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Urban_Habitat_49.0_9-19-2044.64 720.00San 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 0 00000 0 08.00 8.00 0 18.0016.00 0.00 0.00 0.000.00 24.00 0.53 10.44 0.00 118.81 601.19 613161995 0.00 39.20 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 288.00 4273 Other Deduction Detail: SDI: 7.20, Supplemental Dues: 32.00 Male Hispanic American 26.73 431.26 Apple Valley, CA 92307 20715 Stoddard Wells Rd. Fringe Detail: Health & Welfare: $56.00/$8.00, Pension: $58.80/$8.40, Annuity: $6.37/$0.91, Vacation: $34.09/$4.87, Training Fund: $4.90/$0.70, Contract Compliance: $2.10/$0.30, Administrative Fund: $0.42/$0.06, Indust. Stab.Fund: $0.84/$0.12 0 0Landscape Irrigation Labor 4 Daniel J. Carver S D 0 0 00000 0 007.00 0 34.587.00 0.00 0.00 0.000.00 0.00 0.00 6.25 0.00 37.30 393.96 270717343 0.00 4.32 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 242.06 63858 Other Deduction Detail: SDI: 4.32 Male Caucasian 79.55 1283.10 Apple Valley, CA 92308 20250 Itasca Rd. Fringe Detail: Health & Welfare: $217.14/$9.87, Pension: $217.14/$9.87, Vacation: $106.48/$4.84, Training Fund: $33.00/$1.50, Annuity: $5.50/$0.25, Contract Compliance: $6.60/$0.30, Administrative Fund: $1.32/$0.06, Indust. Stab.Fund: $2.64/$0.12 0 0Landscape Oper. Eng 2 Cameron D. Cleland S D 0 0 00000 7.00 8.0007.00 0 38.4522.00 0.00 0.00 0.000.00 99.00 23.83 18.60 0.00 233.81 1049.29 565931366 0.00 12.83 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 845.90 63854 Other Deduction Detail: SDI: 12.83 Male Caucasian 61.39 990.19 Thermal, CA 92274 68990 Harrison St. Space #101 Fringe Detail: Health & Welfare: $23.85/$2.65, Pension: $9.00/$1.00, Vacation: $9.27/$1.03, Annuity: $3.15/$0.35 0 0Landscape Irr. Tender 5 Pedro J. Clemente S D 0 8.00 00000 0 1.0000 0 15.539.00 0.00 0.00 0.000.00 35.00 1.59 14.36 0.00 154.24 835.95 657090571 0.00 41.90 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 139.77 63898 Other Deduction Detail: Supplemental Dues: 32.00, SDI: 9.90 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 49.0 La Quinta SilverRock Park Venue La Quinta SilverRock Resort09/19/2020 2016-08/2016-08 13 14 15 16 17 18 19 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. 57.25 923.43 Thermal, CA 92274 55550 Tyler St. Fringe Detail: Training Fund: $12.78/$1.42, Annuity: $4.59/$0.51, Pension: $75.60/$8.40, Contract Compliance: $2.70/$0.30, Indust. Stab.Fund: $0.72/$0.08, Administrative Fund: $0.54/$0.06, Health & Welfare: $67.23/$7.47, Vacation: $11.97/$1.33 0 0Landscape Irrigation Labor 5 Maurilio P. Cortez S D 0 8.00 00000 0 1.0000 0 24.169.00 0.00 0.00 0.000.00 28.00 0.00 13.39 0.00 107.87 815.56 604521749 0.00 9.23 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 217.44 Apprentice Level 3 63887 Other Deduction Detail: SDI: 9.23 Male Hispanic American 39.56 638.00 Corona, CA 92879 4143 Moody Fringe Detail: Annuity: $7.28/$0.91, Training Fund: $5.60/$0.70, Health & Welfare: $64.00/$8.00, Vacation/ Holiday: $38.96/$4.87, Contract Compliance: $2.40/$0.30, Administrative Fund: $0.48/$0.06, Indust. Stab.Fund: $0. 