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Home My WebLink AboutRedacted - Waterline 91436 Week 11 ended 12.01.18( 1) NAME, ADDRESS AND SOOAL SECURITY NUMBER OF EMPLOYEE Bryce Crespin 4355 (ayucos Ave Atascadero, CA 93422 Bryce Crespin 4355 cayucos Ave Atascadero, CA 93422 Daniel M Delurgio 7460 Iverson Pl Paso Robles, CA 93446 Jacob D Rexford 2761 Chaparral Lane Paso Robles, CA 93446 James Douglas 612 Laura Way Paso Robles, CA 93446 Jose Sanchez Garcia 558 Ferro Lane Paso Robles, CA 93446 Juan Manuel Barrios 1021 Gaylene Dr Santa Maria, CA 93458 Philip C Brainard Ill 1501 14th St Los Osos, CA 93402 Philip C Brainard Ill 1501 14th St Los Osos, CA 93402 Ronnie Ramsey PO Box 141 cayucos, CA 93430-0410 Timothy O Ambrosi 1199 W Hwy 246 #C Buellton, CA 93427 Todd McDonald PO Box 19068 Reno, NV 98511-9998 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# 11 12/1/2018 WORKERS' COMPENSATION POLICY# 4) DAY ( 5) ( 6) ( 2) (3) Sun Mon Tue Wed Thu Fri Sat ·-"'DATE HOURLY Withholding WORK 11/25 11/26 11/27 11/28 11/29 11/30 12/1 TOTAL RATE ,._ 0 0 0 0 0 0 0 0 0 0 0 0 Cl.ASSIFICA TION HOURS WORKED EACH DAY Equip. Opers. carpenters Cement Masons Carpenters Laborer Laborer Laborer Carpenters Laborer Equip. Opers. Equip. Opers. Laborer 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 5 s 0 0 D 0 s 0 8 D 0 0 3 s 0 0 D 0 0 0 s 0 8 D 0 0 2.5 s 0 8 D 0 0 2.5 s 0 8 D 0 0 2 s 0 8 D 0 0 2.5 S = Straight time O = Overtime 0 0 2 0 0 0 0 8 0 0 0 0.5 0 0 0 8 0 0 0 8 0 0 0 0.5 0 0 0 8 0 0 0 0 0 0 0 8 8 0 0 8 4 0 0 0.5 8 0 0 8 0.5 0 0 0.5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 l 0 0 0 0 0 HOURS OF PAY 0 2 $75.23 0 8 $62.02 0 0.5 $81.95 0 8 $35.75 0 8 $62.02 0 0.5 $ 81.95 0 16 $55.73 0 5 $ 77.35 0 8 $55.73 0 24 $55.73 0 7.5 $ 72.85 0 16 $62.02 0 l $81.95 0 8 $55.73 0 2.5 $72.85 0 8 $75.23 0 2.5 $97.88 0 16 $75.23 0 2 $97.88 0 9 555.73 0 2.5 $72.85 CONTRACTOR'S LICENSE # 653307 ADDRESS SPEOA L1Y LICENSE # PO Box 1919 San Luis Obisnn CA 93406 PROJECT OR CONTRACT # Waterline Replace Spec 91436 7J45679A18 PROJECT & LOCATION San Luis Obi<nn (7) ( 8) GROSS AMOUNT EARNED THIS ALL DEDUCTIONS, CONTRIBUTIONS AND PAYMENTS PROJECT PROJECTS FWH MCARE FICA ST TAX SDI VAC/HOL HEAL THIWEU' PENSION S 122.00 $ 21.71 $ 92.85 $ 89.51 $ -$ -$ $ - $ 150.46 $ 1,497.69 TRAINING FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTAi.OED OiKNUM $ -$ -$ -$ -$ $ 117.50 $ 443.57 002941 FWH MCARE FICA ST TAX SOI VAC/HOL HEAL ni/WEU' PENSION $ 122.00 $ 21.71 $ 92.85 $ 89.51 $ $ $ $ $ 537.14 $ 1,497.69 TRAINING FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTAi.OED OiKNUM $ -$ -$ $ $ -S 117.50 $ 443.57 002941 FWH MCARE