HomeMy WebLinkAboutRedacted - Water replacemt 91436 Week 4 ended 10.13.18( 1)
NAME, ADDRESS AND
SOCIAL SECURTIY NUMBER
OF EMPLOYEE
Anthony E Lopez Ramirez
2912 lopez Dr
Arroyo Grande, CA 93420
George Llamas
800 E. Cook
Santa Maria, CA 93454
George Llamas
800 E. Cook
Santa Maria, CA 93454
Jacob D Rexford
2761 Chaparral Lane
Paso Robles, CA 93446
Jacob D Rexford
2761 Chaparral Lane
Paso Robles, CA 9344
Jacob D Rexford
2761 Chaparral Lane
Paso Robles, CA 93446
James Douglas
612 Laura Way
Paso Robles, CA 93446
James R Douglas
1055 Pine Street
Rogue River, OR 97537
James Yanez
538 County Lane
San Luis Obispo, CA 93401
Jose Sanchez Garcia
558 Ferro Lane
Paso Robles, CA 93446
Juan Manuel Barrios
1021 Gaylene Dr
Santa Maria, CA 93458
Manuel Roblerlo
9694 Birmingham Ave
Riverside, CA 92509
FORM A·l -131 (New 2-80)
( 2)
Number of
diR Califomla Department
of Industrial ReJations PUBLIC WORKS PAYROLL REPORTING FORM
NAME OF CONTRACTOR D-KAL Eng ineeri ng CONTRACTOR'S LICENSE II 653307 ADDRESS
OR SUBCONTRACTOR SPECIALTY LICENSE II
PAYROLL NUMBER FOR WEEK ENDING SELF-INSURED CERTIFICATE II PROJECT OR CONTRACT II
4 10/13/2018 WORKERS' COMPENSATION POLICY # 7J45679A17 PROJECT & LOCATION
4) DAY ( 5) ( 6) ( 7) ( 8)
( 3) Sun Mon Tue Werl Thu I Fri Sat GROSS AMOUNT
DATE HOURLY EARNED
PAGE
PO Box 1919 San Luis Obis� CA 93406
Waterline Replace Spec 91436
San Lu is Obisoo
( 9)
NET
WAGES
Withholding WORK 10/7 I 10/8 10/9 10/10 10/11110/12 10/13 TOTAL RATE nus ALL DED UCTIONS, CONTRIBUTIONS AND PAYMENTS PAID FOR
Ex-..nUons CLASSIFICATION HOURS WORKED EACH DAY
Apprentice
0 Laborer
0 Teamsters
0 Laborer
0 Equip. Opers.
0 Carpenters
0 Laborer
0 Laborer
0 Equip. Opers.
0 Equip. Opers.
0 Laborer
0 Laborer
0 Laborer
s 0 0
D
0 0 0
s 0 8
D
0 0 1
s 0 0
D
0 0 2
s 0 0
D
0
s 0 0
D
0
s 0 0
D
0 0 0
s 0 8
D
0 0 4
s 0 8
D
0 0 4
s 0 8
D
0 0 4
s 0 8
D
0 0 4
s 0 0
D
0 0 0
s 0 8
D
0 0 4
s = Straight time
0 = Overtime
D = Doubletime
8
2
8
0
0
2
2
0
6
1.5
8
1.5
8
1.5
7.5
0
8
1.5
0
0
8
1.5
HOURS OF PAY PROJECT PROJECTS WEEK
FWH MCARE FICA ST TAX SDI VAC/HOL HEAL TH/WELF PENSION
7.5 8 6 0 29.5 $18.62 1 90.00 $ 12.14 $ 51.91 $ 35.25 $ $ $ $ -
$ 716.87 $ 716.87 TRAINING FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTAL OED CHKNUM $ 527.57
0 4 0 0 6 $ 27.93 $ $ .$ $ . $ $ $ 189.30 1785
FWH MCA RE FICA ST TAX SDI VAC/HOL HEAL TH/WELF PENSION
8 8 6 0 38 $ 59.91 $ 545.00 $ 45.35 $ 193.91 $ 258.99 $ $ -$ $ -
$ 2,351.93 $ 3,127.61 TRAINING FUNDAOMIN DUES TRV/SUBS SAVINGS OTHER TOfALDED CHK NUM $ 1,834.36
0 0 0 0 1 $ 75.35 $ $ -$ $ $ . $ 250.00 $ 1 293.25 002874
FWH MCARE FICA ST TAX SDI VAC/HOL HEAL THIWELF PENSION
0 0 1.5 0 1.5 $55.73 $ 545.00 $ 45.35 $ 193.91 $ 258.99 $ $ -$ $ .
$ 775.68 $ 3,127.61 TRAINING FUNDAOMIN DUES TRV/SUBS SAVINGS OTHER TOTAL OED CHKNUM $1,834.36
2 3.5 0 0 9.5 $ 72.85 $ $ .$ $ . $ -$ 250.00 $ 1 293.25 002874
FWH MCARE FICA ST TAX SDI VAC/HOL HEAL TH/WELF PENSION
0 4.5 0 0 6.5 $ 75.23 $ 275.00 $ 35.33 $ 151.04 $ 189.01 $ $ $ -$ .
