SDI: 6.99 Female Hispanic American 87.15 1405.54 Riverside, CA 92509 9247 52nd St. Fringe Detail: Administrative Fund: $3.36/$0.12, Training Fund: $19.60/$0.70, Annuity: $25.48/$0.91, Indust. Stab.Fund: $1.68/$0.06, Contract Compliance: $8.40/$0.30, Health & Welfare: $224.00/$8.00, Pension: $235. 20/$8.40, Vacation: $136.36/$4.87 0 0Landscape Irrigation Labor 3 Israel Rincon Garcia S D 0 8.00 00000 0 8.004.00 8.00 0 34.5828.00 0.00 0.00 0.000.00 24.00 25.80 20.38 0.00 174.20 1231.34 610134793 0.00 16.87 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 968.24 65017 Other Deduction Detail: SDI: 16.87 Male 87.15 1405.54 Riverside, CA 92509 9247 52nd St. Fringe Detail: Health & Welfare: $45.80/$11.45, Pension: $42.60/$10.65, Training Fund: $4.00/$1.00, Vacation: $14.20/$3.55, Other: $60.00/$15.00 0 0Landscape Oper. Eng 3 Israel Rincon Garcia S D 0 0 00000 0 04.00 0 0 38.454.00 0.00 0.00 0.000.00 24.00 25.80 20.38 0.00 174.20 1231.34 610134793 0.00 16.87 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 153.80 65017 Other Deduction Detail: SDI: 16.87 Male 90.71 1463.20 Indio, CA 92201 81921 Victoria St. Fringe Detail: Administrative Fund: $1.92/$0.06, Pension: $268.80/$8.40, Annuity: $29.12/$0.91, Vacation: $155.84/$4.87, Contract Compliance: $9.60/$0.30, Indust. Stab.Fund: $3.84/$0.12, Health & Welfare: $256.00/$8.00, Training Fund: $22.40/$0.70 0 0Landscape Irrigation Labor 0 Gerardo Saldivar Mejia S D 0 8.00 00000 0 8.008.00 8.00 0 36.5832.00 0.00 0.00 0.000.00 140.00 40.09 21.22 0.00 309.58 1153.62 607068060 0.00 17.56 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 1170.56 65015 Other Deduction Detail: SDI: 17.56 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 69.2 La Quinta SilverRock Park Venue La Quinta SilverRock Resort02/06/2021 2016-08/2016-08 31 1 2 3 4 5 6 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. 42.45 684.64 Thermal, CA 92274 56725 Harrison St. Fringe Detail: Health & Welfare: $63.60/$2.65, Pension: $24.00/$1.00, Vacation: $24.72/$1.03, Annuity: $8.40/$0.35 0 0Landscape Irr. Tender 0 Rafael Sanchez Garcia S D 0 8.00 00000 0 8.0008.00 0 17.0024.00 0.00 0.00 0.000.00 46.00 7.39 9.93 0.00 145.99 538.65 614126878 0.00 40.22 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 408.00 65052 Other Deduction Detail: SDI: 40.22 Male Hispanic American 84.66 1365.49 Lake Elsinore, CA 92530 15212 Lincoln St. #A Fringe Detail: Training Fund: $32.75/$1.00, Pension: $348.788/$10.65, Health & Welfare: $374.987/$11.45, Vacation/ Holiday: $116.262/$3.55, Other: $4.912/$0.15 0 0Landscape Oper. Eng 0 Jose D. Sandoval Becerra S D 0 3.75 00000 7.75 7.757.75 5.75 0 38.4532.75 0.00 0.00 0.000.00 12.00 22.73 19.84 0.00 155.62 1209.87 612336635 0.00 16.39 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 1259.23 65026 Other Deduction Detail: SDI: 16.39 Male Hispanic American 36.70 592.00 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 3.00 00000 7.75 7.757.75 5.75 0 16.0032.00 0.00 0.00 0.000.00 38.00 11.31 8.58 0.00 101.69 490.31 603024821 0.00 7.10 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 512.00 65000024 Other Deduction Detail: SDI: 7.10 Male Hispanic American 23.56 380.00 Ontario, CA 91762 1015 W. Flora St. Fringe Detail: Vacation: $16.48/$1.03, Pension: $16.00/$1.00, Health & Welfare: $42.40/$2.65, Annuity: $5.60/$0.35 0 0Landscape Irr. Tender 0 Enrique Santana S D 0 8.00 00000 0 8.0000 0 16.0016.00 0.00 0.00 0.000.00 0.00 0.00 5.51 0.00 33.63 346.37 611235342 0.00 4.56 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 256.00 65010 Other Deduction Detail: SDI: 4.56 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 69.2 La Quinta SilverRock Park Venue La Quinta SilverRock Resort02/06/2021 2016-08/2016-08 31 1 2 3 4 5 6 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. 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 69.2 La Quinta SilverRock Park Venue La Quinta SilverRock Resort02/06/2021 2016-08/2016-08 31 1 2 3 4 5 6 Medicare SUN MON TUE WED THU FRI SAT CA-SC-UHWage Det: Check No. Sex Race 39.17 631.88 Palm Springs, CA 92262 2950 N. Indian Fringe Detail: Vacation: $7.725/$1.03, Pension: $7.50/$1.00, Health & Welfare: $19.875/$2.65, Annuity: $2.625/$0.35 0 0Landscape Irr. Tender 0 Jose Sarabia S D 0 0 00000 7.50 000 0 15.537.50 0.00 0.00 0.000.00 33.00 10.44 9.16 0.00 99.35 532.53 609063372 0.00 7.58 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 116.47 65025 Other Deduction Detail: SDI: 7.58 Male Hispanic American 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 #69.2, Contractor License # 963744, Workers Compensation Policy # URWC104739 Urban Habitat 31st Other March 11th, 2021 Urban Habitat 2021 2021FebruaryJanuary6th - * 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.