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Home My WebLink AboutRedacted - Waterline 91436 Week 6 ended 10.27.18( l ) NAME, ADDRESS AND SOCIAL SECURI"TY NUMBER OF EMPLOYEE Anthony E Lopez Ramirez 2912 lopez Dr Arroyo Grande, CA 93420 Bryce Crespin 4355 Cayucos Ave Atascadero, CA 93422 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 93446 xxxxxxxxxx James Douglas 612 Laura Way Paso Robles, CA 93446 xxxxxxxxxJames R Douglas 1055 Pine Street Rogue River, OR 97537 James Yanez 538 County Lane San Luis Obispo, CA 93401 xxxxxxxx Jose Sanchez Garcia 558 Ferro Lane Paso Robles, CA 93446 xxxxxx Juan Manuel Barrios 1021 Gaylene Dr Santa Marai, CA 93458 xxx-xx-xxxx Manuel Robledo 9694 Birmingham Ave Riverside, CA 92509 FORM A-1-131 (New 2·80) ( 2) Numbe" of diR ca 11rom1a Department of Industrial R!!latlon.s PUBLIC WORKS PAYROLL REPORTING FORM NAME OF CONTRACTOR D·KAL Engineering CONTRACTOR'S LICENSE # 653307 ADDRESS OR SUBCONTRACTOR SPECIAL"TY LICENSE# PAYROLL NUMBER FOR WEEK ENDING SELF-INSURED CERTIFICATE# PROJECT OR CONTRACT# 6 10/27/2018 WORKERS' COMPENSATION POLICY # 7J45679Al7 PROJECT & LOCATION 141 DAY ( 5) ( 6) ( 7) ( 8) ( 3) Sun Mon Tue Wed I Thu Fri I Sat GROSS AMOUNT DATE HOURLY EARNED PAGE PO Box 1919 San Luis Obisoo. CA 93406 Waterline Replace Spec 91436 San Luis Obis"" ( 9) NET WAGES Withholding WORK 10/21 10/22 10/23 10/24 10/25 10/26 10127 TOTAL CLASSIFICATION RATE TI-IIS ALL DEDUCTIONS, CONTRIBUTIONS AND PAYMENTS PAID FOR ExemnUons Apprentice 0 Laborer 0 Carpenters 0 Teamsters 0 Laborer 0 Equip . Opers. 0 Laborer 0 Laborer 0 Equip. Opers. 0 Equip. Opers. 0 Laborer 0 Laborer 0 Laborer HOURS WORKED EACH DAY HOURS OF PAY PROJECT PROJECTS WEEK FWH MCA RE FICA ST TAX SDI VAC/HOL HEALni/WELF PENSION s 0 8 8 8 7.5 0 0 31.5 t 18.62 $ 97.00 $ 12.55 $ 53.67 $ 37.40 $ $ t $ D 0 0 3 s 0 8 D 0 0 3 s 0 0 D 0 s 0 0 D 0 0 0 s 0 0 D 0 s 0 0 D 0 0 0 s 0 8 D 0 0 0 s 0 8 D 0 0 0 s 0 8 D 0 0 3 s 0 8 D 0 0 2 s 0 8 D 0 0 3 s 0 8 D 0 0 2 s = Straight time o = Overtime D = Doubletime 1.5 0 0 0 0 0 5 0 2 8 2 8 2 8 1.5 8 1.5 0 0 8 l $ 740.15 $ 740.15 TRAINING FUNDADMIN DUES TRVISUBS 1 0 0 0 5.5 $ 27.93 $ . $ .$ . $ FWH MCARE FICA ST TAX 6.5 8 8 0 30.5 <62.02 $ 211.00 $ 30.99 t 132.52 $ 156.24 $ 2,137.46 $ 2,137.46 TRAINING FUNDADMIN DUES TRV/SUBS 0 0 0 0 3 t 81.95 $ t t . t . FWH MCA RE FICA ST TAX l 6 6 0 13 $59.91 $ 301.00 t 28.15 t 120.39 t 143.47 $ 778.83 $ 1,941.72 TRAINING FUNDADMIN DUES TRV/SUBS $ . t t . $ FWH MCA RE FICA ST TAX 0 2 0 0 2 $ 55.73 $ 301.00 t 28.15 $ 120.39 $ 143.47 $ 147.89 $ 1,941.72 TRAINING FUNDADMIN DUES TRV/SUBS 0 0.5 0 0 0.5 $ 72.85 $ . t . t $ . FWH MCA RE FICA ST TAX 0 0 0 0 5 $ 75.23 $ 342.00 t 39.91 � 170.64 t 223.23 $ 376.15 $ 2,752.17 TRAINING fUNDAOMIN DUES TRV/SUBS $ �. <I t . FWH MCA RE FICA ST TAX 7 0 5.5 0 12.5 t 58.38 $ 342.00 t 39.91 i 170.64 t 223.23 $ 