$ 489.00 $ 2,436.10 TRAINING FUNOADMIN DUES TRV/SUBS SAVINGS OTHER TOTAL OED CHKNUM $ 1,583.36
$ $ -$ $ $ $ 202.36 $ 852.74 002875
FWH MCARE FICA ST TAX SDI VAC/HOL HEAL TH/WELF PENSION
0 3 0 0 3 $ 62.02 $ 275.00 $ 35.33 $ 151.04 $ 189.01 $ $ -$ -$ -
$ 186.06 $ 2,436.10 TRAINING FUNDADM!N DUES TRV/SUBS SAVINGS OTHER TOTAL OED CHKNUM $1,583.36
$ -$ -$ $ -$ $ 202.36 $ 852.74 002875
FWH MCARE FICA ST TAX SDI VAC/HOL HEAL TH/WELF PENSION
8 0 8 0 22 $55.73 $ 275.00 $ 35.33 $ 151.04 $ 189.01 $ $ $ . $ -
$ 1,481.04 $ 2,436.10 TRAINING FUNOAOMIN DUES TRV/SUBS SAVINGS OTHER TOTAL OED CHKNUM $ 1,583.36
2 0 0 0 3.5 $ 72.85 $ $ . $ $ $ $ 202.36 $ 852.74 002875
FWH MCARE FICA ST TAX SDI VAC/HOL HEALTHIWElf PENSION
8 8 8 0 40 $58.38 $ 438.00 $ 47.32 $ 202.33 $ 217.30 $ $ $ $ -
$ 3,263.40 $ 3,263.40 TRAINING FUNDADM!N DUES TRV/SUBS SAVINGS OTHER TOTAL OED CHKNUM $ 2,098.45
2 4 0.5 0 12 $ 77.35 $ $ -$ $ -$ .$ 260.00 $ 1164.95 002876
FWH MCARE FICA ST TAX SDI VAC/HOL HEAL TH/WElf PENSION
8 8 8 0 40 $ 75.23 $ 757.00 $ 62.08 $ 265.46 $ 375.00 $ $ -$ $ .
$ 4,281.64 $ 4,281.64 TRAINING FUNOADMIN DUES TRV/SUBS SAVINGS OTHER TOTAL OED CHKNUM $ 2,557.10
2 5 0.5 0 13 $97.88 $ -$ -$ $ $ $ 265.00 $ 1 724.54 1786
FWH MCA RE FICA ST TAX SDI VAC/HOL HEAL TH/WELF PENSION
8 8 8 0 39.5 $75.23 $ 884.00 $ 60.69 $ 259.52 $ 379.97 $ $ -$ .$
$ 4,048.27 $ 4,385.77 TRAINING FUNOADMIN DUES TRV/SUBS SAVINGS OTHER TOTAL OED CHKNUM $ 2,349.09
2 4 1 0 11 $97.88 $ $ $ -$ .$ $ 452.50 $ 2 036.68 002877
FWH MCARE FICA ST TAX SDI VAC/HOL HEALTH/WELF PENSION
8 8 4 0 36 $ 55.73 $ 236.00 $ 41.72 $ 178.41 $ 151.32 $ -$ -$ $
$ 2,807.63 $ 2,877.63 TRAINING FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTAL OED CHKNUM $ 2,035.18
1.5 4 0 0 11 $ 72.85 $ -$ -$ $ $ -$ 235.00 $ 842.45 1788
FWH MCARE FICA ST TAX SDI VAC/HOL HEALTMIWElf PENSION
8 6.5 6.5 0 21 $55.73 $ 201.00 $ 25.66 $ 109.71 $ 113.32 $ $ -$ $ -
$ 1,279.61 $ 1,769.61 TRAINING FUNOADMIN DUES TRV/SUBS SAVINGS OTHER TOTAL OED CHKNUM $ 1,207.42
1.5 0 0 0 1.5 $ 72.85 $ $ .$ -$ $ -$ 112.50 $ 562.19 002878
FWH MCARE FICA ST TAX SDI VAC/HOL HEAL TMIWElf PENSION
8 8 4 0 36 $62.02 $ 185.00 $ 33.59 $ 143.63 $ 101.08 $ $ $ -$
$ 2,970.27 $ 2,970.27 TRAINING FUNDADM!N DUES TRV/SUBS SAVINGS OTHER TOTAL OED CHKNUM $1,628.27
1.5 2 0 0 9 $ 81.95 $ $ -$ -$ $ .$ 878.70 $ 1342.00 1789
* OTHER • Any other derluctions, contributions and/or payments whether or not includerl or required by prevailing
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
( l) ( 2)
NAME, ADDRESS AND Nimbel-ol
SOCIAL SECUR!1Y NUMBER Wlthholdng OF EMPLOYEE f,omnUons
Timothy D Ambrosi
1199 W Hwy 246 #C
Buellton, CA 93427 0
Todd McDonald
PO Box 19068
Reno, NV 98511-9998 0
FORM A-1-131 (New 2-80)
diR C.llfomla Department ol ltwslnal -PUBLIC WORKS PAYROLL REPORTING FORM
NAME OF CONTRACTOR D·KAL Engineering CONTRACTOR'S LICENSE # 653307 ADDRESS
OR SUBCONTRACTOR SPEOAL 1Y LICENSE #
PAYROLL NUMBER FOR WEEK ENDING SELF-INSURED CERTIACATE # PROJECT OR CONTRACT #
4 10/13/2018 WORKERS' COMPENSATION POLICY # 7J45679A17 PROJECT & LOCATION
PAGE
PO Box 1919 San Luis Obisnn CA 93406
Waterline Replace Spec 91436
San Luis Obisoo
4) DAY ( 5) ( 6) ( 7) (8) ( 9)
( 3) Sun Mon Tue Wed Thu Fri Sat GROSS AMOUNT NET
DATE HOURLY EARNED WAGES
WORK 10/7 10/8 10 /9 10/10 10/11 10/12 10/13 TOTAL RATE THIS ALL DEDUCTIONS, CONTRIBUTIONS AND PAYMENTS PAID FOR
CLASSIACATION HOURS WORKED EACH DAY HOURS OF PAY PROJECT PROJECTS
Equip. Opers.
