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Home My WebLink AboutRedacted - Waterline 91436 Week 10 ended 11.24.18( l) NAME, ADDRESS AND SOOAL SECURITY NUMBER OF EMPLOYEE Bryce Crespin 4355 Cayucos Ave Atascadero, CA 93422 Bryce Crespin 4355 Cayucos Ave Atascadero, CA 93422 Frank J Moralez 328 Mellifont Ave Santa Barbara, CA 93103 George Uamas 800 E. Cook Santa Maria, CA 93454 George Llamas 800 E. Cook Santa Maria, CA 93454 Jacob o Rexford 2761 Chaparral Lane Paso Robles, CA 93446 Jacob D Rexford 2761 Chaparral Lane Paso Robles, CA 93446 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 Robledo 9694 Birmingham Ave Riverside, CA 92509 xxxxxxxx Philip C Brainard III 1501 14th St Los Osos, CA 93402 FORM A-1-131 (New 2·80) diR PUBLIC WORKS PAYROLL REPORTING FORM PAGE NAME OF CONTRACTOR D·KAL Engineering OR SUBCONTRACTOR PAYROLL NUMBER FOR WEEK ENDING SELF-INSURED CERTIFICATE# 10 11124/2018 WORKERS' COMPENSATION POLICY# (4l0AY ( 2) ( 3) Sun Mon Tue Wed I Thu Fri I Sat Numberol DATE Wlthholdlog WORK 11118 11/19 11/20 11/21 11/22 11/23 11/24 I,,_...., CLASSIFICATION HOURS WORKED EACH DAY 0 0 0 0 0 0 0 0 0 0 0 0 s 0 8 Carpenters D 0 0 1 s Laborer D 0 0 5 s 0 8 Cement Masons D Teamsters Laborer Carpenters Laborer !� � Laborer Laborer Laborer Carpenters 0 s 0 3 D 0 s 0 0 D 0 0 2 s 0 8 D 0 0 1 s D 0 0 5 s D 0 14 0 s D 0 0 5 s 0 8 D 0 0 6 s 0 8 D 0 0 5.5 s 0 8 D 0 0 l S = Straight time 0 = Overtime B 6 0 0 1 0 0 0 0 0 0 0 4 0 0 0 6 0 0 0 2 0 0 0 0 0 0 0 8 6.5 0 0 1 0 0 0 0 0 0 0 9 7 0 0 l 0 0 0 8 8 0 0 0.5 0 0 0 8 0 0 0 0.5 0 0 0 8 3 0 0 l 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ( 5) ( 6) HOURLY TOTAL RATE HOURS OF PAY 22 $62.02 2 $81.95 5 $ 72.85 12 S35.75 9 S59.91 2 $55.73 2 $72.85 22.5 $62.02 2 $81.95 5 S 72.85 30 $3,100.00 c: _.,,J I 6 s 72.85 24 $55.73 6.5 $72.85 16 $62.02 6 $ 81.95 19 $62.02 2 $ 81.95 CONTRACTOR'S LICENSE # 653307 ADDRESS SPEOALTY LICENSE# PO Box 1919 San Luis Obisnn CA 93406 PROJECT OR CONTRACT # Waterline Replace Spec 91436 7J45679Al8 PROJECT & LOCATION San Luis Obisnn ( 7) ( 8) GROSS AMOUNT EARNED THIS ALL DEDUCTIONS, CONTRIBUTIONS ANO PAYMENTS PROJECT PROJECTS FWH MCA RE FICA ST TAX SOI YAGHOL HEAi. TH/WELf PENSION $ 166.00 $ 27.45 $ 117.35 S 131.04 $ . s . t . $ . $ 1,528.34 $ 1,892.59 TRAINING FIJNOADMIN DUES TRY/SUBS SAVINGS OTHER TOTAL OED CHKNUM $ . s s . $ . $ . S 145.00 $ 586.84 002931 FWH MCARE FICA ST TAX SOI YAGHOL HEAI.TH/WElF PENSION $ 166.00 s 27.45 S 117.35 S 131.04 $ . s . $ . $. $ 364.25 $1,892.59 TRAINING FUNDADMIN DUES TRVISUBS SAVINGS OTHER TOTAL OED CHKNUM $ . s . s $ s s 145.00 $ 586.84 002931 FWH MCARE FICA ST TAX SOI VAriHOL HEAi. TUIWElf PENSION $ 10.00 t 7.01 s 29.99 s 4.84 $ . s . $ s . $ 429.00 $ 429.00 TRAINING FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTAL OED CHKNUM $ . s . $ $ . $ . $ . $ 51.84 1828 FWH MCARE FICA ST TAX SOI YAOHOL HEAi. TMIWFI c PENSION $ 224.00 -� 23.37 S 99.95 t 105.17 $ s $ . $ $ 539.19 $ 1,612.15 TRAINING FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTAL OED CHKNUM $ . � . "i . t . -t . $ 90.00 $ 542.49 002934 FWH MCARE FICA ST TAX SDI YArlHOL HEAi. TMIWElf PENSION $ 224.00 s 23.37 S 99.95 S 105.17 s $ $ $ . $ 257.16 $ 1,612.15 TRAINING FUNOADMIN DUES TRVISUBS SAVINGS OTHER TOTAL OED CHKNUM $ . $ . s s . s s 90.00 $ 542.49 002934 FWH MCARE FICA ST TAX SOI vArlHOL HEAi. TMIWELF PENSION $ 170.00 $ 27.89 S 119.26 S 134.27 s s . $ . $ . $ 1,559.35 $ 1,923.60 TRAINING FUNDADMIN DUES TRVISUBS SAVINGS OTHER TOTAL OED CHKNUM $ . s . $ $ . $ S 174.86 $ 626.28 DD2935 FWH MCARE FICA ST TAX SOI yAriHOL HEAi. TH/WElf PENSION $ 170.00 s 27.89 S 119.26 S 134.27 $ . < $ . $ . $ 364.25 $ 1,923.60 TRAINING FUNOADMIN DUES TRY/SUBS SAVINGS OTHER TOTAL OED CHKNUM $ . $ . s $ . $ $ 174.86 $ 626.28 DD2935 FWH MCARE FICA ST TAX SOI YAGHOL HEAi. TH/WEI ' PENSION S 437.00 $ 44.95 S 192.20 S 271.24 $ s . $ . $ . $ 3,100.00 $ 3,100.00 TRAINING FUNOADMIN DUES TRVISUBS SAVINGS OTHER TOTAL OED CHKNUM $ . s . s $ . s S 100.00 S l 045.39 002940 FWH MCARE FICA ST TAX SOI YAGHOL HEAi. TH/WEI ' PENSION $ 78.00 $ 24.92 S 106.58 S 45.01 $ . $ $ . $ . $ 437.10 $1,718.89 TRAINING FUNDADMIN DUES TRVISUBS SAVINGS OTHER TOTAL OED CHKNUM $ . $ . $ $ . $ S 145.00 $ 399.51 1831 FWH MCARE FICA ST TAX SOI YAr/HOL HEAi. TMIWELf PENSION S 201.00 $ 26.26 s 112.28 S 113.88 $ . s . $ . s . $ 1,811.05 $ 1,811.05 TRAINING FUNDADMIN DUES TRY/SUBS SAVINGS OTHER TOTAL OED CHKNUM $ . $ s . $ . $ . S 152.50 $ 605.92 002938 FWH MCARE FICA ST TAX SOI YArlHOL HEAi.TM/WE!' PENSION $ 18.00 $ 12.04 S 51.48 S 8.31 $ . $ . $ . $ . $ 1,484.02 $ 1,484.02 TRAINING FUNOADMIN DUES TRVISUBS SAVINGS OTHER TOTAL OED CHKNUM $ . $ . $ $ . $ . $ 763.70 $ 853.53 1832 FWH MCARE FICA ST TAX SOI vArlM OL HEAi. TH/WB c PENSION $ 136.00 $ 21.49 $ 91.86 $ 80.47 $ . s . t . $ . $ 1,342.28 $ 1,481.61 TRAINING FUNDADMIN DUES TRVISUBS SAVINGS OTHER TOTAL OED CHK NUM $ . ,t . ,t $ . ,t . $ 117.50 s 447.32 1833 ( 9) NET WAGES PAID FOR WEEK $1,305.75 $1,305.75 $ 3n.16 $1,069.66 $1,069.66 $1,297.32 $ 1,297.32 $ 2,054.61 $1,319.38 $ 1,205.13 $ 630.49 $1,034.29 D = Ooubletirne * 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 ( l) ( 2) NAME, ADDRESS AND Ncwnl>erol SOCIAL SECURITY NUMBER WlttV10kflng OF EMPLOYEE Ex"'"""""" Philip c Brainard 111 1501 14th St 0 0 0 0 Los Osos, CA 93402 Ronnie Ramsey PO Box 141 cayucos, CA 93430-0410 Ronnie Ramsey PO Box 141 cayucos, CA 93430-0410 Timothy D Ambrosi 1199 W Hwy 246 #C Buellton, CA 93427 Todd McDonald PO Box 19068 Reno, NV 98511-9998 0 FORM A·l-131 (New 2·80) diR ca111om1a Department of Industrial Relations PUBLIC WORKS PAYROLL REPORTING FORM NAME OF CONTRACTOR D·KAL Engineering CONTRACTOR'S LICENSE # 653307 ADDRESS OR SUBCONTRACTOR SPEGAL TY LICENSE # PAYROLL NUMBER FOR WEEK ENDING SELF-INSURED CERTIFICATE # PROJECT OR CONTRACT # 10 11/24/2018 WORKERS' COMPENSATION POLICY # 7J45679Al8 PROJECT & LOCATION (41 DAY ( 5 ) ( 6 ) ( 7) ( 8) ( 3) Sun Mon I Tue