1,938.52 $ 2,752.17 TRAINING FUNDADMIN DUES TRV/SUBS 2.5 0.5 0.5 0 5.5 t72.85 $ . $ . $ . $ FWH MCARE FICA ST TAX 8 8 8 0 40 $58.38 $ 287.00 $ 36.67 $ 156.77 $ 139.64 $ 2,528.58 $ 2,528.58 TRAINING FUNDADM!N DUES TRV/SUBS 0.5 0 0 0 2.5 t77.35 $ $ $ . $ FWH MCA RE FICA ST TAX 8 8 8 0 40 t 75.23 $ 488.00 $ 47.18 $ 201.74 $ 264.95 $ 3,253.90 $ 3,253.90 TRAINING FUNDADMIN DUES TRV/SUBS 0.5 0 0 0 2.5 <97.88 $ $ $ . $ . FWH MCA RE FICA ST TAX 8 8 8 0 40 $75.23 $ 643.00 t 49.96 t 213.62 t 298.88 $ 3,645.42 $ 3,645.42 TRAINING FUNDADMIN DUES TRV/SUBS 2 0 0 0 6.5 $97.88 $ . t . t . $ FWH MCA RE ACA ST TAX 8 6 0 0 30 i; 55.73 $ 105.00 t 28.47 t 121.72 $ 61.93 $ 1,963.30 $ 1,963.30 TRAINING fUNDADMIN DUES TRV/SUBS 0.5 0 0 0 4 $ 72.85 $ t . t . $ FWH MCA RE FICA ST TAX 8 8 8 0 32 $ 55.73 $ 266.00 t 30.99 t 132.52 $ 147.47 $ 2,111.19 $ 2,137.44 TRAINING Fl!NDADMIN DUES TRV/SUBS 1 0.5 0 0 4.5 t 72.85 $ t t . t FWH MCA RE FICA ST TAX 8 8 0 0 32 t62.02 $ 114.00 $ 25.24 $ 107.93 $ 53.68 $ 2,394.39 $ 2,394 .39 TRAINING FUNDADMIN DUES TRV/SUBS 2 0 0 0 5 t8l.95 $ $ $ .$ * OTHER • Any other deduct ions, contributions and/or payments whether or not included or required by preva ilingwage determinations must be separately listed. Use extra sheet if necessary. SAVINGS OTHER TOTAL OED CHKNUM $ 539.53 $ $ t 200.62 1797 SDI VAC/HOL HEAL TH/WELF PENSION $ $ $ $ SAVINGS OTHER TOTALDEO CHKNUM $1,439.21 $ . $ 167.50 $ 698.25 002892 SDI VAC/HOL HEAL=""ELF PENSION $ $ $ $ . SAVINGS OTHER TOTALDEO CHKNUM $ 1,271.21 $ .$ 77.50 $ 670.51 002895 SDI VAC/HOL HEALTMIWElf PENSION $ . $ $ $ . SAVINGS OTHER TOTALDED CHKNUM $ 1,271.21 $ . $ 77.50 $ 670.51 002895 SDI VAC/HOL HEAlni/WELF PENSION $ . $ $ $ . SAVINGS OTHER TOTALDEO CHKNUM $ 1,761.53 $ . $ 214.86 $ 990.64 002896 SDI VAC/HOL HEALTH/WELi' PENSION $ .$ $ $ SAVINGS OTHER TOTALDEO CHKNUM $ 1,761.53 $ $ 214.86 t 990.64 002896 SDI VAC/HOL HEAL1WWELF PENSION $ . $ . t t SAVINGS OTHER TOTAL OED CHKNUM $1,696.00 $ . $ 212.50 t 832.58 002897 SDI VAC/HOL HEAL TH/WELF PENSION $ . $ . $ $ . SAVINGS OTHER TOTALDED CHKNUM $1,934.25 $ . $ 317.78 $ 1 319.65 1798 SDI VAC/HOL HEALTHIWELF PENSION t . $ $ .$ . SAVINGS OTHER TOTAL OED CHKNUM $ 2,007.46 $ . $ 432.50 $ l 637.96 002898 SDI VAC/HOL HEAL TH/WELF PENSION $ . $ . $ $ - SAVINGS OTHER TOTAL OED CHKNUM $1,476.18 $ . $ 170.00 $ 487.12 1800 SDI VAC/HOL HEALTH/WELF PENSION $ . $ . $ $ . SAVINGS OTHER TOTALDEO CHKNUM $ 1,377.96 $ . $ 182.50 $ 759.48 002899 SDI VAC/HOL HEALTH/Wflf PENSION $ $ -t t . SAVINGS OTHER TOTALDEO CHKNUM $1,254.84 $ $ 838.70 t 1 139.55 1801 CERTIFICATION must be completed (see back) Sunburst Software Solutions, Inc. -Certified Payroll Solution www.CertifiedPayrollReports.com ( 1) ( 2) NAME, ADDRESS AND Number of SOCIAL SE CURITY NUMBER Wlthholdlng OF EMPLOYEE Exemntions Timothy D Ambrosi 1199 W Hwy 246 #C Buellton, CA 