Urban_Habitat_50.1_9-26-2045.52
734.19
San Jacinto, CA 92583
258 W. 7th St., Spc. 80
Fringe Detail: Annuity: $11.20/$0.35, Pension: $32.00/$1.00, Health & Welfare: $84.80/$2.65, Vacation/ Holiday: $32.96/$1.03
0
0Landscape Irr. Tender
0
Sergio Carrillo
S
D 0
0
00000
8.00 8.008.00 8.00 0 17.0032.00
0.00
0.00
0.000.00
16.00 7.93 10.65
0.00
87.44 646.75
626545633
0.00
7.34
1)
2)
3)O 0 0 0 0 0 0 0 0.00 0.00 0.00
544.00
63970
Other Deduction Detail: SDI: 7.34
Male Hispanic American
45.52
734.19
San Jacinto, CA 92583
258 W. 7th St., Spc. 80
Fringe Detail: Annuity: $5.005/$0.91, Training Fund: $3.85/$0.70, Administrative Fund: $0.33/$0.06, Indust. Stab.Fund: $0.66/$0.12, Health & Welfare: $44.00/$8.00, Pension: $46.20/$8.40, Vacation/ Holiday: $26.785/$4.87,
Contract Compliance: $1.65/$0.30
0
0Landscape Irrigation
Labor
0
Sergio Carrillo
S
D 0
5.50
00000
0 000 0 34.585.50
0.00
0.00
0.000.00
16.00 7.93 10.65
0.00
87.44 646.75
626545633
0.00
7.34
1)
2)
3)O 0 0 0 0 0 0 0 0.00 0.00 0.00
190.19
63970
Other Deduction Detail: SDI: 7.34
Male Hispanic American
74.69
1204.64
Apple Valley, CA 92308
20250 Itasca Rd.
Fringe Detail: Health & Welfare: $145.582/$9.87, Pension: $145.582/$9.87, Vacation: $71.39/$4.84, Training Fund: $22.125/$1.50, Annuity: $3.688/$0.25, Contract Compliance: $4.425/$0.30, Administrative Fund: $0.
885/$0.06, Indust. Stab.Fund: $1.77/$0.12
0
0Landscape Oper. Eng
2
Cameron D. Cleland
S
D 0
7.50
00000
0 7.2500 0 38.4514.75
0.00
0.00
0.000.00
90.00 18.76 17.47
0.00
212.96 991.68
565931366
0.00
12.04
1)
2)
3)O 0 0 0 0 0 0 0 0.00 0.00 0.00
567.13
63919
Other Deduction Detail: SDI: 12.04
Male Caucasian
44.21
713.09
Thermal, CA 92274
68990 Harrison St. Space #101
Fringe Detail: Health & Welfare: $84.80/$2.65, Pension: $32.00/$1.00, Vacation: $32.96/$1.03, Annuity: $11.20/$0.35
0
0Landscape Irr. Tender
5
Pedro J. Clemente
S
D 0
0
00000
8.00 8.008.00 8.00 0 15.5332.00
0.00
0.00
0.000.00
7.00 0.00 10.34
0.00
68.68 644.41
657090571
0.00
7.13
1)
2)
3)O 0 0 0 0 0 0 0 0.00 0.00 0.00
496.96
63963
Other Deduction Detail: SDI: 7.13
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
50.1 La Quinta SilverRock Park Venue
La Quinta SilverRock Resort09/26/2020 2016-08/2016-08
20 21 22 23 24 25 26
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.
58.79
948.22
Thermal, CA 92274
55550 Tyler St.
Fringe Detail: Training Fund: $45.44/$1.42, Annuity: $16.32/$0.51, Pension: $268.80/$8.40, Contract Compliance: $9.60/$0.30, Indust. Stab.Fund: $2.56/$0.08, Administrative Fund: $1.92/$0.06, Health & Welfare: $239.
04/$7.47, Vacation: $42.56/$1.33
0
0Landscape Irrigation
Labor
5
Maurilio P. Cortez
S
D 0
0
00000
8.00 8.008.00 8.00 0 24.7932.00
0.00
0.00
0.000.00
31.00 0.39 13.75
0.00
113.41 834.81
604521749
0.00
9.48
1)
2)
3)O 0 0 0 0 0 0 0 0.00 0.00 0.00
793.28
Apprentice Level 3 63952
Other Deduction Detail: SDI: 9.48
Male Hispanic American
80.39
1296.75
Temecula, CA 92592
30240 Miraloma Dr.
Fringe Detail: Annuity: $34.125/$0.91, Training Fund: $26.25/$0.70, Administrative Fund: $2.25/$0.06, Indust. Stab.Fund: $4.50/$0.12, Contract Compliance: $11.25/$0.30, Vacation: $182.625/$4.87, Health & Welfare: $315.