Laborer
s 0 0
D
0 0 0
s 0 1
D
0 0 3
s
D
0
s
D
0
s
D
0
s
D
0
s
D
0
s
D
0
s
D
0
s
D
0
s
D
0
s
D
0
s = Straight time
0 = Overtime
D = Doubletime
0
0
0
0
FWH MCA RE ACA ST TAX
8 8 3.5 0 19.5 $75.23 $ 432.00 $ 35.35 $ 151.14 $ -
$ 1,662.75 $ 2,437.75 TRAINING FUNOADM!N DUES TRV/SUBS
0 2 0 0 2 $97.88 $ $ -s $
FWH MCA RE ACA ST TAX
0 0 0 0 1 $55.73 $ 335.00 $ 26.35 S 112.64 $ 66.39
$ 274.28 $ 1,816.78 TRAINING FUNDADMIN DUES TRV/SUBS
0 0 0 0 3 $ 72.85 $ $ -$-$ -
FWH MCA RE ACA ST TAX
TRAINING FUNDAOM!N DUES TRV/SUBS
FWH MCARE ACA ST TAX
TRAINING FUNOADM!N DUES TRV/SUBS
FWH MCARE ACA ST TAX
TRAINING FUNOADMIN DUES TRV/SUBS
FWH MCARE ACA ST TAX
TRAINING FUNDADMIN DUES TRV/SUBS
FWH MCARE ACA ST TAX
TRAINING FUNDADMIN DUES TRV/SUBS
FWH MCARE ACA ST TAX
TRAINING FUNOADMIN DUES TRV/SUBS
FWH MCARE ACA ST TAX
TRAINING FUNOADMIN DUES TRV/SUBS
FWH MCARE ACA ST TAX
TRAINING FUNOADMIN DUES TRV/SUBS
FWH MCARE FICA ST TAX
TRAINING FUHOADMIN DUES TRV/SUBS
FWH MCA RE ACA ST TAX
TRAINING FUNOADMIN DUES TRV/SUBS
• 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 if necessary.
WEEK
SDI VAC/HOL HEAL TH/WEl.f PENSION
$ -$ -$ .$ .
SAVINGS OTHER TOTAL OED OtKNUM $1,711.76
$ -S 107.50 $ 725.99 1790
SDI VAC/HOL HEALTHJWELF PENSION
$ -$ -$ -$ -
SAVINGS OTHER TOTAL OED CHKNUM $1,256.40
$ $ 20.00 $ 560.38 DD2880
SDI VAC/HOL HEAL THIWELF PENSION
SAVINGS OTHER TOTAL OED CHKNUM
SDI VAC/HOL HEALTHIWELF PENSION
SAVlNGS OTHER TOTAL OED CHKNUM
SDI VAC/HOL HEAL TMIWEl.f PENSION
SAVINGS OTHER TOTALDED CHKNUM
SDI VAC/HOL HEAL TH/WEl.f PENSION
SAVINGS OTHER TOTAL OED CHKNUM
SDI VAC/HOL HEAL ,H/WELF PENSION
SAVINGS OTHER TOTAL OED CHKNUM
SDI VAC/HOL HEAL TH/WEl.f PENSION
SAVINGS OTHER TOTAL OED CHKNUM
SDI VAC/HOL HEAL THIWELF PENSION
SAVINGS OTHER TOTAL OED OtKNUM
SOI VAC/HOL HEALTHIWELF PENSION
SAVINGS OTHER TOTAL OED CHKNUM
SDI VAC/HOL HEAL TH/WELF PENSION
SAVINGS OTHER TOTAL OED OtKNUM
SDI VAC/HOL HEAL THIWELF PENSION
SAVINGS OTHER TOTAL OED CHKNUM
CERTIFICATION must be completed (see back)
Sunburst Software Solutions, Inc. -Certified Payroll Solution www.CertifiedPayrollReports.com
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