93427 0 FORM A-1-131 (New 2-80) diR California Department of Industrial Retations PUBLIC WORKS PAYROLL REPORTING FORM NAME OF CONTRACTOR D-KAL Engineering CONTRACTOR'S LICENSE # 653307 ADDRESS OR SUBCONTRACTOR SPECIAL TY LICENSE # PAYROLL NUMBER FOR WEEK ENDING SE LF-INSURED CERTIFICATE # PROJECT OR CONTRACT # 6 10/27/2018 WORKERS' COMPENSATION POLICY # 7J45679A17 PROJECT & LOCATION 4\ DAY ( 5) ( 6) (7) ( 8) ( 3) Sun Mon Tue Wed I Thu Fri I Sat GROSS AMOUNT DATE HOURLY EARNED PAGE PO Box 1919 San Luis Obisnn CA 93406 Waterline Replace Spec 91436 San Luis Obisoo ( 9) NET WAGES WORK 10/21 10/22 10/23 10/24 10/25 10/26110/27 TOTAL RATE THIS ALL DEDUCTIONS, CONTRIBUTIONS AND PAYMENTS PAID FOR CLASSIFICATION HOURS WORKED EACH DAY HOURS OF PAY PROJECT PROJECTS Equip. Opers. s 0 8 D 0 0 2 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 D 0 S = Straight time 0 = Overtime D = Ooubletime 0 0 FWH MCARE FICA ST TAX 5 6 0 0 19 $75.23 $ 241.00 t 23.57 1 100.76 1 $ 1,625.13 $ 1,625.13 lRAINING FUNDADMIN DUES TRV/SUBS 0 0 0 0 2 $97.88 $ -t -t -t - FWH MCARE FICA ST TAX TRAINING FUNDADM!N DUES TRVISUBS FWH MCA RE FICA ST TAX TRAINING FUNDADMIN DUES TIRVISUBS FWH MCA RE FICA ST TAX TRAINING FUNDADMIN DUES TRVISUBS FWH MCA RE FICA ST TAX TRAINING FUNDADMIN DUES TRW SUBS FWH MCA RE FICA ST TAX TRAINING FUNDADMIN DUES TRVISUBS FWH MCA RE FICA ST TAX lRAINING FUNDADMIN DUES TR V/SUBS FWH MCA RE FICA ST TAX TRAINING fUNDADMIN DUES TRViSUBS FWH MCARE FICA ST TAX TRAINING FUNDADMIN DUES TRVISUBS FWH MCA RE FICA ST TAX TRAINING FUNDADMIN DUES TRVISUBS FWH MCA RE FICA ST TAX TRAINING FUNDADMIN DUES TRW SUBS FWH MCA RE FICA ST TAX TRAINING FUNDADMIN 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 HEALTH/WELF PENSION 1 -$ $ SAVINGS OTHER TOTAL OED CHKNUM $1,154.80 t -t 105.00 t 470.33 1802 SOI VAC/HOL HEAL"TWWELF PENSION SAVINGS OTHER TOTAL OED CHKNUM SDI VAC/HOL HEAL TH/WELF PENSION SAVINGS OTHER TOTAL OED CHKNUM SOI VAC'IHOL HEAL TH/WELF PENSION SAVINGS OTHER TOTAL OED CHKNUM SDI VAC'/HOL HEAL"TWWELF PENSION SAVINGS OTHER TOTAL OED CHKNUM SOI VACJHOL HEALTH/WELF PENSION SAVINGS OTHER TOTAL OED CHKNUM SDI VAC/HOL HEAL"TWWELF PENSION SAVINGS OTHER TOTAL OED CHKNUM SDI VAC/HOL HEAL"TWWELF PENSION SAVINGS OTHER TOTAL OED CHKNUM SOI VAC/HOL HEAL"TWWELF PENSION SAVINGS OTHER TOTAL OED CHKNUM SOI VACJHOL HEAL"TWWELF PENSION SAVINGS OTHER TOTAL OED CHKNUM SOI VACJHOL HEAL TH/WELf PENSION SAVINGS OTHER TOTAL OED CHKNUM SOI VAC/HOL HEALT><IWELf PENSION SAVINGS OTHER TOTAL OED CHKNUM CERTIFICATION must be completed (see back) Sunburst Software Solutions, Inc. -Certified Payroll Solution www.CertifiedPayrollReports.com lllglgggggggggg igg;g $ ii$FiigEgis$igiEF$E NJ-l Iti{lll3lnz-{o.i oo3!|- Dz6m It)fiF-{ .rt FI(.) {FIozczImF!ltlz I o1t 1tm-qc- 3d$;Ei$$is5; s$gi$$$;iFs! 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