00/$8.40, Pension: $300.00/$8.00
0
0Landscape Irrigation
Labor
0
Oscar Diaz
S
D 0
5.50
00000
8.00 8.008.00 8.00 0 34.5837.50
0.00
0.00
0.000.00
43.00 58.67 18.80
0.00
213.82 1082.93
615121373
0.00
12.96
1)
2)
3)O 0 0 0 0 0 0 0 0.00 0.00 0.00
1296.75
63961
Other Deduction Detail: SDI: 12.96
Male Hispanic American
44.64
720.00
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
0
00000
0 8.008.00 8.00 0 18.0024.00
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
432.00
63949
Other Deduction Detail: SDI: 7.20
Male Hispanic American
53.42
861.60
Thermal, CA 92274
69455 Pierce St.
Fringe Detail: Training Fund: $13.60/$0.85
0
0Painter: Industrial
8
Juan Guitron Gonzalez
S
D 0
0
00000
0 08.00 8.00 0 35.5216.00
0.00
26.13
0.000.00
0.00 3.24 12.50
0.00
77.77 783.83
655290807
0.00
8.61
1)
2)
3)O 0 0 0 0 0 0 0 0.00 0.00 0.00
986.40
4278
Other Deduction Detail: SDI: 8.61
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
50.1 La Quinta SilverRock Park Venue
La Quinta SilverRock Resort09/26/2020 2016-08/2016-08
20 21 22 23 24 25 26
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.
80.40
1296.75
San Jacinto, CA 92583
258 W. 7th St., Spc. 80
Fringe Detail: Annuity: $34.125/$0.91, Training Fund: $26.25/$0.70, Pension: $315.00/$8.40, Health & Welfare: $300.00/$8.00, Administrative Fund: $2.25/$0.06, Indust. Stab.Fund: $4.50/$0.12, Contract Compliance: $11.
25/$0.30, Vacation: $182.625/$4.87
0
0Landscape Irrigation
Labor
0
Jose Gutierrez
S
D 0
5.50
00000
8.00 8.008.00 8.00 0 34.5837.50
0.00
0.00
0.000.00
0.00 17.66 18.80
0.00
129.82 1166.93
571210268
0.00
12.96
1)
2)
3)O 0 0 0 0 0 0 0 0.00 0.00 0.00
1296.75
63941
Other Deduction Detail: SDI: 12.96
Male Hispanic American
50.52
814.73
Desert Hot Springs, CA 92240
66886 Camino Idilio
Fringe Detail: Health & Welfare: $293.12/$9.16, Pension: $12.16/$0.38, Training Fund: $45.12/$1.41, Other: $34.24/$1.07
0
0Landscape Irrigation
Labor
4
Luis F. Lopez Quintero
S
D 0
0
00000
8.00 8.008.00 8.00 0 21.3032.00
0.00
0.00
0.000.00
46.00 20.79 11.81
0.00
137.26 677.47
164777350
0.00
8.14
1)
2)
3)O 0 0 0 0 0 0 0 0.00 0.00 0.00
681.60
Apprentice Level 2 63947
Other Deduction Detail: SDI: 8.14
Male
44.98
725.59
Thermal, CA 92274
55550 Tyler St. Space #3
Fringe Detail: Health & Welfare: $84.80/$2.65, Pension: $32.00/$1.00, Annuity: $11.20/$0.35, Vacation: $32.96/$1.03
0
0Landscape Irr. Tender
5
Juan LopezMendez
S
D 0
0
00000
8.00 8.008.00 8.00 0 15.5332.00
0.00
0.00
0.000.00
8.00 0.00 10.52
0.00
70.76 654.83
620099088
0.00
7.26
1)
2)
3)O 0 0 0 0 0 0 0 0.00 0.00 0.00
496.96
63944
Other Deduction Detail: SDI: 7.26
Male
85.84
1384.48
Desert Hot Springs, CA 92240
66886 Camino Idilio
Fringe Detail: Health & Welfare: $236.88/$9.87, Pension: $236.88/$9.87, Vacation: $116.16/$4.84, Annuity: $6.00/$0.25, Training Fund: $36.00/$1.50, Contract Compliance: $7.20/$0.30, Administrative Fund: $1.44/$0.06,
Indust. Stab.Fund: $288.00/$12.00
0
0Landscape Oper. Eng
5
Felipe Lopez
S
D 0
0
00000
8.00 08.00 8.00 0 38.4524.00
0.00
0.00
0.000.00
81.00 22.77 20.08
0.00
223.53 1160.95
604137146
0.00
13.84
1)
2)
3)O 0 0 0 0 0 0 0 0.00 0.00 0.00
922.80
6392563976
Other Deduction Detail: SDI: 13.84
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
50.1 La Quinta SilverRock Park Venue
La Quinta SilverRock Resort09/26/2020 2016-08/2016-08
20 21 22 23 24 25 26
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.
