HomeMy WebLinkAboutMGB CPR - 6-8-20 to 6-12-20Public Works Certified Payroll Reporting Form
Certification under penalty of perjury:
"I, TAMARA JENKINS, the undersigned, am the GENERAL MANAGER (position in business) with the authority to act for and on behalf of MGB CONSTRUCTION (name of business and/or contractor), certify
under penalty of perjury that the records or copies thereof submitted and consisting of certified payroll records for the week ending 2020-06-14 are the originals or true, full, and correct copies of the originals
which depict the payroll record(s) of the actual disbursements by way of cash, check, or whatever form to the individual or individuals named. I certify this on 2020-06-25."
Contractor Name: MGB CONSTRUCTION, INC. Contractor PWCR: 1000005831 License Type: CSLB License Number 797075
Address: 91 COMMERCIAL AVE, RIVERSIDE, CA 92507 FEIN: 330951724 Contractor Email: TAMARAR@MGBCONSTRUCTION.NET
Insurance Number: C66378895
Awarding Body: CITY OF SAN LUIS OBISPO DIR Project ID: 325863 Project Name: ISLAY HILL PARK PLAYGROUND RENOVATION
Contract With: CITY SERVICE PAVING County: SAN LUIS OBISPO Address: 1511 TANK FARM, SAN LUIS OBISPO, CA 93401
Payroll #: 1 - 0 Ctr Payroll #: 1-Final Week Ending: 06/14/2020
Employee: GUILLERMO GUTIERREZ 4133 WITT AVE, RIVERSIDE, CA, 92507
SSN� Mon Tue Wed Thu Fri Sat Sun
06/08 06/09 06/10 06111 06/12 06/13 06/14
S SC-23-102-2-2017-2 6.00 5.00 0.00 800 3.00 0.00 0.00
NOTE:
Statement of Non -Performance? I✓ Final payroll for this project?
Total Base Hourly
Vac/ Health pension Other Training Total
Hours Fringe Holiday & Welf Hourly Rate
22.00 3319 19.85 4.59 7.12 753 0.61 0.69 53.73
Travel 8 Subsistence 000 Total Deductions 74535
Public works Certified Payroll Reporting Form 06/25/2020 - Page 1
Public Works Certified Payroll Reporting Form
Contractor Name: MGB CONSTRUCTION, INC.
Project Name: ISLAY HILL PARK PLAYGROUND RENOVATION Week Ending: 06/14/2020 Payroll Number: 1-0
Employee: JOSA GARCIA 2705 MACY ST, SAN BERNARDINO, CA, 92407
SSN:� Mon Tue Wed Thu Fri Sat Sun Total Total Vac/ Health Total
06/08 06/09 06/10 06/11 06/12 06/13 06114 Hours Base Hourly Fringe Holiday & Welf Pension Other Training Hourly Rate
S SC-23-102-2-2017-2 8.00 8.00 0.00 8.00 3.00 0.00 0.00 27.00 33.19 19.85 459 7.12 7.53 0.61 0.69 53.73
NOTE: Travel & Subsistence 0.00 Total Deductions 49601
Public works Certified Payroll Reporting Form 06/25/2020 - Page 2
Public Works Certified Payroll Reporting Form
Contractor Name: MGB CONSTRUCTION, INC. Project Name: ISLAY HILL PARK PLAYGROUND RENOVATION Week Ending: 06/14/2020 Payroll Number: 1-0
Employee: SIXTO GARCIA 1190 S GIBBS ST, POMONA, CA, 91766
SSN:� Mon Tue Wed Thu Fri Sat Sun Total Pension Other Training Total Vac/ Health Total
06/08 06/09 06110 06/11 06/12 06/13 06/14 Hours Base Hourly Fringe Holiday & Welf. Hourly Rate
5 SC-23-102-2-2017-2 0.00 0.00 0.00 8.00 3.00 0.00 0.00 11.00 33.19 19.85 4.59 7.12 7.53 061 0.69 53.73
NOTE: Travel & Subsistence 0.00 Total Deductions 199.17
Public Works certified Payroll Reporting Form 06/25/2020 - Page 3
Public Works Certified Payroll Reporting Form
Contractor Name: MGB CONSTRUCTION, INC.
