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Home My WebLink AboutRedacted - Waterline 91436 Week 17 ended 01.12.19( 1 ) NAME, ADDRESS AND SOOAL SECURITY NUMBER OF EMPLOYEE Bryce Crespin 4355 Cayucos Ave Atascadero, CA 93422 Clinton R Barry 776 Brahma St Paso Robles, CA 93446 George Llamas 800 E. Cook Santa Maria, CA 93454 George Llamas 800 E. C ook Santa Maria, CA 93454 Iran A N 1eves 1628 Village Ct Santa Maria, CA 93454 Jacob D Rexford 2761 Chaparral Lane Paso Robles, CA 93446 James Douglas 612 Laura Way 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 Luis Abarca 13737 Geronimo Rd SANTA MARGARITA, CA 9345 Manuel Robledo 9694 Birmi ngham Ave Riverside, CA 92509 FORM A-1-131 (New 2-80) diR PUBLIC WORKS PAYROLL REPORTING FORM PAGE NAME OF CONTRACTOR D-KAL Engineering CONTRACTOR'S LICENSE # 653307 ADDRESS OR SUBCONTRACTOR SPECIAL TY LICENSE # PO Box 1919 San Luis Ob isno CA 93406 PAYROLL NUMBER FOR WEEK ENDING SELF-INSURED CERTIFICATE # PROJECT OR CONTRACT# Waterline Replace Spec 91436 17 1/12/2019 WORKERS' COMPENSATION POLICY # 7J45679Al8 PROJECT & LOCATION San Luis Ob1s nn 4) DAY ( 5) ( 6) ( 7) ( 8) ( 9) ( 2) ( 3) Sun I Mon I Tue Wed Thu Fri Sat GROSS AMOUNT NET Number of DATE HOURLY EARNED WAGES Wltllhold,ng WORK 116 I 117 I 1/8 1/9 1/10 1/11 1/12 TOTAL RATE THIS ALL DEDUCTIONS, CONTIUBUTIONS AND PAYMENTS PAID FOR '•-ions CLASSIFICATION HOURS WORKED EACH DAY HOURS OF PAY PROJECT PROJECTS WEEK 0 Laborer 0 Equip. Opers. 0 Teamsters 0 Laborer Apprentice 0 Laborer 0 Laborer 0 Laborer 0 Foreperson 0 Laborer 0 Laborer Apprentiee 0 Laborer 0 Laborer s 0 8 D 0 0 2 s 0 8 D 0 0 1 s 0 2.5 D 0 s 0 5.5 D 0 s 0 8 D 0 0 0.5 s 0 1 D 0 0 0 s 0 0 D 0 0 0 s D 0 8 0 s 0 8 D 0 0 0.5 s 0 0 D 0 0 0 s 0 8 D 0 0 0.5 s 0 8 D 0 0 0 S = Straight time 0 = Overtime D = Doubletime 0 0 8 3.5 5.5 0 8 3.5 0 3.5 0 0 0 8 3 8 3.5 8 3 8 3 FWH MCARE FICA ST TAX SDI VAC/HOL HEAL iH/WELF PENSION 0 8 7 0 23 $62.02 $ 217.00 t 32.43 t 138.65 t 159.36 $ -$ $ t $ 1,836.21 $ 2,236.21 TRAINING FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTALDED CHKNUM $ 1,468.77 0 3 0 0 5 $81.95 $ -t -t t $ -'> 220.00 $ 767.44 DD3003 FWH MCARE FICA ST TAX SDI VAC/HOL HEAL TH/WELF PENSION 0 8 0 0 24 $75.23 $ 367.00 c: 45.51 S 194.61 t 255.80 t -$ -$ s $ 2,649.83 $ 3,138.83 TRAINING FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTALDED CHKNUM $ 2,080.91 0 4 0 0 8.5 S 99.33 $ $ $ $ $ -$ 195.00 S 1 057.92 003004 FWH MCA RE FICA ST TAX SDI VAC/HOL HEAL TH/WELF PENSION 0 0 0 0 8 S 59.91 $ 373.00 $ 33.31 S 142.44 S 176.22 $ -$ t -t $ 479.28 $ 2,297.42 TRAINING FUNDADMlN DUES TRV/SUBS SAVINGS OTHER TOTALDED CHK NUM $1,449.95 $ $ $ $ -$ $ 122.50 $ 847.47 003007 FWH MCARE FICA ST TAX SDI VAC/HOL HEAL™""ELF PENSION 0 0 0 0 5.5 $ 55.73 $ 373.00 $ 33.31 S 142.44 S 176.22 $ -$ $ " $ 306.52 $ 2,297.42 TRAINING FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TOTALDED CHK NUM $1,449.95 $ $ $ $ $ -$ 122.50 $ 847.47 DD3007 FWH MCARE FICA ST TAX SDI VAC/HOL HEAL1'MIWfLF PENSION 0 0 7 0 23 $20.48 $ 60.00 t 9.94 t 42.50 t 20.41 t $ $ $ $ 593.92 $ 593.92 TRAINING FUNDADMIN DUES TRVISUBS SAVINGS OTHER TOTALDED CHKNUM $ 461.07 0 0 0 0 4 $ 30.72 $ t t t -$ $ $ 132.85 1883 FWH MCARE FICA ST TAX SDI VAC/HOL HEALTH/WELF PENSION 0 0 4 0 5 $ 55.73 S 340.00 t 40.70 't 174.01 t 222.64 t $ $ $ $ 2,806.49 $ 2,806.49 TRAINING FUNDADMlN DUES TRV/SUBS SAVINGS OTHER TOTALDED CHKNUM $ 1,774.28 0 3 0 0 6.5 $77.35 $ t -i $ -$ $ 254.86 $ 1 032.21 003008 FWH MCARE FICA ST TAX SDI VAOHOL HEAL™""'"• PENSION 0 8 8 0 16 SSS.38 s 84.00 $ 16.91 $ 72.30 .. 31.82 $ $ $ -s$ 1,166.13 $ 1,166.13 TRAINING FUNDADMIN DUES TRVISUBS SAVINGS OTI-IER TOTALDED CHK NUM $ 866.10 0 3 0 0 3 $77.35 $ $ $ s $ -$ 95.00 $ 300.03 003009 FWH MCARE FICA ST TAX SDI VAOHOL HEAL THIWELF PENSION S 426.00 $ 43 .31 s 185.15 s 258.38 S $ $ -$ 8 8 8 0 32 $ 77.50 $ 2,480.00 $ 3,100.00 TRAINING FUNDADMlN DUES TRVISUBS SAVINGS OTI-IER TOTAL DED CHK NUM $ 1,973.53 $ $ $ $ $ -S 213.63 $ 1126.47 003010 FWH MCA RE FICA ST TAX SDI VAOHOL HEALTHIWELF PENSION 0 8 1.5 0 25.5 $ 55.73 $ 144.00 t 33.78 < 144.44 $ 90.72 � $ $ -$ $ 1,967.50 $ 2,329.75 TRAINING FUNDADMIN DUES TRV/SUBS SAVINGS OTI-IER TOTALDED CHK NUM $ 1,719.31 0 4 0 0 7.5 $ 72.85 s t $ -t t $ 197.50 $ 610.44 1885 FWH MCA RE FICA ST TAX SDI VAC/HOL HEALTHIWl'I F PENSION 0 8 7.5 0 23.5 $ 55.73 s 211.00 t 27.14 < 11 6.04 ol 117.58 < -$ $ $ $ 1,856.04 $ 1,871.54 TRAINING FUNDADMIN DUES TRV/SUBS SAVINGS OTI-IER TOTALDED CHK NUM $ 1,244.78 0 4 0 0 7.5 $ 72.85 $ t -< < -$ -$ 155.00 S 626.76 003011 FWH MCARE FICA ST TAX SDI VAOHOL HEAL THIWELf PENSION 0 8 7.5 0 31.5 $22.34 S 173.00 ( 17.74 t 75.86 s 70.64 $ -$ $ $ $ 955.04 $ 1,091.29 TRAINING FUNDADMIN DUES TRV/SUBS SAVINGS OTHER TDTALDED CHK NUM $ 754.05 0 4 0 0 7.5 S33.51 s -$ s s $ -$ s 337.24 1886 FWH MCA RE FICA ST TAX SDI VAOHOL HEAL TH/WELF PENSION 3 8 4 0 31 $62.02 $ 131.00 s 27.43 $ 117.26 $ 62.24 $ -$ t < $ 2,496.27 $ 2,496.27 TRAINING FUNDADMIN DUES TRVISUBS SAVINGS OTI-IER TOTALDED CHK NUM $ 1,363.44 0 4 0 0 7 S 81.95 $ -$ s s s -$ 794.90 s l 132.83 1890 • 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 ) NAME, ADDRESS AND SOOAL SECURITY NUMBER OF EMPLOYEE Philip C Brainard Ill 1355 lJth St Los Osos, CA 93402 Ronnie Ramsey PO Box 141 Cayucos, CA 93430·0410 FORM A·l·l31 {New 2·80) ( 2) Number of Wlthholdlng ,._ 0 0 diR Cal1fom,a �t ot Industrial Relations PUBLIC WORKS PAYROLL REPORTING FORM NAME OF CONTRACTOR D·KAL Engineering CONTRACTOR'S LICENSE # 653307 ADDRESS OR SUBCONTRACTOR SPEOAL TY LICENSE # PAYROLL NUMBER FOR WEEK ENDING SELF-INSURED CERTIFICATE# PROJECT