HomeMy WebLinkAboutRedacted - Waterline 91436 Week 23 ended 02.23.18( 1)
NAME, ADDRESS ANO
SOCIAL SECURITY NUMBER
OF EMPLOYEE
Bryce Crespin
4355 Cayucos Ave
Atascadero, CA 93422
Bryce Crespin
4355 Cayucos Ave
Atascadero, CA 93422
Clinton R Barry
776 Brahma St
Paso Robles, CA 93446
George Llamas
800 E. Cook
Santa Maria, CA 93454
Iran A Nieves
1628 Village Ct Santa
Maria, CA 93454
Jacob O Rexford 2761
Chaparral Lane Paso
Robles, CA 93446
James Douglas
612 Laura Way
Paso Robles, CA 93446
xxxx
James Douglas
612 Laura Way
Paso Robles, CA 93446
xxxxx
James Yanez
538 County Lane
San Luis Obispo, CA 93401
xxxx
Jose Sanchez Garcia
558 Ferro Lane
Paso Robles, CA 93446
xxxxx
Juan Manuel Barrios 1021
Gaylene Or
Santa Maria, CA 93458
xxxxx
Manuel Robledo
9694 Birmingham Ave
Riverside, CA 92509
FORM A·l-131 {New 2·80)
( 2)
Number of
diR (al fDmll Oep,a,rtme,lt
d Indl..6triaf A.e'ibons PUBLIC WORKS PAYROLL REPORTING FORM
NAME OF CONTRACTOR D·KAL Engineering CONTRACT OR'S LICENSE # 653307 ADDRESS
OR SUBCONTRACTOR SPEOALTY LICENSE#
PAYROLL NUMBER FOR WEEK ENDING SELF ·INSURED CERTIFICATE# PR OJECT OR CONTRACT #
23 2/23/2019 WORKERS' CO MPENSATION POLICY # 7J45679A18 PR OJECT&. LOCATION
14) DAY ( 5)( 6)( 7) (8) ( 3)Sun Mon Tue Wed Thu Fri Sat GROSS AMOUNT
DATE HOURLY EARNED
PAGE
PO Box 1919 San Luis Obtsnn CA 93406
Waterline Replace Spec 91436
San Luis Obisoo
( 9)
NET
WAGES
Withholding WORK 2/17 2/18 2/19 2/20 2/21 2/22 2/23 TOTAL RATE THIS All DEDUCTI ONS, CONTRI BUTIONS AND PA YMENTS PAID FOR
•-,ons CL ASSIFICATION HOURS WORKED EACH DAY HOURS OF PAY PR OJECT PROJECTS WEEK
0 Equip . Opers.
0 Laborer
0 Equip. Opers.
0 Teamsters
Apprentice
0 Laborer
0 Laborer
0 Carpenters
0 Laborer
0 Foreperson
0 Laborer
0 Laborer
0 Laborer
s 0 0
D
0
s 0 0
D
0 0 0
s 0 8
D 0 0
0 0 0
s 0 0
D
0
s 0 0
D
0 0 0
s 0 0
D
0 0 0
s 0 0
D
0
s 0 0
D
0 0 0
s
D 0 0
0
s 0 0
D
0 0 0
s 0 0
D
0 0 0
s 0 0
D
0 0 0
S = Straight time
0 = Overtime
D = Ooubletime
4
4
4
8
0
1.5
5
8
2
5
2.5
0
8
0
18
8
3.5
5
3
8
3
FWH MCA RE FICA ST TAX SDI VAC/HOL HEAL TH/WELF PENSION
0 0 0 0 4 $ 75.23 $ 322.00 $ 39.03 $ 166.90 $ 212.85 $ $ $ . 'I; .
$ 300.92 $ 2,691.97 TRAINING FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTAlDED CHK NUM $1,753.69
$ . $ s . $ . $ $ 197.50 � 938.28 003073
FWH MCARE FICA ST TAX SOI VAC/HOL HEAL Tll/WELF PENSION
8 6 0 0 18 $62.02 $ 322.00 $ 39.03 s 166.90 S 212.85 $ s $ . <!; .
