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Certfified Payroll Records 1 thru 5_RedactedCaliforniaJON Department of Herborl Walkup Pipeline Replacement I Herbert Walkup Pipeline Industrial Relations PUBLIC WORKS PAYROLL REPORTING FORM Page 1 of INAME OF CONTRACTOR; Vineiguerra CCnstruction, Inc. CONTRACTOR'S LICENSE NO.: 35ES38 ADDRESS P.O. Sox 157, Sutter Creek, CA, 95585 FOR SUBCONTRACTOR; SPECIALTY LICENSE NO.: PAYROLL NO. FOR WEEK ENDING SELF�NSUREO CERT: PROJECT CR CONTRACT NO. Herbert Walkup Pipeline 1 I 411312024 (WORKERS' COMP: IPROJECTANDLOCATH)N: Herbert Walkup Pipeline Replacement, ELD (1) (2) 1 (3) ' L4j DAY (5) (6) (7) (5) (9) s I M I T I VrI T I F S NAh'E. ADDRESS AND SOCIAL jg ( WORK o - ( Date TOTAL HDLRL GROSS AMOUNT NET WAGES CHECK SECURITYNUMBER ( IFILATION 4107!4106I4JO9I411014111,4112I4113 HOURS DFPAY EARNED DEDilCTlONS,CONTRISJTIONSANDPAYMENTS NO FOR Of EMPLOYEE Hours Worked Each Day WEEK THIS ALL Federal FICA& State SDI Vacation Health& Pension S OJ➢4 6.04 8.00 8.00 e.00 8.00 0.00 40.00 $52.14 PROJECT PROJECTS Tax Medicare Tax Hot" Welfare GRIEGO,DAVID 1730 flack Springs PLUMBER/ � UNpERGROU 5298.00 $158.33 $130.36 522.76 $9.90 $0.00 $0.00 Road Escondido CA O NO UTILITY O 0.00 0.00 0.00 0.00 0.00 0.00 0.00 O.W $t3B.79 51,4£0.15 Do PIPEFITTER Adrnin J $2,985.60 $2,985.60 Training Travel & Does Savings Other Total ( Fringes Sub Deduct ( ❑ i -O.Ri U.UII L1.W -U:UU UAN -1.w twu -[fUU � W. I s16.D0 56.00 50.00 50-00 SO.00 $16.00 $525.45 ikhar ❑educWn Notes: Trainit►QSm I THIS ALL Federal FICA & State SDI Vacatloo Health & Perrslon S 0-00 8-00 8.00 8-00 8.00 8.00 0.00 40-00 552.14 PROJECT PROJECTS Tax Medicare Tax Holiday Welfare M E RCIE R, I BRANDON PLUMBER( S.327 DO $171 Al S144.81 $24.64 50.00 SO= SO-00 AOD Cragmant Court 1 UNOERGROU O ODD 0.50 0,00 0.50 0.00 1.50 0.00 2-50 $68.79 51,572.72 010 Cameron Park CA j NO UTILITY Adrnln 1 Travel & Total r PIPEFITTER $2.257.58 $2,257.58 Training Fringes Dues Sub Savings Other Deduct 0 0.00 4,40 0,04 4,00 0-00 0 00 0.00 0.00 SO•DO SI V.00 SODO $0,00 S6.W SO-00 $17.00 $684.81i Other Dedlidion Notes: Training fee S - STRAIGHT TIME DTkER - Any Tiber deduclipns. contnbubwL arWm peymenis wn ether nr" ndixk:d or required by preynikV wage determmaliam must be sepsratelr ksred CERTIFICATION ML.Sj be compk4ed Form A-1-131 (Now 2�80] O -OVERTIME use exVa dn091f 51 'r necessary. (S" ravpne 5,del 0 = DOUBLETIME SDI =STATE DISA&ILITY INSURANCE California Department of industristrial Relations FATE OF CALIFORNIA fATEMENT OF COMPLIANCE 3NTRACTOR 1 SUBCONTRACTOR V-Jnciguerra Construction, Inc. RST DAY AND DATE OF PAY PERIOD &712024 to hereby ce" under penalty of perjury: Herbert Walkup Pipeline Replacement 1 Herbert Walkup Pipeline PUBLIC WORKS PAYROLL REPORTING FORMA Page 2of2 CONTRACT NUP.