Urban_Habitat_47.0_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
47.0 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.
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
47.0 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.
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: 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/ Holiday: $38.96/$4.87, Health & Welfare: $67.
20/$8.40, Pension: $64.00/$8.00
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
47.0 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.
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
47.0 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.
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
53.62
864.96
Desert Hot Springs, CA 92240
66886 Camino Idilio
Fringe Detail: Health & Welfare: $224.00/$5.60, Pension: $67.20/$1.68, Vacation/ Holiday: $136.40/$3.41, Annuity: $36.40/$0.91, Training Fund: $28.00/$0.70, Contract Compliance: $12.00/$0.30, Indust. Stab.Fund: $3.
20/$0.08, Administrative Fund: $2.40/$0.06, Other: $6.80/$0.17
0
0Landscape Irrigation
Labor
4
Felipe Lopez Luis
S
D 0
8.00
00000
8.00 8.008.00 8.00 0 21.6640.00
0.00
0.00
0.000.00
47.00 21.82 12.54
0.00
143.62 721.34
164777350
0.00
8.64
1)
2)
3)O 0 0 0 0 0 0 0 0.00 0.00 0.00
866.40
Apprentice Level 2 6375663847
Other Deduction Detail: SDI: 8.64
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
47.0 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.
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
53.99
870.72
Thermal, CA 92274
55550 Tyler St Sp#3
Fringe Detail: Annuity: $36.40/$0.91, Health & Welfare: $224.00/$5.60, Pension: $67.20/$1.68, Vacation/ Holiday: $136.40/$3.41, Training Fund: $28.00/$0.70, Contract Compliance: $12.00/$0.30, Indust. Stab.Fund: $3.
20/$0.08, Administrative Fund: $2.40/$0.06, Other: $6.80/$0.17
0
0Landscape Irrigation
Labor
5
P Cortez Maurilio
S
D 0
8.00
00000
8.00 8.008.00 8.00 0 21.6640.00
0.00
0.00
0.000.00
19.00 0.00 12.62
0.00
94.32 776.40
604521749
0.00
8.71
1)
2)
3)O 0 0 0 0 0 0 0 0.00 0.00 0.00
866.40
Apprentice 2.00%6376163848
Other Deduction Detail: SDI: 8.71
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
47.0 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.
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
47.0 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.
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
47.0 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.
Contract #2016-08, Wage Decision #CA-SC-UH Mod 0 10/01/19,Payroll #47, Contractor
License # 963744, Workers Compensation Policy # URWC004126
Urban Habitat
30th
President
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, President
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