$ 1,771.96 $ 2,691.97 TRAINING FUNDADMIN DUES TRVISUBS SAVINGS OTHER TOTALDED CHKNUM $ 1,753.69
4 0 0 0 8 $ 81.95 $ . $ . $ $ . $ $ 197.50 $ 938.28 003073
FWH MCA RE FICA ST TAX SDI VACJHOL HEAL"""'ELF PENSION
8 0 0 0 24 S 75.23 S 575.00 $ 59.10 s 252.73 s 360.70 S $ $ . $ .
1 0 0 0 1 $123.42 $ 2,475.26 $ 4,076.26 TRAINING FUNDADMIN DUES TRVISUBS SAVINGS OTHER TOTAL OED CHKNUM $ 2,828 73
4 0 0 0 5.5 S99.33 $ $ . s $ $ $ S 1 247.53 1924
FWH MCA RE FICA ST TAX SOI VAriHOL HEAL TH/WELF PENSION
0 0 0 0 5 $59.91 $ 163.00 $ 18.55 -t 79.34 $ 71.89 s $ s . $ $ 299.55 $ 1,279.55 TRAINING FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTALDEO CHKNUM $ 921.77
$ <; � s . s $ 25.00 s 357.78 003076
FWH MCARE FICA ST TAX SOI VAC/HOL HEAL TH/WELF PENSION
8 0 0 0 16 $20.48 $ 40.00 $ 7.51 s 32.14 $ 11.39 $ . $ $
$ 450.56 $ 450.56 TRAINING FUNDADMIN DUES TRVISUBS SAVINGS OTHER TOTAL OED CHKNUM $ 35952
2 0 0 0 4 $30.72 $ . $ $ . $ . $ . $ $ 91.04 003077
FWH MCARE FICA ST TAX SDI VACJHOL HEAL TH/WELF PENSION
8 0 0 0 13 S55.73 $ 491.00 s 41.91 S 179.19 S 174.21 $ $ . $ $
$ 1,198.02 $ 2,890.21 TRAINING FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTAL OED CHK NUM $ 1,751.54
4 0 0 0 6.5 $ 72.85 $ . $ s $ $ s 252.36 � 1 138.67 003078
FWH MCA RE FICA ST TAX SDI VAC/HOL HEALTH/WELf PENSION
2 0 0 0 2 $62.02 $ 315.00 $ 38.56 $ 164.89 S 151.11 $ . $ $ .
$ 124.04 $ 2,659.52 TRAINING FUNDAOMIN DUES TRVISUBS SAVINGS OTHER TOTAL OED CHK NUM $1,792.46
$ $ $ $ $ S 197.50 $ 867.06 003084
FWH MCA RE FICA ST TAX SOI VAC/HOL HEAL TH/WELF PENSION
6 0 0 0 14 $ 55.73 $ 315.00 $ 38.56 s 164.89 S 151.11 $ $ < <
$ 925.92 $ 2,659.52 TRAINING FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTAL OED CHK NUM $1,792.46
2 0 0 0 2 S 72.85 $ $ . $ $ $ S 197.50 $ 867.06 003084
FWH MCARE FICA ST TAX SOI VACJHOL HEALTH/WELF PENSION
$ 393.00 $ 41.13 $ 175.85 s 241.53 $ . $ $
12 8 0 0 38 $ 73.75 $ 2,802.50 $ 2,950.00 TRAINING FUNDADMIN DUES TRWSUBS SAVINGS OTHER TOTAL OED CHK NUM $1,884.86
$ $ . <; $ $ $ 213.63 S 1 065.14 003080
FWH MCA RE FICA ST TAX SDI VAriHOL HEAL Tll/WELF PENSION
6 0 0 0 14 S55.73 $ 66.00 � 23.59 -i 100.86 $ 35.61 $ $ $ $ .