-1BER Herbert Walkup Pipeline LAST DAY AND DATE OF PAY PERIOD 411312024 (1) That I pay or supervise payment to employees of the abov"eferenced contraclor on the above -referenced contract. Ali persons employed on said project for the above -referenced time period have been paid their full weekly wages earned, that no rebates have been or will be made either directly or indirectly to or on behaff of said contracto r from the full weekly wages earned by any person and that no deductions have been made eithe r directly or indirectly from the full wages earned by any person other than permissible d eductions. (2) That this employer has complied with the requirements of the California Labor Code Seclons. 1771, 1811. and 1815 for all performed on this publicworks project, and that the classifications set forth therein for each trade rate conform with the work performed. (3) That any payrolls otherwise under this control required to be submitted for the above period are correct and complete; that the wage rates for laborers or mechanics contained therein are not less that the applicable wages rates: (a) ❑ Specified in the applicable wage determination incorporated into the contract. (b) 0 Determined by the Director of Industrial Relations for the county or counties in which the work is performed; that the classification set forth therein for each laborer or mechanic conform with the work he or she performed. (4) That any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with a State apprenticeship agency. (5) That fringes benefits as listed in the contract: (a) ❑ Have been or will be paid to the approved plan(s), funds(s), or programs) for the benefit of listed employees). except as noted below. (b) ❑x Have been paid directly to the listed employee(s), except as noted below. (c) See exceptions noted below. EXCEPTION CRAFT MARKS: Except for Training funds for all crafts paid directly to CAC. F-CPLANATION �,ME (PLEASE PRINT) TITLE .istin Vinciguerra President GNATURE: I i � # _ -_ DATE C - 51612024 i federally -funded projects, permissible deductions are defined in title 29, Code of Federal Regulations, part 3, issued by the Secretary of Labor under the Copeiand Act, (40 U. S. C. 276c}. also, the willful :sification of any of the above statements may subject the contractor or subcontractor to civil or criminal prosecution (See section 1001 of title 18 and section 3729 of title 31 of the United States CDde). GEM 2%3 )A Notice For individuals with sensory disabilities, this document is available in alternate fom►ats. For information call (916) 654-6410 or TOO (916) 654-3880 or write Records and Forms Management. 1120 N Street, MS-89, Sacramenic, CA 95814. Calliffmiss Herbert Walkup Pipeline Replacement/ Herbert Walkup Pipeline Deparmillo of Depa Industrial Relations PUBLIC WORKS PAYROLL REPORTING FORM Page I oft NAME OF CONTRACTOR: Vinclguwra Construction, Inc. CONTRACTOR'S LICENSE NO.: 358M ADDRESS P. 0. Box 157, Sutter Creek, CA, 95685 OR SUSCONTRACTOR: SPECIALTY UCENSE NO.: 1 PAYROLL NO- FOR WEEK ENDING: CERT:PROJECTOR CONTRACT NO. Herber! Walkup Pipeline j 2 4QW2024 I ISELF-4NSURED WORKERS' COMP: PROJECTAND LOCATION: Herbert WaEkup Pipeline Replacement, FLD I (3) (4) DAY (5) (6) (7) 11 {9} $�MITIWITIFIS NAME, ADDRESS AND SOCIAL I YVOIiiS ❑ I Cow Dam TOTAL HOURL Y1;AFE GROSS