96/$0.12, Pension: $67.20/$8.40 0 0Landscape Irrigation Labor 2 Nabor Cruz S D 0 0 00000 0 08.00 0 0 34.588.00 0.00 0.00 0.000.00 24.00 8.37 9.25 0.00 119.56 518.44 555291126 0.00 38.38 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 276.64 63893 Other Deduction Detail: SDI: 6.38, Supplemental Dues: 32.00 Male 39.56 638.00 Corona, CA 92879 4143 Moody Fringe Detail: Annuity: $2.80/$0.35, Health & Welfare: $21.12/$2.64, Pension: $8.00/$1.00, Vacation: $8.24/$1.03 0 0Landscape Irr. Tender 2 Nabor Cruz S D 0 0 00000 0 008.00 0 15.308.00 0.00 0.00 0.000.00 24.00 8.37 9.25 0.00 119.56 518.44 555291126 0.00 38.38 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 122.40 63893 Other Deduction Detail: SDI: 6.38, Supplemental Dues: 32.00 Male 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, Contract Compliance: $12.00/$0.30, Vacation: $194.80/$4.87, Health & Welfare: $336. 00/$8.40, Pension: $320.00/$8.00 0 0Landscape Irrigation Labor 2 Oscar Diaz 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 20.06 0.00 240.17 1143.03 615121373 0.00 13.84 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 1383.20 63896 Other Deduction Detail: SDI: 13.84 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 49.0 La Quinta SilverRock Park Venue La Quinta SilverRock Resort09/19/2020 2016-08/2016-08 13 14 15 16 17 18 19 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. 60.00 967.84 Coachella, CA 92236 84711 Ave. 51 Fringe Detail: Annuity: $8.40/$0.35, Health & Welfare: $63.60/$2.65, Vacation/ Holiday: $24.72/$1.03, Pension: $24.00/$1.00 0 0Landscape Irr. Tender 2 Marco A. Garcia Alonso S D 0 8.00 00000 8.00 008.00 0 18.0024.00 0.00 0.00 0.000.00 61.00 8.57 14.04 0.00 185.29 782.55 641513170 0.00 41.68 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 432.00 63884 Other Deduction Detail: SDI: 9.68, Supplemental Dues: 32.00 Male Hispanic American 60.00 967.84 Coachella, CA 92236 84711 Ave. 51 Fringe Detail: Annuity: $7.28/$0.91, Health & Welfare: $64.00/$8.00, Pension: $67.20/$8.40, Vacation/ Holiday: $38.96/$4.87, Administrative Fund: $0.48/$0.06, Contract Compliance: $2.40/$0.30, Training Fund: $5.60/$0.70, Indust. Stab.Fund: $0.96/$0.12 0 0Landscape Irrigation Labor 2 Marco A. Garcia Alonso S D 0 0 00000 0 8.0000 0 34.588.00 0.00 0.00 0.000.00 61.00 8.57 14.04 0.00 185.29 782.55 641513170 0.00 41.68 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 276.64 63884 Other Deduction Detail: SDI: 9.68, Supplemental Dues: 32.00 Male Hispanic American 71.21 1148.56 Indio, CA 92201 81-921 Victoria St. Fringe Detail: Annuity: $10.01/$0.91, Training Fund: $7.70/$0.70, Administrative Fund: $0.66/$0.06, Indust. Stab.Fund: $1.32/$0.12, Health & Welfare: $92.40/$8.40, Pension: $88.00/$8.00, Vacation/ Holiday: $53.57/$4.87, Contract Compliance: $3.30/$0.30 0 0Landscape Irrigation Labor 0 Saldivar Mejia Gerardo S D 0 3.00 00000 0 008.00 0 34.5811.00 0.00 0.00 0.000.00 103.00 21.46 16.66 0.00 223.82 924.74 607068060 0.00 11.49 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 380.38 63864 Other Deduction Detail: SDI: 11.49 71.21 1148.56 Indio, CA 92201 81-921 Victoria St. 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, Health & Welfare: $134.40/$8.40, Pension: $128.00/$8.00, Vacation/ Holiday: $77.92/$4.87, Contract Compliance: $4.80/$0.30 0 0Landscape Irrigation Labor 0 Saldivar Mejia Gerardo S D 0 0 00000 8.00 8.0000 0 36.5816.00 0.00 0.00 0.000.00 103.00 21.46 16.66 0.00 223.82 924.74 607068060 0.00 11.49 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 585.28 63864 Other Deduction Detail: SDI: 11.49 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 49.0 La Quinta SilverRock Park Venue La Quinta SilverRock Resort09/19/2020 2016-08/2016-08 13 14 15 16 17 18 19 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. 