Project Name: ISLAY HILL PARK PLAYGROUND RENOVATION
Week Ending: 06/14/2020
Payroll Number: 1-0
Employee: MARCO MENDOZA2246 W 3RD ST, SAN BERNARDINO, CA, 92405
SSN:
Mon Tue Wed Thu Fri Sat Sun Total Total
Vac/ Health
Total
Hours Base Houriy Fringe
O6/08 06/09 O6/10 O6111 O6/12 O6113 O6/14 9
Holiday & Welf. Pension
Y
Other Training Hourly Rate
Y
S SC-23-102-2-2017-2
8.00 8.00 0.00 8.00 3.00 0.00 0.00 27 00 33 19 19.85
4.59 7.12 7.53
0.61 0.69 53 73
NOTE:
Travel & Subsistence 0.00
Total Deductions 49751
Public Works Certified Payroll Reporting Form 06/25/2020 - Page 4
Public Works Certified Payroll Reporting Form
Contractor Name: MGB CONSTRUCTION, INC. Project Name: ISLAY HILL PARK PLAYGROUND RENOVATION
Week Ending: 06/14/2020
Payroll Number: 1-0
Employee: RIGOBERTO SANCHEZ 265 W G STAPT 44, COLTON, CA, 92324
SSN Mon Tue Wed Thu Fri Sat Sun Total Total
Vac/ Health
Total
06/08 06/09 06/10 06/11 06/12 06113 06/14 Hours Base Hourly Fringe
Holiday & Welf. Pension
Other Training Hourly Rate
5 SC-23-102-2-2017-2 8.00 5.00 0.00 8.00 3.00 0.00 0.00 24.00 33.19 19.85
4.59 712 7.53
0.61 0.69 3.73
NOTE:
Travel & Subsistence 0.00
Total Deductions 383.64
Public Works Certified Payroll Reporting Form 06/25/2020 - Page 5
Public Works Certified Payroll Reporting Form
Contractor Name: MGB CONSTRUCTION, INC. Project Name: ISLAY HILL PARK PLAYGROUND RENOVATION Week Ending: 06/14/2020 Payroll Number: 1-0
Employee: GUILLERMO GUTIERREZ 4133 WITT AVE, RIVERSIDE, CA, 92507
SSN:ow Mon Tue Wed Thu Fri Sat Sun Total Total Vac/ Health Total
Hours Base Hourly Fringe Holiday & Welf. Pension Other Training Hourl Rate
O6/OB O6/09 06I10 06/11 O6/12 06/13 06/14 9 Y Y
S SC-23-203-2-2017-1 0.00 3.00 8.00 0.00 0.00 0.00 0.00 t' 00 37.00 25.16 7.04 8.17 9.68 0.27 064 62.80
NOTE: Travel & Subsistence 0.00 Total Deductions 745.35
Public Works Certified Payroll Reporting Form 06/25/2020 - Page 6
Public Works Certified Payroll Reporting Form
Contractor Name: MGB CONSTRUCTION, INC. Project Name: ISLAY HILL PARK PLAYGROUND RENOVATION Week Ending: 06/14/2020 Payroll Number: 1-0
Employee: JOSE GARCIA 2705 MACY ST, SAN BERNARDINO, CA, 92407
SSN:� Mon Tue Wed Thu Fri Sat Sun Total Pension Other Trainin
Total Vac/ Health Total
06108 06/09 06/10 06/11 06112 06113 06/14 Hours Base Hourly Fringe Holiday & Welf. g Hourly bate
S SC-23-203-2-2017-1 0.00 0.00 8.00 0.00 0.00 0.00 0.00 0.00 37.00 25.16 7.04 8.17 9.68 0.27 0.64 62.B0
NOTE: Travel & Subsistence 0.00 Total Deductions 496.01
Public Works Certified Payroll Reporting Form 06/25/2020 - Page 7
Public Works Certified Payroll Reporting Form
Contractor Name: MGB CONSTRUCTION, INC. Project Name: ISLAY HILL PARK PLAYGROUND RENOVATION
Week Ending: 06/14/2020
Payroll Number: 1-0
Employee: SIXTO GARCIA 1190 S GIBBS ST, POMONA, CA, 91766
SSN: ® Mon Tue Wed Thu Fri Sat Sun Total Base Hourly Total
Vac/ Health Pension
Other Training Total
06/08 06/09 06110 06/11 06112 06/13 06/14 Hours Fringe
Holiday & Welf.