AIJOUNT DEDUCTIONS. CONTRIBUMONS NET WAGES AND PAYMENTS PAD CHECK NO. SECURITY NUMBER Y I IFICATION 4114 14115 1 4/16 1 4117 1 411E 1 4119 41 OF PAY EARNED FOR OF EMPLOYEE I HoursWEEK Worked Each Day THIS ALL Pederal FICA & State SDI Vacation Health 8 Pension I S 0.00 6.00 0.00 8.00 8.00 0.00 0.00 24.00 SU.14 PROJECT PROJEM Tax Medicare Tax Holiday Welfare GRIEGO. DAVID I PLUMBER/ - --- $251.00 S141.84 $105.33 $20.40 50.00 30.00 50.00 173Q Rock Springs I UNDERGROU Road Escondido CA 0 NO UTILITY O 0.00 OA0 0.00 0.00 QAO 0.00 0.00 0-00 $68.79 Tr TOW S1.332.69 DID PIPEFITTER I $1.251.36 $1.863.86 Training Frnges Dues Subavel& Savings Other DedtrcL U UA0 UA$Jj U" v.UU uxmU V.w -u.LU Luk) %u-uu $9.60 SD.DO $6.00 S0.00 $0.00 39.60 $531.17 �- - Other Deduction Notes: Trainirrn fee THIS ALL Federal FICA & State SDI Vacation Health & Pan°ron I S OAR 0.00 B-00 8.00 0.00 8.00 0.00 24.00 S52.14 PROJECT PROJECTS Tax Medicare Tax Holiday Welfare ME RCI ER. I BRANDON PLUMBER l I UNDERGROU SMD.00 $146.24 $113.83 $21.32 SO.00 $0.00 SO-00 400 Cra9morit Court 1 O 0.00OAO 1.00 1.50 0.00 0.00 0.00 2.50 568.79 51,394.35 DIE) CarrtervnParkGA I ND UTILITY ND U ITTER $1,423.34 $1.948,34 Training Admin 1 Fringes Dues rravei8 Sub total Savings Other Deduct D I O.DD 0.00 0.00 0.00 0.00 Q_00 0.00 0-00 $0.00 f $10.60 I s0.o0 $0.00 S0.00 S0,00 $10.60 3553,99 Other Deduction Notes' Training 1 THIS ALL federal FICA & State SDI Vacation Health & Pension j S 0.00 ODD a.00 O.00 0.00 0.00 0.00 8.00 $95.64 PROJECT PROJECTS Tax Medicare Tax Holiday Welfare VINCIGUERRA, AUSTIN I S54d.00 $291-92 S302.92 $41.97 $0.00 f0.00 S0.00 330 Bodega Court El ENOpw I avier 2 (Heavy & O 0.00 D.00 0.00 0.00 0.00 Q.00 0.00 O.00 $127.p $2,635.11 R1t7 Dorado Hills CA I Highway work} 1 0 3765.12 $3,825.00 Trarning Ad min 1 Fringes Des Travel 8 SubS'kWOther Total Deduct Group 3 Area 7 D 0.00 0.00 OMD.00 j 0.00 0.00 0.00 0.00 $0.00 $9.68 SOAO $0.00 50.00 $1,190-4 $0.00 $9.68 9 Other Deducton Notes: Training fee S = STP-W-R-fT TIME -OTHER - Any other dedILC6N . c[nW Wtians Wifor payments wiNether flr nal kxkx M or required by preva*V wage dererm ina*ym rn mA be separa.ey Asted- CERTIFICATION WJSI be ownpbw ❑ - OVERTIME use e=tra sneegs) if necrssary- (See reverse side) Fw%A-1-131 (Newt2-W) D.DOUSLETIME SEA -STATE DISADJLITY INSURANCE JEN California Department of Industrial Relations TATE OF CALIFORNLk TATEMENT OF COMFL.IANCE ONTRACTORISUBCONTRACTOR Vinciguerra construction, Inc. RST DAY AND DATE OF PAY PERIOD 411412024 Herbert Walkup Pipeline Replacernent 1 Herbert Walkup Pipeline PUBLIC WORKS PAYROLL REPORTING FORM Page 2of2 CONTRACT NUMBER Herbert Walkup Pipeline LAST DAY AND DATE OF PAY PERIOD 412012024 to hereby certify under penalty of perjury: (1) That I pay or supervise payment to employees of the above —referenced contractor on the above —referenced con -track All persons employed on said project for the above—rreftrewed time period have been paid their full weekly wages earned, that no rebates have been or will be made either directly or indirectly to or on behalf of said contractor frorn the full weekly wages earned by any person and that no deductions have been made either directly or indirectly from the full wages earned by any person other than permissible. deductions. (2) That this employer has complied with the requirements of the California Labor Code Sectiens. 