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Cerfified Payroll Records 10 thru 14_RedactedCalifornia jmml Department of Herbert Walkup Pipeline Replacement J Herbert WalkLp Pipeline IndusblalRel-Wons PUBLIC WORKS PAYROLL REPORTING FORM Page.1of7 ! NAME OF CONTRACTOR: Vinciguerra Construction, Inc. CONTRACTOR'S LICENSE NO.- 338338 ADDRESS P. O. Box 157, Sutter Creek. CA, 95685 1OR SUBCONTRACTOR: SPECWTY LICENSE NO.: PAYROL I FOR 1�F� ¢dING: PROJECT OR CONTRACT NOH-,bert Wa ine IReplacemem. 100 I WORKERF CQNIP- IpROJECT AND LOCA710N-Herbon Walk plKup Pipeline ELD (1) (2) 1 (3) (4) DAY (5) (6) (7) (6) (9) S I M I T I w T I F I s NAME, ADD RESS I m I NET AND SOCIAL SECURrTY NUMBER av_ WORK o'Q I 66 s CLAS - 74� I Dam 6109 16110 11 16113 I TOTAL rl0ill�5 r°uR� Y RATE DFPar GROSSAMOUNT WAGES CHECK EARNED DEDUCTIONS. CONTRIBUTIONS AND PAYMENTS PAID A NO OF EMPLOYEE IFICATION 6l11 EM2 BI74 BI75 Hours Worked Each bay WEEK S DDO 4.00 4.00 4,00 4.00 4.00 0-DO 20.00 990.64 THIS ALL Federal FICA & PROJECT PROJECTS Tax Medicare Stale Tax Vacation Health & SDI Holiday Welfare Pensipn AREVALO, JOSHUA I Operating 1 Engineer - $0.00 W3.62 $0-00 $47.97 $0.00 *O.00 $0.00 155 Hillside place 5642 d (Heavy & 1Highway work) J Group 3 Area 1 O 0.00 0.40 O.OU 0.00 0.00 0.00 0.00 0.0Q 3119 .5 O Admin 1 ir] ;1,812.8(I 54.402.26 Tratiryf Dues $3,60D.15 DID Travel & SOther Total avings -- Fringes Sub Ded uot. 1 1 Lr U.LiU U-uLf u.uu V.t1t1 U.IIU 0.00 I1.W -Q.� 30m - - � 52420 $O-00 f i 50.00 SQ.Ov $Q-oU 3420.52 i8O2.11 I -1---1 Other Deduction Notes= I[aining Fee, Gamishmepl, COI Savers THIS ALL Federal FICA$ State VacaWn Health B S D.00 4.00 4.00 4.OD CM 4JW 0.00 20M $52.14 PROJECT PROJECTS Tax � Medliicam Tax SDI Holiday LV:Nare Pension AREVALO, JOSHUA I PLUMBER/ 1 $0-W M-52 MOD $47.97 SoAO $0.00 $0-00 155 HiWde Pbee aa JacksCA 95CA2 UNDERGROU 4 I ND UTILITY O 0-00 2.00 2-00 2A0 2_W 240 1I.00 10.00 SM79 S3,fi00.15 DID - I PIPEFITTER Admin 1 $1,730.70 34,402-26 Training rringes Dues Travel & Totem Savings Other Sub Deduct. 1 D 0.04 0.40 0-00 0.00 0.00 0.00 e.Qe 0.00 $0.{I0 $12.00 S0.00 $0.00 $OAO $0.00 $420.52 $602.:1 Other Deduction Notes: Trainina ! . Gammhmant. Cal Savers 1 S 0.00 BOO S.QO 8.00 8.00 8,00 0.00 40.00 S52A4 THIS ALL Federal FICA & PROJECT PROJECTS Tax Medicare State Tax Vacation Health & SDI Holiday Welfare Pensior CORREA. ERICK 1 &35 Hussman � pLUMBER J PLUMBER/ S185.00 W5A1 $127-22 $29.64 $0.00 $0.00 $0.00 Avenue Gardnerville 0 NO Y I O 0.00 2.00 2,00 1.00 1.50 1.50 0.00 &00 $6&79 82.137.94 2343 1 PIPEFITFITT ER L, �2 #2,7Sk1Admin J .71 Training Dues Travel & Total Savings Other Fringes Sub Deduct 1 D 0,00 0-00 0-00 0.00 100 0-00 0-00 0.00 $0.00 $19.20 $0-00 $0-00 $0.00 $0-00 $19.00 S56617 