202109231214452749/23/2021
Contractor:
CreeksideElectrical Contractors, Inc.
For week beginning on: S/S/2O21
For week ending on: Q/15/2U21
Payroll Number: 6
09-21 Keller Water Storage Improvements Project
09-21 Keller Water Storage Improvements Project
1, Jennifer Andrews the undersigned, am the President with the authority to actfor and onbehalf ufCnaoksideElectrical
Contractors, Inc,
certify under penalty of perjury that no work was performed for the week for week ending on: 9/15/2021.
| herein certify under penalty ofperjury that all nfthe above istrue and correct as submitted.
I4if Andrews resident�
9/23/21, 12:06 PM eCPR Form Application
eCPR Online Confirmation
Your payroll submission request: has been processed.
Please review the results of your submission. Should you have any questions please contact the eCPR unit at
publicworks@dir.ca.gov.
Statement of non-performance created...
Contractor Name: CREEKSIDE ELECTRICAL CONTRACTORS, INC.
Contractor Address: 3059 AIRPORT RD. CARSON CITY NV 89706
Awarding Body: SOUTH TAHOE PUBLIC UTILITY DISTRICT
Project ID: 371032
Contract With: WHITE ROCK CONSTRUCTION, INC.
Week Ending Date: 2021-09-15
Payroll Number: 6
Amendment Number: 0
0 employee payroll record(s) processed
Your Transaction ID is: 12157979
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Submit another set of payroll records
https://efiling.dir.ca.gov/eCPR/pages/eCPROnlineFormPreFill.jsp 1/1
S/23/2O21
Contractor.
CveekoidoElectrical Contractors, Inc.
For week beginning on: Q/16/2O2i
For week ending on: 9/22/2021
Payroll Number: 7
09-21 Keller Water Storage Improvements Project
O9-21Keller Water Storage Improvements Project
CA
CERTIFICATION FOR NON -PERFORMING WEEV
LJennifer Andrews the undersigned, amthe President with the authority hmact for and nnbehalf ofCraeko|deElectrical
Contractors, Inc.
certify under penalty of perjury that no work was performed for the week for week ending on: 9/22/2021.
| herein certify under penalty ofperjury that all ofthe above is true and correct aesubmitted.
Her Andrews, resident
9/23/21, 12:08 PM eCPR Form Application
eCPR Online Confirmation
Your payroll submission request has been processed.
Please review the results of your submission. Should you have any questions please contact the eCPR unit at
publicworks@dir,ca.gov.
Statement of non-performance created...
Contractor Name: CREEKSIDE ELECTRICAL CONTRACTORS, INC.
Contractor Address: 3059 AIRPORT RD. CARSON CITY NV 89706
Awarding Body: SOUTH TAHOE PUBLIC UTILITY DISTRICT
Project ID: 371032
Contract With: WHITE ROCK CONSTRUCTION, INC.
Week Ending Date: 2021-09-22
Payroll Number: 7
Amendment Number: 0
0 employee payroll record(s) processed
Your Transaction ID is: 12158026
Print this Page
r _=i
View your submission Vie'
Submit another set of payroll records
hops://efiling.dir.ca.gov/eCPR/pages/eCPROnlineFormPreFill.jsp 1/1