Wed I Thu I Fri I Sat GROSS AMOUNT DATE HOURLY EARNED PAGE 2 PO Box 1919 San Luis Obisnn CA 93406 Waterline Replace Spec 91436 San Luis Obisoo ( 9) NET WAGES WORK 11 /18 11/19 11/20 11/21111/22 11/23111/24 TOTAL RATE THlS ALL DEDUCTIONS, CONTRIBUTIONS AND PAYMENTS PAID FOR CLASSIFICATION HOURS WORKED EACH DAY Laborer Equip. Opers. Laborer Equip. Opers. Laborer s 0 0 0 0 s 0 8 D 0 0 0.5 s 0 0 0 0 s 0 4 D 0 0 0 s 0 4 D 0 0 l s 0 0 s D 0 s D 0 s D 0 s 0 0 s 0 0 s D 0 S = Straight time o = Overtime 0 2.5 0 0 8 3.5 0 0 0.5 0 0 0 0 2 0 0 8 0 0 0 0.5 0 0 0 8 0 0 0 0.5 0 0 0 0 0 0 0 0 0 0 0 HOURS OF PAY PROJECT PROJECTS FWH MCARE 2.5 $ 55.73 $ 136.00 $ 21.49 $ 139.33 $ 1,481.61 TRAINING FUNDADMIN $ .$ . FWH MCARE 19.5 S 75.23 S 233.00 $ 24.31 $ 1,564.87 $ 1,676.33 TRAINING FUNDADM!N l S 97.88 $ .$ FWH MCA RE 2 S 55.73 S 233.00 $ 24.31 $ lll.46 $ 1,676.33 TRAINING FUND ADMIN $ $ FWH MCARE 12 $75.23 S 164.00 $ 18.16 $ 951.70 $ 1,252.62 TRAINING FUND ADMIN 0.5 S 97.88 $ $ FWH MCA RE 12 $55.73 $ 206.00 $ 19.61 $ 778.04 $ 1,352.42 TRAINING FUNDADMIN 1.5 S 72.85 s .$ . FWH MCA RE TRAINING FUNDADMIN FWH MCARE TRAINING FUNDADMIN FWH MCARE TRAINING FUNDAOMIN FWH MCARE TRAINING FUNOADMIN FWH MCA RE TRAINING FUNDADM!N FWH MCARE TRAINING FUNDADMIN FWH MCARE TRAINING FUNDADMIN FICA ST TAX SDI VAC/HOL $ 91.86 $ 80.47 $ $ . DUES TRV/SUBS SAVINGS OTHER $ .$ .$ $ 117.50 FICA ST TAX SDI VAC/HOL $ 103.93 $ ll0.08 $ $ DUES TRV/SUBS SAVINGS OTHER $ .$ $ $ 112.50 FICA ST TAX SDI VAC/HOL $ 103.93 $ 110.08 $ . $ . DUES TRV/SUBS SAVINGS OTHER $ .$ . $ .$ 112.50 FICA ST TAX SDI VActHOL $ 77.66 $ $ .$ . DUES TRV/SUBS SAVINGS OTHER s $ $ . $ 82.50 FICA ST TAX SDI VAC/HOL $ 83.85 $ 27.46 $ . $ . DUES TRV/SUBS SAVINGS OTHER $ .$ $ . $ 302.31 FICA ST TAX SDI VAC/HOL DUES TRV/SUBS SAVINGS OTHER FICA ST TAX SDI VAC/HOL DUES TRVISUBS SAVINGS OTHER FICA ST TAX SDI VAC/HOL DUES TRV/SUBS SAVINGS OTHER FICA ST TAX SDI VAC/HOL DUES TRV/SUBS SAVINGS OTHER FICA ST TAX SDI VAC/HOL DUES TRV/SUBS SAVINGS OTHER FICA ST TAX SDI VAC/HOL DUES TRV/SUBS SAVINGS OTHER FICA ST TAX SOI VAC/HOL DUES TRV/SUBS SAVINGS OTHER HEALTI1/WEI.F $ TOTAI.OfD $ 447.32 HEALTH/W B.f $ . TOTAI.OfD $ 583.82 HEAL THIWB.f $ . TOTAL OED $ 583.82 HEAL lli/WEL • $ . TOTALOfD $ 342.32 HEAL TM/WB.f $ . TOTAI.OfD $ 639.23 HEAL TMIWB.f TOTAI.OfD HEALTMIWB.f TOTAL OED HEALTMIWB.f TOTALOfD HEALTM IWElf TOTAI.OfD HEAL TH/WElf TOTAI.OfD HEAL TMIWELf TOTAi.OED HEAL TI1/WEI.F TOTAi.OED WEEK PENSION CHKNUM $1,034.29 1833 PENSION $ CHKNUM $1,092.51 1834 PENSION $ . CHKNUM $1,092.51 1834 PENSION $ . CHKNUM $ 910.30 1835 PENSION CHKNUM $ 713.19 002939 PENSION CHKNUM PENSION CHKNUM PENSION CHK NUM PENSION CHK NUM PENSION CHKNUM PENSION CHKNUM PENSION CHKNUM D = Doubletirne *OTHER · Any other deduct ions, contributions and/or pa yments 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 o D -lm3mz{ o'lroo3!|-t{ zom IomF-{ .lI t.) {t{ozczI F!Ftz { o.rt ! 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