85.84
1384.48
Desert Hot Springs, CA 92240
66886 Camino Idilio
Fringe Detail: Health & Welfare: $8.00/$8.00, Pension: $8.40/$8.40, Annuity: $0.91/$0.91, Vacation: $4.87/$4.87, Training Fund: $0.70/$0.70, Contract Compliance: $0.30/$0.30, Administrative Fund: $0.06/$0.06, Indust.
Stab.Fund: $0.12/$0.12
0
0Landscape Irrigation
Labor
5
Felipe Lopez
S
D 0
1.00
00000
0 000 0 34.581.00
0.00
0.00
0.000.00
81.00 22.77 20.08
0.00
223.53 1160.95
604137146
0.00
13.84
1)
2)
3)O 0 0 0 0 0 0 0 0.00 0.00 0.00
34.58
6392563976
Other Deduction Detail: SDI: 13.84
Male
39.53
637.50
Coachella, CA 92236
51285 Frederick St
Fringe Detail: Annuity: $4.725/$0.35, Vacation: $13.905/$1.03, Pension: $13.50/$1.00, Health & Welfare: $35.775/$2.65
0
0Landscape Irr. Tender
3
Otoniel A. Penalosa
S
D 0
5.50
00000
0 8.0000 0 17.0013.50
0.00
0.00
0.000.00
16.00 0.00 9.25
0.00
71.15 566.35
621666061
0.00
6.37
1)
2)
3)O 0 0 0 0 0 0 0 0.00 0.00 0.00
229.50
63962
Other Deduction Detail: SDI: 6.37
Male Hispanic American
90.72
1463.20
Indio, CA 92201
81921 Victoria St.
Fringe Detail: Administrative Fund: $1.44/$0.06, Pension: $201.60/$8.40, Annuity: $21.84/$0.91, Vacation: $116.88/$4.87, Contract Compliance: $7.20/$0.30, Indust. Stab.Fund: $2.88/$0.12, Health & Welfare: $192.00/$8.00,
Training Fund: $16.80/$0.70
0
0Landscape Irrigation
Labor
0
Gerardo Saldivar Mejia
S
D 0
0
00000
8.00 8.0008.00 0 36.5824.00
0.00
0.00
0.000.00
141.00 41.03 21.21
0.00
308.59 1154.61
607068060
0.00
14.63
1)
2)
3)O 0 0 0 0 0 0 0 0.00 0.00 0.00
877.92
63928
Other Deduction Detail: SDI: 14.63
Male Hispanic American
72.68
1172.24
Thermal, CA 92274
56725 Harrison St.
Fringe Detail: Annuity: $18.20/$0.91, Pension: $168.00/$8.40, Contract Compliance: $6.00/$0.30, Vacation: $97.40/$4.87, Administrative Fund: $1.20/$0.06, Training Fund: $14.00/$0.70, Indust. Stab.Fund: $2.40/$0.12, Health
& Welfare: $160.00/$8.00
0
0Landscape Irrigation
Labor
0
Rafael Sanchez Garcia
S
D 0
0
00000
0 8.004.00 8.00 0 34.5820.00
0.00
0.00
0.000.00
106.00 22.50 17.00
0.00
229.90 942.34
614126878
0.00
11.72
1)
2)
3)O 0 0 0 0 0 0 0 0.00 0.00 0.00
691.60
63967
Other Deduction Detail: SDI: 11.72
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
50.1 La Quinta SilverRock Park Venue
La Quinta SilverRock Resort09/26/2020 2016-08/2016-08
20 21 22 23 24 25 26
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.