$ 1,035.20 $ 1,626.74 TRAINING FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTALDED CHK NUM $1,263.18
0 0 0 0 3.5 s 72.85 $ . ,t --,t ,t . s . $ 137.50 $ 363.56 1919
FWH MCARE FICA ST TAX SDI VACJHOL HEAL TH/WELF PENSION
8 0 0 0 13 $55.73 $ 265.00 ,t 31.14 ,i; 133.15 $ 145.51 $ -s $ $ .
$ 943.04 $ 2,147.61 TRAINING FUNDADMIN DUES TRVISUBS SAVINGS OTHER TOTALDED CHKNUM $1,387.81
0 0 0 0 3 $ 72.85 $ s . -s . $ -$ s 185.00 s 759.80 003081
FWH MCA RE FICA ST TAX SDI VACJHOL HEAL TH/WELF PENSION
6 4 5 0 23 $62.02 $ 75.00 s 19.86 $ 84.93 $ 30.06 $ . $ . $ . $ .
$ 1,672.31 $ 1,672.31 TRAINING FUNDADMIN DUES TRVISUBS SAVINGS OTI-iER TOTAL OED CHKNUM $ 1,030.01
0 0 0 0 3 $ 81.95 $ $ -$ . $ $ t 432.45 � 642.30 1920
* OTHER • Any other deductions, contributions and/or payments whether or not included or required by prevailing
wage determinations must be separately listed. Use extra sheet 1f necessary. CERTIFICATION must be completed (see back)
Sunburst Software Solutions, Inc. -Certified Payroll Solution www.CertifiedPayrollReports.com
( 1 ) ( 2) NAME, ADDRESS AND ��of SOCIAL SECURITY NUMBER W1thhold1ng OF EMPLOYEE ·--Manuel Robledo
9694 Bormongham Ave
Riverside, CA 92509 0
Philip C Brainard
Ill 1355 13th St Los Osos, CA 93402 0
Philip C Brainard Ill 1355 13th St Los Osos, CA 93402 0
Ronnie Ramsey PO Box 141
Cayucos, CA 93430-0410 0
FORM A-1-131 (New 2-80)
diR PUBLIC WORKS PAYROLL REPORTING FORM PAGE
NAME OF CONTRACTOR D-KAL Engineering CONTRACTOR'S LICENSE II 653307 ADDRESS OR SUBCONTRACTOR SPEGAL TY LICENSE II PO Box 1919 San Luos Ob1snn CA 93406 PAYROLL NUMBER FOR WEEK ENDING SELF-INSURED CERTIFICATE II PROJECT OR CONTRACT II Waterline Replace Spec 91436 23 7/23/2019 WORKERS' COMPENSATION POLICY II 7J45679Al8 PR OJECT & LOCATION San Luis Obosoo
4lDAY ( 5) ( 6) ( 7) ( 8) ( 9 ) ( 3) Sun Mon Tue Wed Thu I Fri Sat GROSS AMOUNT NET
DATE HOURLY EARNED WAGES WORK 2/17 2/18 2/19 2/20 2/21 2/22 2/23 TOTAL RATE THIS ALL DEDUCTIONS, CONTRIBUTIONS AND PAYMENTS PAID FOR CLASSIFICATION HOURS WORKED EACH DAY
Laborer
Carpenters
Laborer
Equip. Opers.