62.58 1009.2811122 Liverpool, CA 92503 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, Vacation/ Holiday: $77.92/$4.87, Pension: $134.40/$8.40, Health & Welfare: $128.00/$8.00, Contract Compliance: $4.80/$0.30 0 0Landscape Irrigation Labor 0 Miguel de Jesus Guillen Villanueva S D 0 0 00000 0 08.00 8.00 0 34.5816.00 0.00 0.00 0.000.00 89.00 37.14 14.64 0.00 213.45 795.83 549256183 0.00 10.09 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 553.28 63889 Other Deduction Detail: SDI: 10.09 Male Hispanic American 85.76 1383.20 San Jacinto, CA 92583 258 W. 7th St., Spc. 80 Fringe Detail: Annuity: $36.40/$0.91, Training Fund: $28.00/$0.70, Pension: $336.00/$8.40, Health & Welfare: $320.00/$8.00, Administrative Fund: $2.40/$0.06, Indust. Stab.Fund: $4.80/$0.12, Contract Compliance: $12. 00/$0.30, Vacation: $194.80/$4.87 0 0Landscape Irrigation Labor 6 Jose Gutierrez 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 0.00 173.12 1210.08 571210268 0.00 45.84 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 1383.20 63877 Other Deduction Detail: SDI: 45.84 Male Hispanic American 28.65 462.00 Thousand Palms, CA 92276 30700 Sierra del So. Fringe Detail: Vacation: $45.36/$5.67, LECET: $0.72/$0.09, Indust. Stab.Fund: $0.64/$0.08, Training Fund: $3.84/$0.48, Administrative Fund: $0.48/$0.06, Pension: $67.20/$8.40, Annuity: $7.28/$0.91, Supplemental Dues: $15.68/$1.96, Health & Welfare: $64.00/$8.00, Other: $3.44/$0.43 0 0Cement Mason 0 Joe Hernandez, Jr. S D 0 0 00000 0 000 0 38.500.00 0.00 0.00 0.000.00 0.00 1.22 6.70 0.00 41.19 420.81 607366852 0.00 4.62 1) 2) 3)O 0 0 0 0 0 0 8.00 8.00 57.75 0.00 462.00 4275 Other Deduction Detail: SDI: 4.62 Male Hispanic American 95.35 1538.00 Lake Elsinore, CA 92530 15212 Lincoln St A Fringe Detail: Vacation/ Holiday: $142.00/$3.55, Pension: $426.00/$10.65, Training Fund: $40.00/$1.00, Health & Welfare: $458.00/$11.45, Other: $6.00/$0.15 0 0Landscape Oper. Eng 4 A Sando Jose S D 0 8.00 00000 8.00 8.008.00 8.00 0 38.4540.00 0.00 0.00 0.000.00 33.00 32.96 22.30 0.00 198.99 1339.01 603024821 0.00 15.38 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 1538.00 63875 Other Deduction Detail: SDI: 15.38 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 49.0 La Quinta SilverRock Park Venue La Quinta SilverRock Resort09/19/2020 2016-08/2016-08 13 14 15 16 17 18 19 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. 60.43 974.66 Thermal, CA 92274 55550 Tyler St. Space #3 Fringe Detail: Annuity: $2.80/$0.35, Pension: $8.00/$1.00, Vacation/ Holiday: $8.24/$1.03, Health & Welfare: $21.20/$2.65 0 0Landscape Irr. Tender 5 LopezMendez Juan S D 0 8.00 00000 0 000 0 15.538.00 0.00 0.00 0.000.00 33.00 0.97 14.13 0.00 150.03 824.63 620099088 0.00 41.50 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 124.24 63880 Other Deduction Detail: Supplemental Dues: 32.00, SDI: 9.50 49.19 793.43 Desert Hot Springs, CA 92240 66886 Camino Idilio Fringe Detail: Health & Welfare: $119.08/$9.16, Pension: $4.94/$0.38, Training Fund: $18.33/$1.41, Other: $13.91/$1.07 0 0Landscape Irrigation Labor 4 Luis F. Lopez Quintero S D 0 8.00 00000 0 1.0004.00 0 21.3013.00 0.00 0.00 0.000.00 0.00 19.38 11.51 0.00 88.02 705.41 164777350 0.00 7.94 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 276.90 Apprentice Level 2 63883 Other Deduction Detail: SDI: 7.94 Male 92.57 1493.05 Desert Hot Springs, CA 92240 66886 Camino Idilio Fringe Detail: Health & Welfare: $62.00/$8.00, Pension: $65.10/$8.40, Annuity: $7.053/$0.91, Vacation: $37.742/$4.87, Training Fund: $5.425/$0.70, Contract Compliance: $2.325/$0.30, Administrative Fund: $0.465/$0.06, Indust. Stab.Fund: $0.93/$0.12 0 0Landscape Irrigation Labor 5 Felipe Lopez S D 0 0 00000 0.75 2.001.00 4.00 0 34.587.75 0.00 0.00 0.000.00 94.00 30.76 21.65 0.00 253.91 1239.14 604137146 0.00 14.93 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 267.99 63861 Other Deduction Detail: SDI: 14.93 Male 92.57 1493.05 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 8.00 00000 0 000 0 36.588.00 0.00 0.00 0.000.00 94.00 30.76 21.65 0.00 253.91 1239.14 604137146 0.00 14.93 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 292.64 63861 Other Deduction Detail: SDI: 14.93 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 49.0 La Quinta SilverRock Park Venue La Quinta SilverRock Resort09/19/2020 2016-08/2016-08 13 14 15 16 17 18 19 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. 28.65 462.00 Cathedral City, CA 92234 37520 Cathedral Canyon Dr. Fringe Detail: Vacation: $45.36/$5.67, Pension: $67.20/$8.40, LECET: $0.72/$0.09, Annuity: $7.28/$0.91, Indust. Stab.Fund: $0.64/$0.08, Supplemental Dues: $15.68/$1.96, Training Fund: $3.84/$0.48, Health & Welfare: $64.00/$8.00, Administrative Fund: $0.48/$0.06, Other: $3.44/$0.43 0 0Cement Mason 0 Manuel Lopez S D 0 0 00000 0 000 0 37.000.00 0.00 0.00 0.000.00 0.00 0.00 6.70 0.00 39.97 422.03 673201716 0.00 4.62 1) 2) 3)O 0 0 0 0 0 0 8.00 8.00 57.75 0.00 462.00 4277 Other Deduction Detail: SDI: 4.62 Male Hispanic American 85.75 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 0.00 316.98 1066.22 622987861 0.00 13.83 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 1383.20 63890 Other Deduction Detail: SDI: 13.83 73.49 1185.28 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. Ortz S D 0 0 00000 0 08.00 8.00 0 34.5816.00 0.00 0.00 0.000.00 97.00 50.05 17.18 0.00 281.57 903.71 573495026 0.00 43.85 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 553.28 63876 Other Deduction Detail: SDI: 11.85, Supplemental Dues: 32.00 Male Hispanic American 42.16 680.00 Coachella, CA 92236 51285 Fredrick St. Apt. G-104 Fringe Detail: Annuity: $11.20/$0.35, Health & Welfare: $84.80/$2.65, Pension: $32.00/$1.00, Vacation/ Holiday: $32.96/$1.03 0 0Landscape Irr. Tender 3 Arias Penalosa Otoniel S D 0 0 00000 8.00 8.008.00 8.00 0 17.0032.00 0.00 0.00 0.000.00 20.00 0.00 9.86 0.00 110.82 569.18 621666061 0.00 38.80 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 544.00 63897 Other Deduction Detail: SDI: 6.80, Supplemental Dues: 32.00 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 49.0 La Quinta SilverRock Park Venue La Quinta SilverRock Resort09/19/2020 2016-08/2016-08 13 14 15 16 17 18 19 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. 72.38 1167.38 Coachella, CA 92236 84-499 Pedro Dr. Fringe Detail: Annuity: $3.85/$0.35, Vacation: $11.33/$1.03, Health & Welfare: $29.15/$2.65, Pension: $11.00/$1.00 0 0Landscape Irr. Tender 0 Rodriguez Rodrigu Rafael S D 0 3.00 00000 0 008.00 0 17.0011.00 0.00 0.00 0.000.00 105.00 22.29 16.92 0.00 260.26 907.12 615031278 0.00 43.67 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 187.00 63902 Other Deduction Detail: SDI: 11.67, Supplemental Dues: 32.00 72.38 1167.38 Coachella, CA 92236 84-499 Pedro Dr. 