1771, 1811, and 1815 for all performed on this public works project, and that the classifications set forth therein for each trade rate conform with the work performed. (3) That any payrolls otherwise under this control required to be submitted for the above period are correct and complete; that the wage rates for laborers or mechanics contained ttierein are not less that the applicable wages rates: (a) © Specified in the applicable wage determination incorporated into the contract; (b) 0 Determined by the Director of Industrial Relations for the county or counties in which the wank is performed; that the classification set forth therein for each laborer or mechanic conform with the work he or she performed. (4) That any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with a State apprenticeship agency_ (5a That fringes benefits as listed in the contract: (a) Have been or will be paid to the approved plans), funds(s), or programs) for the benefit of listed employee{s), except as noted below. (b) 0 Have been paid directly to the listed employees), except as noted below. (c) See exceptions noted below. EXCEPTION CRAFT EMARKS: Except far Training funds for all crafts paid directlyto CAC. kME (PLEASE PRINT.) ustin Vinciguerra TITLE President EXPLANATION iGNATURE I DATE 511$12Q24 in federally —funded Projects, permissible deductons are defined in title 29, Code of Federal Regulations, part 3, issued by the Secretafy of Labor under the Copeland Act, (40 UJ 5. C. 276c). Also, the willful Isification of any of the above statements may subject the contractor or subcontractor to civil or criminal prosecution (See section 1001 of title 18 and section 3729 of title 31 of the United states Code). DA No#ice For individuals with sensory disabilities, this document is available in alternate formats. For information call (916) 654-6410 or TDU (916) 654-3880 orwrite Records and Forms GEM 2503 Management, 1120 N Street, MS-89, Sacramento, CA135814. Certified Payroll Report for Contractor: Vinciguerra Construction, Inc. For week beginning on: 4/21/2024 For week ending on: 4/27/2024 Payroll Number: 3 Project: Herbert Walkup Pipeline Herbert Walkup Pipeline Replacement In Res. area between Herbert Ave. and Walk South Lake Tahoe CA 96150 CERTIFICATION FOR NON -PERFORMING Rd. Week 5/16/2024 I, Austin Vinciguerra the undersigned, am th President with the authority to act for and on behalf of Vinciguerra Construction, Inc. certify under penalty of perjury that no work as performed for the week ending on: 4/2712024. 