Other Deduction Notes: Trpining fee S e STRAIGHT TIME 'OTHER - Any orherdeduuUi . e bbutiam anWor payments who Ihet or not induced or mq aired by preva" wage dew"inativns mus! be separately listed. CERTIFICATION MUST pe Computed Form A-1-131 2-gp 0 - OVERTIME usa extra ViceXs) ifrocemary, (S �e gam) I►ae+r y D = DOUBLETII.I E SDI = STATE USAWLrTY INSURANCE California De partrnentof Her4ertWalkup Pipeline Replacement; Herbert Walkup Pipeline Industrial Relations PUBLIC WORKS PAYROLL REPORTING FORM Page 2of7 (1) (2) 1 (3) (4) DAY 51 (6j ;7; (8) $IMITIWITIFIS NAME,ADDRESS AND SOCIAL ?L } WORK [ Date TOTAL HouRL GROSS AMOUNT NET WAGES CHECK SECURITY NUMBER OF EMPLOYEE d CLASS- IFICATION 6109 1 8110 1 6111 16I12 1 6113 I W14 16115 HOURS Y RATE OF PAY EARNED DEOUCTIC)NS. CONTRIBUTIONS AND PAYMENTS PAID FOR NO� k Hours Worked Each Day WEEK I THIS ALL Federal FICA & State SDI Vacation Health & Pension S 0.00 4.00 4.00 4,00 4.00 4.00 0.00 20_DO $90-64 PROJECT PROJECTS Tax Medicare Tax Holiday Welfare COWAN, THOMAS I Operating 12650 C I Engineer 5680.00 $268.31 $277.44 $38.5B $0.00 $0_00 so -co Shenandoah Road _, 0 I (Heavy & 0 O.OD 0-OD 0.00 0.00 D.00 D_00 0-00 0.pO 5119.50 $1,905.13 DID r CA 95668 Highway wont) l I Group 3 $1,$12.80 $3,543-SQ Training Adrrtin 1 Dues Travel FS Sates Total Other Area t Fnnges Sub Deduct. 0 0.00 0-00 0.00 0.00 0-00 0.00 0.00 0.00 So-00 S24.20 50-00 $0-00 SO -DO SO.00 S374-04 $1.B38.3 Other Deduction Notes: Training ipp QwWshrnent [ S 0A0 4.D0 4.00 4.00 400 4.0D 0.00 20.00 $52.14 PROJECT PROJECTS Tax Medicare Tax SDI Holiday Welfare Pension COWAN, THOMA53 12650C I PLUMBER ! I i i 5680.04 S266,37 $277.44 438.58 50.04 $0-00 SD.00 Shenandoah Road 0 UNDERGROU I ND Ulm, I O OJDO 2J7D 2.00 1.00 2.00 1-50 0.00 8.50 56i3.79 51.905.13 DID Plymouth CA 95669 I PIPEFITTER $1,627-52 $3,543.50 Training Adrrrn 1 Dues Travel Savings Other Total - Fringes Sub DeducL 13 0.00 0.00 0,00 OA0 0.0OI 0.00 0.00 0.00 $0.00 911-40 $0-00 $0,00 50.00 50.00 S374.04 S1,63a-7 Other Deduction Notes: Training fee. Garnishment S THIS ALL Federal FICA 8 State SEI Vacation Heath & Per'sivn [ 0.00 0_ D 6.50 8.00 &DO 0-00 0.00 22,50 $52,14 PROJECT PROJECT$ Tax Medicare Tax Holiday Welfare GABREE, PAUL 611 Glenbrook Drive [ PLUMBER 1 I UNOERGROU 521$.0D' $184�$ $156.73 $26.58 50.00 $0.00 $0.00 fone CA 95" 3 I ND UTILITY 0 0.00 0.00 2-00 2.00 2.00 0.00 O.DO 6.00 568.79 $1 830.50 DID - PIPE FITTER I $1,585.89 $2,429,89 Trairrng AdI- I Dues Travel & Savings Total Other Fringes Fringes Sua Deduct O 4.OQ 0.04 0.00 O,OD 0,04 0.00 0.00 0-{]0 $0,00 511.4C $0.00 $0.00 $0.00 $0,00 51320 W9-39 Other Deduction Notes: Training fee [ S 0.00 8.00 8-00 8.00 8.00 0.00 0.00 32.00 SS2.74 THIS PROJECT ALL Federal PROJECTS Tax