72.68
1172.24
Thermal, CA 92274
56725 Harrison St.
Fringe Detail: Health & Welfare: $9.80/$2.45, Pension: $4.00/$1.00, Vacation: $4.12/$1.03, Annuity: $1.00/$0.25
0
0Landscape Irr. Tender
0
Rafael Sanchez Garcia
S
D 0
4.00
00000
0 000 0 17.004.00
0.00
0.00
0.000.00
106.00 22.50 17.00
0.00
229.90 942.34
614126878
0.00
11.72
1)
2)
3)O 0 0 0 0 0 0 0 0.00 0.00 0.00
68.00
63967
Other Deduction Detail: SDI: 11.72
Male Hispanic American
81.39
1312.75
Thermal, CA 92274
55550 Tyler St. Space #3
Fringe Detail: Health & Welfare: $232.00/$8.00, Pension: $243.60/$8.40, Vacation: $141.23/$4.87, Training Fund: $20.30/$0.70, Annuity: $26.39/$0.91, Contract Compliance: $8.70/$0.30, Administrative Fund: $1.74/$0.06,
Indust. Stab.Fund: $3.48/$0.12
0
0Landscape Irrigation
Labor
4
Miguel L. Sanchez
S
D 0
5.00
00000
8.00 8.0008.00 0 34.5829.00
0.00
0.00
0.000.00
119.00 55.14 19.04
0.00
287.70 1025.05
622987861
0.00
13.13
1)
2)
3)O 0 0 0 0 0 0 0 0.00 0.00 0.00
1002.82
63955
Other Deduction Detail: SDI: 13.13
Male
81.39
1312.75
Thermal, CA 92274
55550 Tyler St. Space #3
Fringe Detail: Health & Welfare: $64.00/$8.00, Pension: $67.20/$8.40, Vacation: $38.96/$4.87, Training Fund: $5.60/$0.70, Annuity: $7.28/$0.91, Contract Compliance: $2.40/$0.30, Administrative Fund: $0.48/$0.06, Indust.
Stab.Fund: $0.96/$0.12
0
0Landscape Irrigation
Labor
4
Miguel L. Sanchez
S
D 0
0
00000
0 08.00 0 0 36.588.00
0.00
0.00
0.000.00
119.00 55.14 19.04
0.00
287.70 1025.05
622987861
0.00
13.13
1)
2)
3)O 0 0 0 0 0 0 0 0.00 0.00 0.00
292.64
63955
Other Deduction Detail: SDI: 13.13
Male
90.00
1451.49
Lake Elsinore, CA 92530
15212 Lincoln St. #A
Fringe Detail: Training Fund: $37.75/$1.00, Pension: $402.038/$10.65, Health & Welfare: $432.237/$11.45, Vacation/ Holiday: $134.012/$3.55, Other: $5.662/$0.15
0
0Landscape Oper. Eng
0
Jose D. Sandoval Becerra
S
D 0
5.75
00000
8.00 8.008.00 8.00 0 38.4537.75
0.00
0.00
0.000.00
23.00 27.25 21.04
0.00
175.81 1275.68
612336635
0.00
14.52
1)
2)
3)O 0 0 0 0 0 0 0 0.00 0.00 0.00
1451.48
63939
Other Deduction Detail: SDI: 14.52
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
50.1 La Quinta SilverRock Park Venue
La Quinta SilverRock Resort09/26/2020 2016-08/2016-08
20 21 22 23 24 25 26
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.
37.44
604.00
Lake Elsinore, CA 92530
15212 Lincoln St. #A
Fringe Detail: Annuity: $13.212/$0.35, Pension: $37.75/$1.00, Vacation: $38.883/$1.03, Health & Welfare: $100.037/$2.65
0
0Landscape Irr. Tender
0
Jose A. Sandoval
S
D 0
5.75
00000
8.00 8.008.00 8.00 0 16.0037.75
0.00
0.00
0.000.00
40.00 12.04 8.75
0.00
104.27 499.73
603024821
0.00
6.04
1)
2)
3)O 0 0 0 0 0 0 0 0.00 0.00 0.00
604.00
63937
Other Deduction Detail: SDI: 6.04
Male Hispanic American
47.48
765.84
Mecca, CA 92203
91889 Montenegro Dr.
Fringe Detail: Pension: $24.00/$1.00, Vacation/ Holiday: $24.72/$1.03, Annuity: $8.40/$0.35, Health & Welfare: $63.60/$2.65
0
0Landscape Irr. Tender
0
Cesar Torres
S
D 0
0
00000
0 8.008.00 8.00 0 15.5324.00
0.00
0.00
0.000.00
21.00 17.56 11.10
0.00
104.79 661.05
604246965
0.00
7.65
1)
2)
3)O 0 0 0 0 0 0 0 0.00 0.00 0.00
372.72
63920
Other Deduction Detail: SDI: 7.65
Male Hispanic American
57.75
931.38
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 08.00 0 0 34.588.00
0.00
0.00
0.000.00
6.00 5.18 13.51
0.00
91.75 839.63
604924822
0.00
9.31
1)
2)
3)O 0 0 0 0 0 0 0 0.00 0.00 0.00
276.64
63930
Other Deduction Detail: SDI: 9.31
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
50.1 La Quinta SilverRock Park Venue
La Quinta SilverRock Resort09/26/2020 2016-08/2016-08
20 21 22 23 24 25 26
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,Revised Payroll #50.1,
Contractor License # 963744, Workers Compensation Policy # URWC004126
Urban Habitat
20th
President
October 7th, 2020
Urban Habitat
2020 2020SeptemberSeptember26th
-
* 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