1 herein certify under penalty of perjury that all of the above is true and correct as submitted. Austin Vinciguerra, President Certified Payroll Report for Non-'erforming Week 5/22/2024 Contractor: Vinciguerra Construction, Inc. For week beginning on: 4/28/2024 For week ending on: 5/4/2024 Payroll Number: 4 Project: Herbert Walkup Pipeline Herbert Walkup Pipeline Replacement In Res, area between Herbert Ave. and Walk tip Rd. South Lake Tahoe CA 96150 CERTIFICATION FOR NON -PERFORMING WEEK I, Austin Vinciguerra the undersigned, am the President with the authority to act for and on behalf of Vinciguerra Construction, Inc. certify under penalty of perjury that no work v as performed for the week ending on: 5/4/2024. I herein certify under penalty of perjury that a I of the above is true and correct as submitted. Austin inciguerra, President California Depm pepartent of Herbert Walkup Pipeline Replacement J Herbert Walkup Pipeline Industrial Relations PUBLIC WORKS PAYROLL REPORTING FORM Page 1 of 1 NAME OF CONTRACTOR: Vinciguerra Construction, Inc. CONTRACTOR'S LICENSE NO_: 3SM38 ADDRESS P. 0, Box 157. Sutter Creek, CA, 95M OR SUBCONTRACTOR SPECIALTY LICENSE NO.: 1 PAYROLL NO. FOR VVEEK ENDINC: SELF -INSURED CERT PROJECT OR CONTRACT NO. Herbert Walkup Pipeline j 5 5111f2024 WORKERS COhIP PROJECTAND LOCATION: Herbert Walkup Pipeline Replacement, ELD {I] {21 I (3) (4) BAY (5) (5) (7) (8) (9) ITI ITIPIs NAME. ADDRESS AND SOCIAL �1 ( WORK °� ( Date TOT nt HOURL NET WAGES CHECK SECURITY NUMBER CLA55- z i IFICATION 5105 I &&6 15M7 I &W 1 5109 I &10 15J11 IiOURS Y RATE ❑F PAY EARNED DEDUCTIONS. , CONTRIBUTIONS AND PAYMENTS PAID FOR NO. OF EMPLOYt E WEEK ` Hours worlred Each nor j e THIS ALL Federal FICA $ State SDI Vacation Health & Pension S 0.00 0.00 8.00 8-00 820 0.00 0.00 24.00 552.14 PROJECT PROJECTS Tax Medicare Tax HoWay Welfare AREVALO, JOSHUA I PLUMBER 1 $164.00 $152.98 $123.21 $22.00 SO.00 $0.00 $0A0 155 Hillside Place UNDERGROU 4 O 0.00 0.00 1.00 2-00 2.00 0-00 0-00 5-00 $88.79 $1 4i$,7fi DID 642 NO UTILITY Travel TOW PIPEFITTER E S1,595.31 $2,012.29 Trai mnq Dues Subs SaVFge Dow Deduct- 0 o:oo oJ>6 o.Go 0.00 v.ou o.Ga 0.000.00 woo - t111-60 SQ,flD SORO $100 SO,00 $133.34 S595.53 mer Deduction Notes: Irainina fee and CASaveng rQnldhgjM THIS ALL Federal FICA & State SDI Vacation Health & Parisian S 0-00 OAD O.OD 8.00 8.00 4-50 0.00 20.50 $52-14 PROJEr;T PROJECTS Tax Medicare Tax Holiday Welfare GIRARDIN, FLOYD I PLUMBER/ $89-00 $51.14 $31.02 411-67 50.00 50.00 SO-00 P 0. Box 11)2 River 1 UNDERGROU O a.00 0.00 0.0D 0.00 0.00 0.00 OA0 0-00 $68.79 S947-84 010 Pines CA 95675 - NO UTILITY PIPEFIT1ER $1.068.87 $1,068.87 Training Adrrlin 1 Dues Travel & Savlir-gs Other TOW Frirpes Sub DeducL D 13.OD 0-00 0.00 0.00 0.00 11AO 0.00 CLOG $0.00 $8,20 $0.00 $0.00 so-W SO.00 $5,20 $221,03 Other Deduction Notes: Training fee 1 THIS ALL Federal FICA d Stale 'tax SDI Vacation Health & Pension S 0.00 0.00 0-00 6.50 8-a0 0-00 0-00 14-50 $52-14 PROJECT PROJECTS Tax Medicare Holiday welfare MERCIER. I BR NDON PLUMBER) $84.00 $83,92 $33.42 $12.07 50.00 $0.00 50A0 400 CragmoM Court 1 UNDERGROU O ODD 0.00 ' ❑.00 0.00 2.00 0.00 0.00 2.00 $68.79 $883.60 DID Cameron Park CA 1 NO UTILITY Ad Run 1 Travel & Total PIPEFITTER 4893,61 $1,103,61 Training Fringes Dues Sub Savings Other Deduct. 