s 0 0
0
0 0 0
s
0
0 0 0
s 0 0
0
0 0 0
s 0 0
0
0 0 0
s
D
0
s
D
0
s
D
0
s
0
0
s
D
0
s
0
0
s
D
0
s
D
0
S = Straight time
0 = Overtime
8 6 4 5
3 0 0 0
0 5.5 0 0
8 8 0 0
2.5 0 0 0
8 0 0 0
0.5 0 0 0
0
0
0
0
0
0
0
HOURS OF PAY PROJECT PROJECTS
FWH MCA RE
23 $62.02 $ 75.00 � 19 86
$ 1,672.31 $ 1,672.31 TRAINING fUNDADMIN
3 $ 81.95 $ -sFWH MCARE
$ 451.00 t 43.03
$ 450.73 $ 2,967.59 TRAINING fUNDADMIN
5.5 $81.95 $ -$ FWH MCA RE
16 S55.73 $ 451.00 $ 43.03
$ 1,073.81 $ 2,967.59 TRAINING fUNDADMIN
2.5 $ 72.85 $ -$
FWH MCA RE
8 $ 75.23 $ 51.00 $ 9.45
$ 651.51 $ 651.51 TRAINING fUNDADMIN
0.5 $99.33 $ $ FWH MCA RE
TRAINING fUNDADMIN
FWH MCARE
TRAINING fUNDADMIN
FWH MCA RE
TRAINING fUNDADMIN
FWH MCA RE
TRAINING FUNDADMIN
FWH MCA RE
TRAINING fUNDADMIN
FWH MCA RE
TRAINING fUNDADMIN
FWH MCA RE
TRAINING fUNDADMIN
FWH MCA RE
TRAINING fUNDADMIN
WEEK
FICA ST TAX SDI VAC/HOL HEAL TH/WElf PENSION � 84.93 � 30.06 � t -sDUES TRV/SUBS SAVINGS OTHER TOTALDED CHK NUM $1,030.01
$ t t -t 432.45 s 642.30 1920
FICA ST TAX SDI VAC/HOL HEALTH/WRF PENSION
t 183.99 t 233.24 $ -t $ ..DUES TRV/SUBS SAVINGS OTHER TOTALDED CHKNUM $1,828.83
$ s s S 227.50 S 1 138.76 1921
FICA ST TAX SDI VACIHOL HEAL THIWELF PENSION
S 183.99 $ 233.24 s $ -$ DUES TRVISUBS SAVINGS OTHER TOTALDED CHKNUM $1,828.83
$ -$ -s S 227.50 $ 1138.76 1921
FICA ST TAX SDI VACIHOL HEALTH/WElf PENSION
$ 40.39 $ 16.71 $ -$ -$ DUES TRVISUBS SAVINGS OTHER TOTALDED CHKNUM $ 491.46
$ $ s -s 42.50 $ 160.05 1922 FICA ST TAX SDI VACJHOL HEAL TH/WElf PENSION
DUES TR\IISUBS SAVINGS OTHER TOTALDED CHKNUM
FICA ST TAX SDI VAC/HOL HEAL TH/WELF PENSION
DUES TRV/SUBS SAVINGS OTHER TOTALDED CHKNUM
FICA ST TAX SDI VAC/HOL HEAL TH/WELF PENSION
DUES TRV/SUBS SAVINGS OTHER TOTALDED CHK NUM
FICA ST TAX SDI VAC/HOL HEAL TH/WELF PENSION
DUES TRV/SUBS SAVINGS OTHER TOTALDED CHKNUM
FICA ST TAX SDI VAC/HOL HEAL TH/WELF PENSION
DUES TRV/SUBS SAVINGS OTHER TOTALDEO CHKNUM
FICA ST TAX SDI VAC/HOL HEAL TH/WELF PENSION
DUES TR\1/SUBS SAVINGS OTHER TOTALDfD CHKNUM
FICA ST TAX SDI VAC/HOL HEAL TH/WELF PENSION
DUES TRV/SUBS SAVINGS OTHER TOTALDED CHKNUM
FICA ST TAX SDI VAC/HOL HEALTH/WELF PENSION
DUES TRVISUBS SAVINGS OTHER TOTALDED CHKNUM
D =Doubletime • OTHER -Any other deductions, contributions and/or payments whether or not included or required by prevalllng
wage determinations must be separately listed. Use extra sheet if necessary. CERTIFICATION must be completed (see back)
Sunburst Software Solutions, Inc. -Certified Payroll Solution www.CertifiedPayrollReports.com
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