HomeMy WebLinkAbout2019.07.27 SOC #2STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
STATEMENT OF COMPLIANCE
CEM -2503 (REV 05/2019) Page 1 of 2
CONTRACTOR/SUBCONTRACTOR CONTRACT NUMBER
Papich Construction Co Inc 1000023 City of SLO, South Broad St Improvements Payroll #2
DEPARTMENT OF INDUSTRIAL RELATIONS REGISTRATION NUMBER CONTRACTORS STATE LICENSE BOARD NUMBER
1000004169 767055
FIRST DAY AND DATE OF PAY PERIOD LAST DAY AND DATE OF PAY PERIOD
July 21 2019 July 27, 2019
I do hereby certify under penalty of perjury:
(1) That I pay or supervise payment to employees of the above -referenced contractor on the above -referenced contract. All persons employed
on said project for the above -referenced time period have been paid their full weekly wages earned, that no rebates have been or will be made
either directly or indirectly to or on behalf of said contractor from the full weekly wages earned by 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.
(2) That any payrolls otherwise under this control required to be submitted for the above period are correct and complete; that the wage rates
for laborers or mechanics contained therein are not less that the applicable wages rates:
(a) ❑ Specified in the applicable wage determination incorporated into the contract;
(b) ® Determined by the Director of Industrial Relations for the county or counties in which the work is performed; that the classification
set forth therein for each laborer or mechanic conform with the work he or she performed.
(3) That any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with a State
apprenticeship agency.
(4) That fringe benefits as listed in the contract:
(a) ® Have been or will be paid to the approved plan(s), fund(s), or program(s) for the benefit of listed employee(s), except as
noted below.
(b) Have been paid directly to the listed employee(s), except as noted below.
(c) See exceptions noted below.
EXCEPTION CRAFT EXPLANATION
REMARKS
NAME (PLEASE PRINT) TITLE
April Papich CFO
SIGNATURE DATE
9/26/
On federally -funded projects, permissible deduc i ed in Code of Federal Regulations, Title 29, Part 3.
Also, the willful falsification of any of the above statements may subject the contractor or subcontractor to civil or criminal prosecution (see
United States Code, Title 18, Section 1001 and Title 31, Section 3729).
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