1 I 0 U.00 0-00 0.00 a.00 0-00 0-00 0-00 0-00 $000 $6.50 S0.06 50-00 S0-00 50.00 t6.60 $220.01 - - - C(hw DeducOw Nobw Train mg f� S = STRAIGHT nmE 'OTHER -Any other deAivaam. owtrd uUom ardror payments whether or not included or required by preva ing wage deiemunaWns must be sr paMWy !sle(1_ CERTIFICATION MUST be co n pWed 0 - OVERTIME Um ox" shoegas it necessary. (Sue revorsc side) Fvrrn A-1-131 (New 2-40) D - DOU13LETIME SDI -STATE OISAS LnY INSLIRANCE California Department of Herbert Walkup Pipeline Replacement 1 Herbert Walkup Pipeline IndustrialRelabons PUBLIC WORKS PAYROLL REPORTING FORM Page 2of3 (11 t2) 1 i3� (4) DAY (5) (6) [7; (8)NET (gJ I S I M 17 I W I T I F S NAME, ADDRESS `° I AG ES AND SDClAL o WORK Date TOTAL YHRATE GROSS AMOUNT DEDUCTIONS, CONTRIBuT1ONS AND PAYMENTS PAID CHECK EMPLOYEE PLOYEE NUMBER x Z 6 j IFICATION S105 5108 15r107 15108 I S10S 15110 15111 t'�I� OF PAY EARNED FOR NO. Haurs Worked Each Day WEEK I THIS ALL Federal FICA & State SDI Vacation Heahh & Pens�m S 0,00 0.00 0,00 8.00 8.00 5.00 0.00 21.00 $52.14 PROJECT PROJECTS Tax Medicare Tax Holiday Welfare REYNOSO, LUIS I PLUMBER! 592.00 $83.12 M.78 S11,95 $0.00 $0.00 50.00 8399 Sleeilhead 1 UNDERGROU Avenue Kings Beach 0 O 0,00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 S68.79 $863.69 DID I ND UTILITY Adman 1 Travel &Total I PIPEFLTTER 81,094.94 $1,094.94 Training Fringes Dies Sub Savings Other Deduedu cf. D 0.00 0.00 3.00 0.00 0.W 0.00 0.00 0.00 $0.00 $8.40 $0.00 $0.00 $0.00 $0.00 $8.40 3231.25 Other Deduction Notes: Tra nmg fee IF 1 trAl.- �r.,..- 1 5 0,00 0.00 0.00 8.00 8M j 5.00 000 21AD M-14 PROJECT PROJECTS Tax Medicare Tax DUI Holiday Welfare pension SASK MORGAN I PLUMBER/ $105.00 $90.27 S43.56 $13.08 S0.00 $OAX SO-00 1413 Rancho Way 1 UNDERGROU Scuds Lake Tahoe 0 1 NO UTILITY O ODD 0A0 0.00 1.00 OMb O.00 0.00 1.50 W.79 Total 5936.52 DID PIPEFITTER $1.198.13 $1,198.13 Training Adman 1 Dues Travel 8 Savings Other Deduct. 1 Fringes Sub Qducl. 1 D ODD0-00 0.00 0.00 OJDO 0.00 0.00 0.00 $000 - 1 59.00 50.E $0.00 5n_00 S0.00 $9.00 $261.81 Other DeUud:on Notes. Training fee THIS ALL Federal FICA & State Vacation Health & PBnsgrh 1 S 0-00 0.0p 0-00 8.00 8.00 8.00 0.00 24.00 S95 64 PROJECT PROJECTS Tax Medicare Tax 301 Haiiday Walfa+e VINCIGUERRA. Operating AUSTIN SSQ-00 $29044 S300.94 $41.77 50.00 $0.00 $0.00 33D Bodega Court El I Engineer S127.0 2 (Heavy & 0 0.00 0.00 ODD 0.00 ODD 0.00 0.00 0.00 S2 623.41 CrD Dorado H�sOA Highway wont) J 0 Adman 1 Travel & Total 7 1 Group 3 Area I$2,295.36 i3,825.8t1 Training Fringes Dues Sub Savings Other Deduct 1 D 0,00 0 00 0 00 0.00 0.00 0.00 0.00 0.00 $0.00 $1,202.1 1 sze.o4 sv.no $v.Da $a.vD sn,DD I' $29.04 9 Other Deduction Notes: Training fee S = STRAIGHT TIME -OTHER - Any other deductions. vontribubx andbF payments whether cr not included or required by preyalrtg w age delermnat,ens must be s"r*Wy listed CERTIFICAUDN MUST Ge CMpletW Form /N1-131 [New 2 90} 0 OVERTIME Use eara shmX&( it noowswy- {See re,,ma sides 0 = DOUECETIME