HomeMy WebLinkAboutRedacted - WATERLINE 91436 WEEK 3 ENDED 10.06.18( 1 ) ( 2)
NAME, ADDRESS AND Nurnbtt of
SOGAL SECURI1Y NUMBER Wlthholdlng
Ex:emotlons
0
0
OF EMPLOYEE
Anthony E Lopez Ramirez
2912 lopez Dr
Arroyo Grande, CA 93420
Elliott Woeste
772 Crystal Way Nipomo,
CA 93444
George Llamas
800 E. Cook
Santa Maria, CA 93454 0
Jacob D Rexford
2761 Chaparral Lane
Paso Robles, CA 93446 0
Jacob D Rexford
2761 Chaparral Lane
Paso Robles, CA 93446 0
Jacob D Rexford
2761 Chaparral Lane
Paso Robles, CA 93446 0
James Douglas
612 Laura Way
Paso Robles, CA 93446 0
0
0
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 0
Juan Manuel Barrios
1021 Gaylene Dr
Santa Maria, CA 93458 0
Juan Manuel Barrios
1021 Gaylene Dr
Santa Maria, CA 93458 0
FORM A-1-131 (New 2-80)
diR ea1,1om1a 0epar1ment
of lodustrial Relations PUBLIC WORKS PAYROLL REPORTING FORM PAGE
NAME OF CONTRACTOR D-KAL Engineering
DR SUBCONTRACTOR
PAYROLL NUMBER FOR WEEK ENDING SELF-INSURED CERTIFICATE#
3 10/6 /2018 WORKERS' COMPENSATION POLICY #
4) DAY
( 3) Sun Mon Tue Wed Thu Fri
DATE
WORK 9/30 10/1 10/2 10/3 10/4 10/5
CLASSIFICATION HOURS WORKED EACH DAY
Apprentice
Laborer
Equip. Opers.
Teamsters
Equip. Opers.
Carpenters
Laborer
Laborer
Equip. Opers.
Equip. Opers.
Laborer
Equip. Opers.
Carpenters
s 0 7.5
D
0 0 0
s 0 8
D
0 0 0
s 0 8
D
0 0 0
s 0 6
D
0
s 0 0
D
0 0 0
s 0 2.5
D
0 0 0
s 0 0
D
0 0 0
s 0 8
D
0 0 0
s 0 8
D
0 0 0.5
s 0 8
D
0 0 0
s 0 1
D
0
s 0 0
D
0
S = Straight time o = Overtime
8 0 8 8
3 0 2 2.5
8 0 8 8
0 0 3 3
8 0 8 8
2 0 2 3
0 0 2.5 0
0 0 5.5 0
0 0 2.5 0
8 0 0 8
4 0 0 3.5
8 2 0 0
4 0 0 0
8 0 8 8
4 0 3 3.5
8 3.5 8 8
4 0 3 3.5
8 0 8 8
4 0 2.5 4
0 0 0 0
0 0 2 0
( 5) ( 6)
Sat
HOURLY
10/6 TOTAL RATE
HOURS OF PAY
0 31.5 $18.62
0 7.5 $ 27.93
0 32 $ 75.23
1 7 $97.88
0 32 $ 59.91
0 7 $ 75.35
0 8.5 $ 75.23
0 5.5 $ 62.02
0 2.5 $ 81.95
0 18.5 $ 55.73
0 7.5 $72.85
0 10 $ 55.73
0 4 $72.85
0 32 $ 75.23
0 10.5 $97.88
0 35.5 $75.23
0 11 $97.88
0 32 $55.73
0 10.5 $ 72.85
0 1 $ 75.23
0 2 $62.02
CONTRACTOR'S LICENSE #
SPEGAL 1Y LICENSE #
7J45679A17
( 7)
GROSS AMOUNT
EARNED
THIS ALL
PROJECT PROJECTS
FWH
$ 110.00
$ 796.01 $ 796.01 TRAINING
$ -
FWH
$ 581.00
$ 3,190.40 $ 3,988.00 TRAINING
$ FWH
$ 406.00
$ 2,444.57 $ 2,497.07 TRAINING
$ FWH
$ 447.00
$ 639.46 $ 2,762.84 TRAINING
$ FWH
$ 447.00
$ 545.99 $ 2,762.84 TRAINING
$ FWH
$ 447.00
$ 1,577.39 $ 2,762.84 TRAINING
$ -
FWH
$ 310.00
$ 2,636.57 $ 2,636.57 TRAINING
$ -
FWH
$ 532.00
$ 3,435.10 $ 3,435.10 TRAINING
$ -
FWH
$ 763.00
$ 3,747.35 $ 3,787.35 TRAINING
$
FWH
$ 170.00
$ 2,548.29 $ 2,548.29 TRAINING
$ FWH
$ 355.00
$ 75.23 $ 2,533.77 TRAINING
$ FWH
$ 355.00
$ 124.04 $ 2,533.77 TRAINING
$
653307 ADDRESS
PO Box 1919 San Luis Obisac, CA 93406
PROJECT OR CONTRACT # Waterline Replace Spec 91436
PROJECT & LOCATION San Luis Obisoo
( 8)
DEDUCTIONS, CONTRIBUTIONS AND PAYMENTS
MCA RE FICA STTAX SDI VACJHOL HEAL TH/WELF PENSION
$ 13.46 $ 57.55 $ 42.72 $ -$ $ $
FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTAL OED CHKNUM
$ $ $ -$ $ $ 223.73 1779
MCA RE FICA ST TAX SDI VACJHOL HEAL TH/WELF PENSION