FICA ST TAX SOI VAC/HOL HEAL THJWEU' PENSION $ 2.00 $ 4.67 $ 19.99 $ 4.37 $ -$ -$ -$ - $ 286.00 $ 286.00 TRAINING FUNDADMIN DUES TRV/SUBS SAV INGS OTHER TOTAi.OED OiKNUM $ -$ -$ -$ -$ $ $ 31.03 1836 FWH MCARE FICA ST TAX SOI VAC/HOL HEAL TMIWELJ' PENSION S 111.00 $ 20.34 $ 86.99 $ 79.38 $ $ $ -$ - $ 537.14 $ 1,402.96 TRAINING FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTAi.OED OiKNUM $ -$ -$ -$ -$ $ 139.86 $ 437.57 002945 FWH MCARE FICA ST TAX SOI VAC/HOL HEALTH/WB.F PENSION $ 192.00 $ 29.76 $ 127.23 $ 94.63 $ $ $ -$ - $ 1,460.56 $ 2,052.10 TRAINING FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTAi.OED OiKNUM s -$ -$ -$ -$ S 167.50 $ 611.12 002946 FWH MCA RE FICA ST TAX SOI VAC/HOL HEAL THJWEU' PENSION $ 66.00 $ 23.34 s 99.79 s 37.19 $ $ $ -$ - $ 445.84 $ 1,609.62 TRAINING FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTAi.OED OiKNUM $ -s -$ $ -$ -$ 137.50 $ 363.82 1839 FWH MCARE FICA ST TAX SOI VAC/HOL HEALTH/WELF PENSION S 227.00 s 28.08 S 120.06 $ 127.44 $ -$ -$ -$ $ 1,883.90 $ 1,936.40 TRAINING FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTAi.OED OiKNUM $ -$ -$ -$ -$ -$ 157.50 $ 660.08 002948 FWH MCARE FICA ST TAX SOI VAC/HOL HEAL THIWEU' PENSION $ 180.00 $ 24.68 $ 105.54 $ 103.19 $ -$ -$ -$ - $ 1,074.27 $ 1,702.24 TRAINING FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTAL OED CHK NUM $ -$ -$ $ -$ -S 137.50 $ 550.91 1841 FWH MCARE FICA ST TAX SOI VAC/HOL HEAL TH/WBJ' PENSION $ 180.00 $ 24.68 $ 105.54 $ 103.19 $ -$ $ -$ - $ 627.97 $ 1,702.24 TRAINING FUNOADMIN DUES TRV/SUBS SAVINGS OTHER TOTAi.OED OiKNUM $ -$ -$ -$ $ -$ 137.50 $ 550.91 1841 FWH MCARE FICA ST TAX SOI VAC/HOL HEALTH/WRF PENSION $ 248.00 $ 25.26 $ 108.00 $ 117.97 $ -$ $ $ - $ 846.54 $ 1,742.02 TRAINING FUNOAOMIN DUES TRV/SUBS SAVINGS OTHER TOTAi.OED OiKNUM $ -$ -$ -$ -$ -$ 107.50 $ 606.73 1842 FWH MCARE FICA ST TAX SOI VAC/HOL HEAL TH/WRF PENSION $ 150.00 $ 17.40 $ 74.36 $ -$ -$ -$ $ - $ 1,399.44 $ 1,399.44 TRAINING FUNDAOMIN DUES TRV/SUBS SAVINGS OTHER TOTAi.OED OiKNUM $ -5 -$ -$ -$ -$ 290.00 $ 531.76 1843 FWH MCARE FICA ST TAX SOI VAC/HOL HEALTHIWB• PENSION S 351.00 $ 29.46 $ 125.97 $ 72.01 $ -$ -$ -$ - $ 683.70 $ 2,031.67 TRAINING AJNDAOMIN DUES TRV/SUBS SAVINGS OTHER TOTAi.OED OiKNUM $ -$ -$ -$ -$ -$ 335.19 $ 913.63 002950 ( 9) NET WAGES PAID FOR WEEK $1,054.12 $1,054.12 $ 254.97 $ 965.39 $ 1,440.98 $1,245.80 $1,276.32 $ 1,151.33 $1,151.33 $1,135.29 $ 867.68 $1,118.04 D = Doubletlme * OTHER -Any other deductions, contributions and/or payments whether or not Included or required by prevailing wage determinations must be separately listed. 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