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/ Holiday: $77.92/$4.87, Administrative Fund: $0.96/$0.06, Indust. Stab.Fund: $1.92/$0.12, Contract Compliance: $4.80/$0.30 0 0Landscape Irrigation Labor 0 Rodriguez Rodrigu Rafael S D 0 0 00000 8.00 8.0000 0 34.5816.00 0.00 0.00 0.000.00 105.00 22.29 16.92 0.00 260.26 907.12 615031278 0.00 43.67 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 553.28 63902 Other Deduction Detail: SDI: 11.67, Supplemental Dues: 32.00 39.19 632.00 Lake Elsinore, CA 92530 15212 Lincoln St. #A Fringe Detail: Annuity: $13.825/$0.35, Pension: $39.50/$1.00, Vacation: $40.685/$1.03, Health & Welfare: $104.675/$2.65 0 0Landscape Irr. Tender 0 Jose A. Sandoval S D 0 7.50 00000 8.00 8.008.00 8.00 0 16.0039.50 0.00 0.00 0.000.00 43.00 13.27 9.17 0.00 142.95 489.05 603024821 0.00 38.32 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 632.00 63873 Other Deduction Detail: SDI: 38.32 Male Hispanic American 42.16 680.00 San Jacinto, CA 92583 258 W 7th Street Spc 80 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 2 Carrillo Sergio S D 0 8.00 00000 8.00 8.008.00 8.00 0 17.0040.00 0.00 0.00 0.000.00 11.00 6.73 9.86 0.00 108.55 571.45 626545633 0.00 38.80 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 680.00 63906 Other Deduction Detail: SDI: 6.80, Supplemental Dues: 32.00 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 49.0 La Quinta SilverRock Park Venue La Quinta SilverRock Resort09/19/2020 2016-08/2016-08 13 14 15 16 17 18 19 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. 28.64 462.00 Indio, CA 92201 81860 Shadow Palms Ave. Fringe Detail: Vacation: $45.36/$5.67, Pension: $67.20/$8.40, LECET: $0.72/$0.09, Annuity: $7.28/$0.91, Indust. Stab.Fund: $0.64/$0.08, Supplemental Dues: $15.68/$1.96, Training Fund: $3.84/$0.48, Health & Welfare: $64.00/$8.00, Administrative Fund: $0.48/$0.06, Other: $3.44/$0.43 0 0Cement Mason 0 Juan Tapia S D 0 0 00000 0 000 0 37.000.00 0.00 0.00 0.000.00 0.00 0.00 6.70 0.00 39.96 422.04 619124504 0.00 4.62 1) 2) 3)O 0 0 0 0 0 0 8.00 8.00 57.75 0.00 462.00 4276 Other Deduction Detail: SDI: 4.62 Male Hispanic American 45.42 732.64 San Bernardino, CA 92404 1659 McKinley Ave. Fringe Detail: Annuity: $7.28/$0.91, Training Fund: $5.60/$0.70, Health & Welfare: $64.00/$8.00, Pension: $67.20/$8.40, Contract Compliance: $2.40/$0.30, Administrative Fund: $0.48/$0.06, Vacation/ Holiday: $38.96/$4.87, Indust. Stab.Fund: $0.96/$0.12 0 0Landscape Irrigation Labor 2 Gustavo Torres S D 0 0 00000 0 008.00 0 34.588.00 0.00 0.00 0.000.00 0.00 0.81 10.62 0.00 64.18 668.46 604924822 0.00 7.33 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 276.64 63866 Other Deduction Detail: SDI: 7.33 Male Hispanic American 39.68 640.00 Desert Hot Springs, CA 92240 66834 Estrella Ave. Fringe Detail: Annuity: $11.20/$0.35, Health & Welfare: $84.80/$2.65, Pension: $32.00/$1.00, Vacation: $32.96/$1.03 0 0Landscape Irr. Tender 0 Jesus A. Varela, Jr. S D 0 0 00000 8.00 8.008.00 8.00 0 16.0032.00 0.00 0.00 0.000.00 44.00 13.62 9.28 0.00 144.98 495.02 605083377 0.00 38.40 1) 2) 3)O 0 0 0 0 0 0 0 0.00 0.00 0.00 512.00 63871 Other Deduction Detail: SDI: 38.40 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 49.0 La Quinta SilverRock Park Venue La Quinta SilverRock Resort09/19/2020 2016-08/2016-08 13 14 15 16 17 18 19 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 #49, Contractor License # 963744, Workers Compensation Policy # URWC004126 Urban Habitat 13th President October 6th, 2020 Urban Habitat 2020 2020SeptemberSeptember19th - * 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, Supplemental Dues