$ 57.83 $ 247.26 $ 292.67 $ $ $ $
FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTAL OED CHKNUM
$ $ $ -$ $ 190.00 $ 1 368.76 1778
MCA RE FICA ST TAX SDI VACJHOL HEALTMIWELF PENSION
$ 36.20 $ 154.82 $ 193.81 $ $ $ $
FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTAL OED CHKNUM
$ $ -$ -$ $ 195.00 $ 985.83 002865
MCA RE FICA ST TAX SDI VAC/HOL HEAL THIWELF PENSION
$ 40.06 $ 171.30 $ 219.45 $ -$ $ $
FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TDTALDED CHKNUM
$ $ $ -$ $ 239.86 $ 1 117.67 002866
MCARE FICA ST TAX SDI VAC/HOL HEAi. TH/WELF PENSION
$ 40.06 $ 171.30 $ 219.45 $ -$ -$ -$ -
FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTALDED CHKNUM
$ -$ $ $ $ 239.86 $ 1 117.67 002866
MCARE FICA ST TAX SDI VACJHOL HEALTH/WELF PENSION
$ 40.06 $ 171.30 $ 219.45 $ $ $ -$
FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTAL OED CHKNUM
$ -$ $ $ $ 239.86 $ 1 117.67 002866
MCA RE FICA ST TAX SDI VACJHOL HEAL TH/WELF PENSION
$ 38.23 $ 163.46 $ 151.50 $ $ $ -$
FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTAL OED CHKNUM
$ $ $ $ $ 215.00 $ 878.19 002867
MCARE FICA ST TAX SDI VAC/HOL HEAL TH/WELF PENSION
$ 49.81 $ 212.98 $ 285.30 $ $ $ -$
FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTALDED CHKNUM
$ $ $ -$ $ 212.50 $ 1 292.59 1780
MCARE FICA ST TAX SDI VAC/HOL HEAL TM IWELF PENSION
$ 54.92 $ 234.82 $ 337.29 $ $ -$ -$ -
FUNDADMIN DUES TRVISUBS SAVINGS OTHER TOTAL OED CHKNUM
$ -$ -$ -$ -$ 232.50 $ 1 622.53 002868
MCA RE FICA ST TAX SOI VAC/HOL HEAL TH/WELF PENSION
$ 36.95 $ 157.99 $ 116.63 $ -$ $ $
FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTALDED CHKNUM
$ -$ -$ -$ $ 212.50 $ 694.07 1782
MCARE FICA ST TAX SDI VAC/HOL HEAL TH/WELF PENSION
$ 36.74 $ 157.10 $ 189.41 $ $ $ $
FUNDADMIN DUES TRVISUBS SAVINGS OTHER TOTAL OED CHKNUM
$ -$ $ $ $ 207.50 $ 945.75 002869
MCARE FICA ST TAX SDI VAC/HOL HEALTH/WELF PENSION
$ 36.74 $ 157.10 $ 189.41 $ -$ $ $
FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTALDED CHKNUM
$ -$ -$ -$ -$ 207.50 $ 945.75 002869
( 9)
NET
WAGES
PAID FOR
WEEK
$ 572.28
$ 2,619.24
$ 1,511.24
$ 1,645.17
$ 1,645.17
$ 1,645.17
$ 1,758.38
$ 2,142.51
$ 2,164.82
$1,854.22
$ 1,588.02
$ 1,588.02
D =Ooubletime
* 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. CERTIFICATION must be completed (see back)
Sunburst Software Solutions, Inc. -Certified Payroll Solution www.CertifiedPayrollReports.com
( 1 ) ( 2)
NAME, ADDRESS AND Number of
SOOAL SECURTIY NUMBER Withholding
OF EMPLOYEE Exem�-
Juan Manuel Barrios
1021 Gaylene Dr
Santa Maria, CA 93458 0
xxx-xx-xxxx
Manuel Robledo
9694 Birmingham Ave
Riverside, CA 92509 0
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 Callfom\a Department or Industrial Re\atJons PUBLIC WORKS PAYROLL REPORTING FORM PAGE
NAME OF CONTRACTOR 0-KAL Engineering
OR SUBCONTRACTOR PAYROLL NUMBER FOR WEEK ENDING SELF-INSURED CERTIFICATE #
3 10/6/2018 WORKERS' COMPENSATION POLICY #
(4) DAY ( 3) Sun Mon Tue Wed Thu Fri
DATE
WORK 9130 1611 10/2 10/3 10/4 10/5
CLASSIFICATION HOURS WORKED EACH DAY
Laborer
Laborer
Equip. Opers.