Hourly Rate
S SC-23-203-2-2017-1 0.00 0.00 8.00 0.00 0.00 0.00 0.00 8.00 37.00 25.16
7.04 8.17 9.68
0.27 0.64 62.80
NOTE:
Travel & Subsistence 000
Total Deductions 199.17
Public works certified Payroll Reporting Form 06/25/2020 - Page 8
Public Works Certified Payroll Reporting Form
Contractor Name: MGB CONSTRUCTION, INC. Project Name: ISLAY HILL PARK PLAYGROUND RENOVATION
Week Ending: 06/14/2020
Payroll Number: 1-0
Employee: ALEJANDRO GUITERREZ 4133 WITT AVE, RIVERSIDE, CA, 92507
SSN:9ft
Mon Tue Wed Thu Fri Sat Sun Total Total
Vac/ Health
Total
Hours Base Hourly Fringe
O6/08 O6/09 O6/10 O6/11 06/12 O6/13 O6/14 9
Holida & Welf Pension
Y
Other Training Hourly Rate
Y
S SC-23-203-2-2017-1 0.00 3.00 8.00 0.00 0.00 0.00 0.00 1100 37.00 25.16
7.04 817 9.68
0.27 0.64 62.80
NOTE:
Travel & Subsistence 0.00
Total Deductions 682.44
Public works Certified Payroll Reporting Form 06/25/2020 - Page 9
Public Works Certified Payroll Reporting Form
Contractor Name: MGB CONSTRUCTION, INC. Project Name: ISLAY HILL PARK PLAYGROUND RENOVATION Week Ending: 06/14/2020 Payroll Number: 1-0
Employee: MARCO MENDOZA2246 W 3RD ST, SAN BERNARDINO, CA, 92405
SSN:� Mon Tue Wed Thu Fri Sat Sun Total Total Vac/ Health Total
06108 06/09 06/10 06/11 06/12 06/13 06/14 Hours Base Hourly Fringe Holiday & Welf. Pension Other Training Hourly Rate
S SC-23-203-2-2017-1 0.00 0.00 8.00 0.00 0.00 0.00 0.00 8.00 37.00 25.16 7.04 8.17 9.68 0.27 0.64 62.80
NOTE: Travel B Subsidence 0.00 Total Deductions 497.51
Public works Certified Payroll Reporting Form 06/25/2020 - Page 10
Public Works Certified Payroll Reporting Form
Contractor Name: MGB CONSTRUCTION, INC.
Project Name: ISLAY HILL PARK PLAYGROUND RENOVATION Week Ending: 06/14/2020 Payroll Number: 1-0
Employee: RIGOBERTO SANCHEZ 265 W G STAPT 4, COLTON, CA, 92324
SSN Mon Tue Wed Thu Fri Sat Sun Total Total Vac/ Health Total
06/08 06/09 06/10 06/11 06112 06/13 06/14 Hours Base Hourly Fringe Holiday & Welf. Pension Other Training Hourly Rate
S SC-23-203-2-2017-1 0.00 3.00 8.00 0.00 0.00 0.00 0.00 11 00 37.00 2516 7.04 8.17 9.68 0.27 0.64 52.80
NOTE: Travel & Subsistence 0.00 Total Deductions 383.64
Public works Certified Payroll Reporting Form 06/25/2020 - Page 11
Public Works Certified Payroll Reporting Form
Contractor Name: MGB CONSTRUCTION, INC.
Project Name: ISLAY HILL PARK PLAYGROUND RENOVATION Week Ending: 06/14/2020 Payroll Number- 1-0
Employee: ALEJANDRO GUTIERREZ 4133 WITT ST, RIVERSIDE, CA, 92507
SSN aw
Mon Tue Wed Thu Fri Sat Sun Total Total
Vac/ Health
Total
06108 06/09 06110 061ll 06/12 06/13 06/14 Hours Base Hourly Fringe
Holiday & Welf. Pension
Other Training
Hourly Rate
S SC-23-102-2-2017-2 8.00 5.00 0.00 8.00 3.00 0.00 0.00 24.00 33.19 19.85
4.59 7.12 753
0.61 0.69
53.73
NOTE:
Travel & Subsistence 000
Total Deductions
682.44
Public Works Certified Payroll Reporting Form 06/25/2020 - Page 12