OR CONTRACT # 17 1/17/2019 WORKERS' COMPENSATION POLICY # 7J45679A18 PROJECT & LOCATION PAGE PO Box 1919 San Luis Obis"" CA 93406 Waterline Replace Spec 91436 San Luis Obi<nn (4) DAY ( 5) ( 6) (7) ( 8) ( 9 ) ( 3) Sun Mon Tue Wed I Thu I Fri Sat GROSS AMOUNT NET DATE HOURLY EARNED WAGES WORK 1/6 1/7 1/8 1/9 1/10 1/11 1/12 TOTAL RATE THIS ALL DEDUCTIONS, CONTRI8lJTIONS AND PAYMENTS PAID FOR CLASSIFICATION HOURS WORKED EACH DAY HOURS OF PAY PROJECT PROJECTS WEEK Laborer Equip. Opers. s 0 8 D 0 0 0.5 s 0 8 D 0 0 1 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 o = Doubletlme 8 3.5 8 3.5 FWH MCA RE FICA ST TAX 0 8 0 0 24 $55.73 $ 288.00 s 32.70 $ 139.79 $ 157.02 $ 1,920.32 $ 2,254.70 TRAINING FUNDADMIN DUES TRW SUBS 0 4 0 0 8 $ 72.85 $ . s $ $ FWH MCA RE FICA ST TAX 0 8 5 0 29 $ 75.23 S 510.00 $ 42.44 $ 181.45 $ 240.74 $ 2,926.65 $ 2,926.65 TRAINING FUNDADMIN DUES TRV/SUBS 0 3 0 0 7.5 $99.33 $ $ . $ . $ FWH MCA RE FICA ST TAX TRAINING FUNDAOMIN DUES TRV/SUBS FWH MCA RE FICA ST TAX TRAINING FUNDADMIN DUES TRV/SUBS FWH MCARE FICA ST TAX TRAINING FUNDADMIN DUES TRVISUBS FWH MCARE FICA ST TAX TRAINING FUNDADMIN DUES TRVISUBS FWH MCARE FICA ST TAX TRAINING FUNDADM!N DUES TRV/SUBS FWH MCARE FICA ST TAX TRAINING FUNDADM(N DUES TRV/SUBS FWH MCARE FICA ST TAX TRAINING FUNDADMIN DUES TRVISUBS FWH MCARE FICA ST TAX TRAINING FUNDADMIN DUES TRVISUBS FWH MCARE FICA ST TAX TRAINING FUNDADMIN DUES TRV/SUBS FWH MCARE FICA ST TAX TRAINING FUNDADMIN DUES TRV/SUBS * OTHER • Any other deductions, contributions and/or payments whether or not inc luded or re quired by pre vailing wage determinations must be separately listed. Use extra sheet if necessary. SDI VAC/HOL HEAL TH!WELF PENSION $ $ $ . SAVINGS OTHER TOTALDED CHKNUM $ 1,447.19 $ s 190.00 $ 807.51 1888 SDI VAC/HOL HEAL """'ELF PENSION $ $ $ $ SAVINGS OTHER TOTAL OED CHK NUM $ 1,769.52 $ $ 182.50 S 1157.13 1889 SDI VN'/HOL HEAL THIWELF PENSION SAVINGS OTHER TOTAL OED CHKNUM SDI VAC/HOL HEALTMIWELF PENSION SAVINGS OTHER TOTAL OED CHK NUM SDI VA<IHOL HEAL TH/WELF PENSION SAVINGS OTHER TOTAL OED CHK NUM SDI VAC/HOL HEALTH/WELF PENSION SAVINGS OTHER TOTAL OED CHKNUM SDI VAC/HOL HEAL TH/WELF PENSION SAVINGS OTHER TOTALDED CHK NUM SDI VAC/HOL HEAL"""'ELF PENSION SAVJNGS OTHER TOTAL OED CHK NUM SD! VAC/HOL HEAL"'""ElF PENSION SAVINGS OTHER TOTAL OED CHK NUM SD! VAGHOL HEAL"""'ElF PENSION SAVINGS OTHER TOTALDED CHKNUM SDI VAGHOL HEAL THIWELF PENSION SAVINGS OTHER TOTAL OED CHKNUM SDI VAC/HOL HEALTH/WELF PENSION SAVINGS OTHER TOTAL OED CHKNUM CERTIFICATION must be completed (see back) Sunburst Software Solutions, Inc. -Certified Payroll Solution www.CertifiedPayrollReports.com so@l\,oF|o: g F: ;.l.i 9* H i a5 n e q{5; F q*6'i5 € 9=li n ui +-=^! 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