Laborer
s 0 7
D
0 0 0
s 0 7
D
0 0 0
s 0 8
D
0 0 0
s 0 0
D
0 0 0
s
D
0
s
D
s
D
0
s
D
0
s
D
0
s
D
0
s
D
0
s
D
0
S = Straight time O = Overtime
8 0 6 8
3.5 0 2 4
8 2 8 8
4 0 2.5 2.5
8 0 0 8
2 0 0 1
0 0 0 8
0 0 0 3
( 5) ( 6) Sat HOURLY
10/6 TOTAL RATE
HOURS OF PAY
0 29 $ 55.73
0 9.5 $ 72.85
0 33 $62.02
0 9 $ 81.95
0 24 $75.23
0 3 $97.88
0 8 $ 55.73
0 3 $ 72.85
CONTRACTOR'S LICENSE # SPEOAL1Y LICENSE#
7J45679A17
( 7) GROSS AMOUNT
EARNED
THIS ALL
PROJECT PROJECTS FWH
$ 355.00
$ 2,308.25 $ 2,533.77 TRAINING
$ FWH
$ 158.00
$ 2,784.21 $ 2,784.21 TRAINING
,t -
FWH
-,t 345.00
$ 2,099.16 $ 2,099.16 TRAINING
t FWH t 487.00
$ 664.39 $ 2,484.39 TRAINING
t FWH
TRAINING
FWH
TRAINING
FWH
TRAINING
FWH
TRAINING
FWH
TRAINING
FWH
TRAINING
FWH
TRAINING
FWH
TRAINING
653307 ADDRESS PO Box 1919 San Luis Obis� CA 93406
PROJECT OR CONTRACT # Waterline Replace Spec 91436
PROJECT & LOCATION San Luis Obisoo
( 8)
DEDUCTIONS, CONTRJBUTIONS AND PAYMENTS
MCARE FICA ST TAX SDI VAC/HOL HEAL TH/WELF PENSION
$ 36.74 $ 157.10 $ 189.41 $ $ -$ $
FUND ADMIN DUES TRV/SUBS SAVINGS OTHER TOTAL OED CHKNUM
$ -$ $ $ -s 207.50 $ 945.75 002869
MCARE FICA ST TAX SDI VAC/HOL HEALTH/WELF PENSION
$ 30.89 $ 132.09 $ 84.18 $ -,t $ -$
FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTAL OED CHKNUM
$ $ -$ $ t 863.70 S 1 268.86 1783
MCA RE FICA SfTAX SDI VAC/HOL HEAL TH/WELF PENSION
$ 30.44 $ 130.15 $ $ -$ -"'-t
FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTAL OED CHKNUM
$ $ -$ $ $ 135.00 $ 640.59 1784
MCARE FICA ST TAX SDI VAGHOL HEAL TH/WELF PENSION
$ 36.02 $ 154.03 $ 125.94 $ -$ t t
FUNOADMIN DUES TRV/SUBS SAVINGS OTHER TOTALDEO CHKNUM
$ $ $ $ -$ 55.00 $ 857.99 002871
MCARE FICA ST TAX SDI VAC'JHOL HEALTHIWELF PENSION
FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTALDED CHKNUM
MCARE FICA ST TAX SDI VAC/HOL HEAL THIWELF PENSION
FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTALDED CHKNUM
MCARE FICA ST TAX SDI VAC/HOL HEAL TH/WELF PENSION
FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTAL OED CHKNUM
MCA RE FICA ST TAX SDI VAC/HOL HEALTH/WELF PENSION
FUNDADMJN DUES TRV/SUBS SAVINGS OTHER TOTALDEO CHKNUM
MCA RE FICA ST TAX SDI VAC/HOL HEAL TH/WELF PENSION
FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTAL OED CHKNUM
MCARE FICA ST TAX SDI VAC/HOL HEAL TH/WELF PENSION
FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTAL OED CHKNUM
MCARE FICA ST TAX SDI VAGHOL HEAL THIWELF PENSION
FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTAL OED CHKNUM
MCARE FICA ST TAX SDI VAC/HOL HEAL TH/WELF PENSION
FUNDADMIN DUES TRV/SUBS SAVINGS OnlER TOTAL OED CHKNUM
( 9) NET
WAGES PAID FOR
WEEK
$1,588.02
$1,515.35
$ 1,458.57
$ 1,626.40
D = Doubletime
* 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. CERTIFICATION must be completed (see back)
Sunburst Software Solutions, Inc. -Certified Payroll Solution www.CertifiedPayrollReports.com
q 6 ='A X - o_aFi*ig Ii a I9< itFAefE EO^ ll =- lV'<iia:^+ o€E {39 6qCq^d.a4sigilE a;.e.''-E e 3o:6='e
idgF d e
a*'463
=
q d-,6 4" 3gf,3EF Z
iEfifrI ill.; P d =. 6
383;+ i
sIEE g Eitr*i3 nStilE I
[aE ea iiF''lltio
{l-lozaee2I ; x;Extr!: SSFEXnglEF!!#d2 ge*EIaE'EE,HaE- qqiil46-mar:il 61
4*cqqE63i+e H:=€:T'q ri >+!i5 ?.* jmil;lF:tqis3l ;q4q;o,3>=x;*o XfrelI:4f;FR*1F m<
d'Fage5;E#3 E
F4[*n-=[9f,H? d
=$H+=Eiea*.* t
aafi tr -e*s +3 Qa=i:+ qH-3:fr E
=rFX iiQE: -a+,HeI -53--: F
== =,i d-n uX:sA Eg*a -=-:6p9 HSFE edq58 3F 9 z.i+b=* r Ui+Ofra a a.\
5fr i;ec$ +R 1t$*gE$+,{;9;; a $fl=e*X 6 t.:6'9,X6'-P o-o.<-<; AE6 i:.d'-Pe"-&J,eFln€rEs*;ii; Es=_:ix= FvEqsEEq*a$tsETEH$id.9;; og =N-cE-- 5 5 S =eni.ii9; $ifi ts: A{giFE:bbrl:;-BiE Rg
HH F*Eq; e 3::&Fg e
$g+1s1*qt1fi iB$1
iEtEEgEEFEESEg
fl*$E$EgE+glsiErdx= 639 d d'j =g$qse'39 3FE*"
-r u| !-r !X
sEFEF+ ilsFsreas#E$iE+q $s3gilA*igiliE*! qr=i$iac3*s#sag* giEai:5[rq;,qF;it ;9:-9.-ge:+Frg€s 1s^ii#llfngSiaig dflrif;qsiI$HgCq iiiisliis+El9q'+ EJ68eeAF=
E€eir tgri+€gEeE*H',x qiq4[1ff,iHjga d'iA3a{rs
e.d 3i i $sgd aE'H;
=d.=i9 Id='r;Fide6A:4e fld+=e&Fd5=;f; qifsq:q'fl
E; eeq +: a 13,;;.fiBp:6 riE:E* a9
fr$nE =s sE3 rilfr3 d-x a; dq*l4 eoq Ra{e- F
m3
tsl9telg IEFEE]Fl#lE l=t8 t-ld t=IFHF IEtlt+FE
HHIFH
EEEE
HliHli
to|:to
lEleF
l{lq l$
td
=.)
d
a)
d
mxa)m
z.
oF
f
'no
=lDo,
J
d
t.c
3
>I:tlD7=
o=
a)lD
HE
.D
o)d
o
c
o-
o
0
r
o
E
Fz.4
z
-1-m
€
qc
I
ETq
z.o
z,
--l
=m
8z-t
q
o
o
c
@
oz-{
co
3
=;aP
Y,>
zqai+
>;i
i=F5
:t?
m
z,I
m
3
z
-t
=m
-{Im