FICA& Medicare State Tax SDI Vacation Health& Holiday Welfare Pion ANT B N�l I PLUMBER I $400.DO $178-98 S157-98 $25.74 SD.DO $0.00 SO-00 P. 4. Box 965 Sutter 0 ERGROU N D UTILITY DUTILITY I N O 0.00 2.00 2.00 1.50 2.00 0.00 0.00 7.60 $W.79 S1,576,U D)D Creek CA 9W5 - I PIPEFITTER $2,1t#-4i $2,35t3.3$ Training Admin I Frizgas Dues Travel & Sub Savings Total Other Oeduct I D 0.00 0.00 0.00 O.OD 0,00 0.00 0.00 O.OD $0.00 $15.80 $0-00 $0.00 50.00 5D_00 $16.80 $779.50 Other Deduction Notes_ Tra inmg fee S = STI7AIGHT TIME 'OTHER -Any ocher deductiom conlrbotions axuor payments w tedw or not r*dLxfed or required by prevadrg wage dMerminatians musl be aeparalery listed. CERTIFICATION 1NLJU bi) oomplelad O = OVERTIME Use edra ShOLXSj if ncocaaary- (See reverse aide) Fm! A-1-131 [New 2-00] D= DOUSLETIME SDI = STATE DISABILITY INSURANCE CAlifnrnia 151 Department of Herbert Walkup Pipeline Replacement I Herbert Walkup Pipeline 4am IndustrialRelaftna PUBLIC WORKS PAYROLL REPORTING FORM Page 3of7 (1) (2) 1 (3) (4) DAY (5) (e) (71 (8) (9) 1 SIMITIWIT F I S NAME, ADDRESS AND Si7ClAL P I .Lo WORK o 51 I Date TorAL HOJRL GROSS AMOUNT NET WAGES CHECK SECURITY NUMBER o s 1 CLASS- x 1 IFICATIUN &W 1 6110 1 6111 18112 1 6113 I W14 WIS �� v RATE OFPAv EARNED DEDUCTIONS, CONTRIBUTIONS AND PAYMENTS PAID NO. OF EMPLOYEE 1 Hours Worked Each Day FOR WEEK 8 0.00 8.00 8.00 8.00 8.00 8,00 0,00 40.00 S52.14 THIS PROJECT ALL Federal ALL Tax FICA & Medicare State Tax SDI Vacation Holiday Health & Welfare Pension GIRARDIN. FLOYD O. I PLUMBER 1 I $501.t10 $223.71 $214.77 432.77 $D,00 $0.00 SO -DO P_ Box 102 Rver U 1 0 0.00 2.00 2.00 2,00 2.00 2,OR 0.00 10.00 568.79 75 I NO UTILITY UTILROiJ 51.952.83 IVD PIPEFFTTER $2,773.5Q 52,945.48 Tralning Adman J Dtnea Travel & Sawregs Sher Total Fringes Sub Deduct 1 D D.00 0.00 0.00 0.00 0.00 D.DO 0.00 0.00 $0.00 S"'Do 50.00 $0.00 S0.00 SO.00 $21.00 $992.65 Utter Deduction Notes: Tmirling fB8 I S 0.00 8.00 8.00 800 8.00 8.00 0.00 40.00 S52.14 TNNIG PROJECT LL a c.yl PROJECTS Tax 2 - Medicare Gm« Tax SDI •�wuu Hpl" vrear.e.t Welfare Pension GRIFen. DAVID 1730 Rods Springs I pLUMBERI 1 UNDERGROU 55m.40 f2'd3.71 $217.82 S32A7 S0.00 $0.00 $0,00 Road Escondido CA 0 I ND UTILITY 0 D.00 2.00 2.00 2.00 2.00 2.00 0.00 10.DO 568.79 S1 949.78 DID 92026 1 PIPEFITTER $2.773.50 $2,945.48 Traning Adman ! Dues Travel & Savings Other TWai - Fringes Sub DeducL i D 0.00 0-DO 0.00 0.00 OAO 0.00 9.00 0.00 $0.00 i $20.00 50.00 $0.00 $0,00 $0.00 $21.D0 $W5.70 Other Dedudion Notes_ Training Ise 1 THIS ALL Federal FICA& Stale SDI Vacation Health& Pension S 0.00 8.00 8.00 8-00 8.00 8.00 0.00 40,101 552.14 PROJECT PROJECTS Tax Medicare Tax Holiday Welfare LIMAS. ABRAHAM 1535 Flvssrrlan I PLUMBER I I UNDERGROU $194.00 $205.41 S121.13 $29.53 $0.00 $0.00 $0.00 AvenueGardnerville 0 I NO UTILITY 0 0.00 2.00 2.00 1.00 1,50 1.50 0.00 B-00 588.79 32,135.04 2344 NV B94ID PIPEFITTER $2.635.92 $2.704.71 Training Admin I Dues Travel 9 Savings Other TDhA Fringes Sup Oedutit. I D 0,00 0.00 0.00 0,00 0.00 0.00 0.00 0.00 50.00 $19.20 50.00 $0A0 $0.00 $0.00 $18.60 $569.67 Other Deduction Notes: Trainngfee THIS ALL Federal FICA $, State SDi Vacation Health & PensJan S 0,00 8.00 8.00 8.00 8.00 0.00 0,00 32.00 $52.14 PROJECT PROJECTS Tax Medicare Tax Holiday Welfare MERCIER. I BRANDON PLUMBERI 1 S408-DO $197.29 S179A2 928.37 SO-00 $0.00 $0.00 400 Cragmonl Court Cameron Park CA UNDERGROU 11 NO UTILITY O 0.00 2.00200 200 200 q.00 Q.00 8.00 5B8.79 $1.76687 DID i PIPEFITTER $2.218.80 $2,597.15 Training Admin J '' Dues Travel 8 Savings Ulher Total Pongee Sub Deduct- i 0 o.RR 0.00 11.00 0.m 0.00 e.00 0.00 0.00 $0.De $18.00 SD.aD 50.00 sa.gD $o.oa $18.20 s831.28 Other Deduction Notes: Trarnrng fee S - STRAIGHT TIME 'OTHER -Any o[3ior da&Ktiorts. dxitriMiriens an6'or payments whether or not 016ILK I or regwed by preraihog -age deler nati rrx= be sspamg * Fsled. CERTIFICATION x� be completed 2�0 Form A-1-S 31 N9w 0 = OVERTIME use exera srweosj ifneoes+sary, (Sey my ege sm) I 1 D = Doust-Ellme SDI - STATE 015ABILI TY INSURANCE Department Herbert Walku Pipeline Replacement 1 Herbert Walks Pi lire Department of P Pe � P p Pe Industrial Relations PUBLIC WORKS PAYROLL REPORTING FORM Page 1ofz (1) (2) I (3) �4y CAY (5) (6) I1; ,8} � i I i9l S�MITIWITIFIS NAME,ADUftE55 I NET AND SOCIAL ��a I CLASS- Date TOTAi r GROSS AMOUNT DEDUCTIONS CONTRIBUTIONS AND PAYMENTS WAGES CHECK SECURITY NUMBER aY % I IFICATtON 6109 I Bf10 16111 I Sl72 16113 16f7d 15115 OF PAY EARNED FOR "D OF EMPLOYEE 44ouM Worked Each Day WEEK I THIS ALL Federal FICA & State Vacation Health & 5 0.00 8.00 8,00 8.00 8,00 8.00 O.00 40,00 $52.14 PROJECT PROJECTS Tax Medicare Tax 501 Holiday Welfare Pension PASTEN I VELASQUEZ, PLUMBER/ 5189.00 $194.95 $170.20 $28,04 $0.00 $0.00 S0.00 EIJSIO I UNDERGROU 0 0 0.00 2.00 2,00 1.00 1.50 D_DO 0.00 6.% $6e.79 7429ourrlDr I N❑UTILITY 51,966.74 Enid 9577$ I PIPEFITTER - $2.532.74 $2.567.13 Training Fringes Dues Travel Savings OtheF Deodu� ❑ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ;0.00 518-60 SO-00 $0.00 S0.00 $0.00 $18.80 $600.99 i p Other Deduction Notes' Tr Ai foe A;,- t \ �„� _QAJt L-: SDI a� . Welfa7. pension S 0.04 8.00 8.00 8.00 5.00 8.D0 0.00 40.00 560.00 PROJECT PROJECTS Tax Medicare Tax Holiday re PERFL SERGIO I PLUMBER I $55d_00 $234.51 S229.20 $33.72 50.00 $0.0C SO.DO 149 Oak Ridge Drive t I f1Nr)FRGROU Q 0.00 7.00 2AD 7 50 2.00 1.50 0-OD 8-DO S80.58 lane CA 95640 I ND UTILITY Admin I Travel$. Total $2,014.10 