SDI = STATE UISAMUTY INSII RANCE California Depariment of Industrial Relations FATE OF CALIFORNIA. rATEMENT OF COMPLIANCE DNTRACTORISUBCONTRACTOR Vinciguerra Construction, Inc. RST DAY AND DATE OF PAY PERIOD 51512024 io hereby certify under penalty of perjury: Herbert Walkup Pipeline Replacement l Herbert Walkup Pipeline PUBLIC WORKS PAYROLL REPORTING FORM Page 3 of 3 CONTRACT NUMBER Herbert Walkup Ripeltne, LAST DAY AND DATE OF PAY PERIOD 511MO24 (1) That I pay or supervise payment to employees of the above -referenced contractor on the above -referenced contract. All persons employed an said project for the above -referenced time period have been paid their full weekly wages earned, that no rebates have been or will be made either directly or indirectly to or on behalf of said contractor from the full weekly wages earned by any person and that no deductions have been made either directly or indirectly from the full wages eamad by any person other than permissible deductions. (2) That this emp€oyer has complied with the requirements of the California Labor Code Sections. 1771, 1811, and 1815 for all performed on this public works project, and that the classifications set forth therein for each trade rate conform with the work performed. (3) That any payrolls otherwise under this control required to be submitted for the above period are correct and complete; that the wage rates for laborers or mechanics contained therein are not Tess that the applicable wages rates: (a) r-I Specified in the applicable wage determination incorporated into the contract; l (b) 0 Determined by the Director of Industrial Relations for the county or counties in which the work is performed; that the classiflcafion set forth thereln for each laborer or mechanic conform with the work he or she performed. (4) That any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with a State apprenticeship agency. (5) That fringes benefits as listed in the contract (a) Have been or will be paid to the approved plan(s), funds(s), or programs) for the benefit of listed employee(s): except as noted below. (b) 0 Have been paid directly to the listed emptoyee(s), except as noted below. (c) 0 See exceptions noted below. EXCEPTION CRAFT EXPLANATION MARKS: Except for Training funds for all crafts paid directly to CAC. AME. (PLEASE PRINT.) -- TITLE ustirt Vinciguerra President GNATURE:I G� DATE W2212024 n federally -funded projects, permissible deductions are defined in title 29, Code of Federal Regulations, part 31 issued by the Secretary of Labor under the Copeland Act, (40 U. S. C. 276c). Also, the willful Isificaiion of any of the above statements may subject the contractor or subcontractor to civil or criminal prosecution (See section 1001 of ttile 18 and section 3729 of title 31 of the United States Code). DA Notice For individuals with sensory disabilities, this document is available in aitemate formats. For information call (916) E54-6410 or TDD (916) 654-3880 or write Records and Forms CEPA Management, 1120 N Street, MS-89, Sacramento, CA 95814.