DfD I PIPEFITTER $3,044-64 $3,084.93 Tratnlreg Fringes Dues Sub Savings Other Deduct ❑ 0.D0 0.01) 0.00 0.00 0-00 0.00 0.00 U_00 $0.00 $19-20 $0.00 $0.00 50-00 50.00 S18.40 S1,070.8 Other Deduction Notes: T(a'niallfee THIS ALL Federal FICA & State Vacation Health & S 0.00 8-00 8-DO 8.00 8.00 8-W 0.00 40.00 S5214 PRO.:ECT PROJECTS Tax Medimna Tax SDI Holiday Welfare Pension 839 Ntteeread LUIS �� SLeeNlI PLUMBER I S435.00 S202.80 $189.83 $29.16 S0.00 $0.00 S0.00 I Avenue Kings Beach 0 UNDERGROUND UTILITY 8.00 0.00 2,00 2.00 1.00 1.50 1.50 0.00 8.00 $fib-79 S1 794.13 DID I PIPEFITTER $2.635,92 52,670.3ini 2 Trang Fdmtn 1 Dues Travel & Savings 01111m Total Fringes Suo deduct. I D 0,00 0.00 0.00 0.00 0.00 0_00 0.00 0,00 $0.00 � 51920 $0.00 $0.00 SO.DQ SD.OU $19.40 $876.19 Other Deduction Notes: Training fee THIS ALL Federal FICA & State Vacation Health & S 000 3.00 8.D0 8.00 8.00 8.00 0.00 40.00 552.t41 PROJECT PROJECTS Tax Medicare Tax SDI Holiday Welfare Penstonl SABIA, MORGAN I PLUMBER I 1 1413 Rancho Way I $0.00 $2132$ S0-00 S30.67 $0.00 $0.00 $0-00 South Lake Tahoe 0 UNDERGROU $2,543.77 DID O 0.00 2.00 2.00 1.50 2.00 2.00 0.00 9.50 W. 79 CA96150 I ND UTILITY Admin I Travel & Telal - I PIPEFITTER -- - $2 739-11 $2.807.90 Training Fringes Dues Sub Savings Other Deduct. i D 0.00 0.00 0.001 0,00 0,00 0.00 UAO 0.01) $000 S19.80 $0.00 50.00 $0.00 S0.00 $2D.20 SM-13 I y Other Dedudtan Notes: Training fie S = STPAGFfT TIME 'OTHER -Any other deductions, oontyWiaru andlor paymenls whether or not induded cv required try prey &g wage deaeern;nations rtwst he separately 0sied. CERTI FICATIDN I l&j be completed Fpm A-1-131 New 3�p 0 = OVERTIME t]se extra shcet s) it ncxcssery. (� a we!) t } 0=DOUBLE71ME s,V = STATE DISABI!_rTY INSURANCE California Department of Herbert Walkup Pipeline Replacement 1 Herbert Walkup Pipeline ' IndustrialRefations PUBLIC WORDS PAYROLL REPORTING FORM Page 5cf� (1) (2) 1 (3) (4) DAY (5) (6) m (8) j 91MITIWIT11; NAME. AMRESS cg i NET AND SOCIAL SECURITY NUMBER �� o_a I CLASS- r� If 1CATI0N &09 16/10 1 fi111T12 om4e 6f13 611d 16115 TOTS HOURS HWRL Y (?ATE 4F PAY GROSS AMOUNT EARNED DEDUCTIONS. CONTRIBUTIONS WAGES CHECK AND PAYMENTS PAID ' NO - OP RYEE FOR Hours Worked Each Day WEEK I O-OD I 800 8,00 8.00 8.00 8.00 0,00 40-DO $95.64 THIS PROJECT ALL Federal PROJECTS Tax FICA Medicare State Tax SDI Vacation Holiday Health& Welfare Peasior VINCIS UERRA. Operating �-, - I AUSTI Engineer $932,00 $418.87 5472.88 $6023 S100 $0.0D S9.00 3W Bed OBoclega ado Hills Aunt El 2 i (Heavy & O 0.00 2.00 2.00 1.50 2.00 2.0U 0.00 9.50 $12T p S3.591.58 INN 957= Highway work) J Group 3 Area 1 $5,032.10 i5,540.10 Training Adm n 1 Fr rges Dues Travel & Subs"other Total Deduct_ D 0.00 0.00 0.00 0-DO 0.00 0.00 0.00 0.00 $0.00 $59.90 S0.00 $0.00 SD.00 SO.00 $84.74 $1,948.2 Other Deduction Notes: Training fee SDI Pension S 0-00 6.00 8.00 8.00 8A0 6.00 U-00 36,W S95.64 PROJECT PP1CLXCTS Tax Medicare Tex Holiday WeUare VINCIGUERRIk , Clparatinr� CASEY Engineer -- 5527.tJ[I $298 55 5305.70 $42,93 $000 $0.00 SO.00 470 Broadmeadows CouA Sc11er Creak 4 ' (Heavy & 4 0.00 0.00 0X0 2.DO 2,00 0.00 C.00 4.00 $127.0 52,491.40 D U Highway work)1 � Group 3 Area 1 $3,951.04 $3.951,04 Training n 1 Fringes Dues Dues Trav Savings Other Thal Deduct, D' 0100 WDD O.OD OX 0.00 0.00 O_DO 0.00 $0.00 $49.40 $0.00 $0-00 $0,00 $0-00 $285.46 S1.459.4 Other DedLH;lion Notes. Trairtina fPe. rah S ;1e - I -- THIS ALL Federal FICA & Stale SDI Vacation. Health & Pension S 0.00 SAQ 8.00 8.00 8.00 8.00 0,00 40.00 $52.14 PROJECT PROJECTS Taos Mebane Tax Holiday Welfare WILLSON, $LOAN 3020 Newton Road, PLUMBFJ2 f 1 S440.00 $21328 Si9449 $30.67 SO.00 $M00 SO -DO Sp, 1 Placerville GA UNQERGR 5 ND UTILITY O 0.00 2.00 2.00 1.50 2.00 1.50 0.00 9.00 $68.79 S1.785.70 DU956fi7 PIPEFITTER � $2,704,71 $2.807.90' Training Adno 1 Frirhgtls Dues Travel& Savings Other Total Sub Deduct I 0 0.00 O.OU 0,00 0.00 0.00 0.00 0.00 0.00 3D.00 $19.60 5000 p0.03 $0.00 $0.00 S1022.2 $135. .58 0 Other DeducWn Notes_ Training fee. Garnishment h l THIS ALL Federal FICA & State SOI Vacation HB811111 B Pension S 0.00 8.00 9,00 8.00 8.00 S.00 0.00 40.D0 S95.64 PROJECT PROJECTS Tax Medicare Tax Holklay WW*e YOUNG, JIM Operating I Engineer $876.00 $394-80 $443,56 $58.77 50.00 $0,00 $0,00 P.0.8out5$ 95629 1 (Heavy& f O 0.00 ZAD 240 1.50 2,00 2.00 0.00 9M $t27.0 p $3.076.40 M Highway worlt)f l ( Group 3 Area 1 _ $5,032,10 $5,222.60 Training Admin 1 Fringes Dues Travel & Sub Savings Fetal Other DeducL D 0-OD OM 0.00 O.00 0.00 0.00 0.00 0.00 $0.0o S59,90 SODO 9.00 SO.00 SO.00 $375.07 S2,146.20 Other Deduction Notes: Tra:nino Tr?. f al Savers S - STRAIGHT TIME 'OTHER - My alner de&vUuns_ cugnbuUms andror payments whether nr not nduded orsequred by prev ling wage determmabor-s must be separately listed. CERTIFICATION uh M be axnpleled D = OVERTIME Use extra "eel(&) it rgary- (reveside i Form A-1-131 ( New 2--80) 0 = DOUSLETIME t��(Sewrse Stll = S7ATE DISABILITY INSURANCE Department at Herbert Walkup Pipeline Replacement I Herbert Walkup Pipeline CARCalifornia Industrial ReWlon$ PUBLIC WORKS PAYROLL REPORTING FORM Page 6 of 7 (1) (2) (3) j4) DAY (s) I S I M I T I Vi I 7I F I S NANIE, ADDRESS i g YET AND SOCIAL SECURITY NUMBER o�vWORK d�F CLPSS Date 6f09 16fiD I ti111 ] 6112 I sn3 16f14 I fi115 TOTAL HOURS HOURL Y RATE of pnr GRQSSAMOCNT DEDUCTIONS. GONTR{FICTIONS FINED AND PAYMENTS WAGES CHECK PAID NO' OF EMPLOYEEIFICATION FOR Hours Waked Each Day WEEK I 5 0-00 S-UD 8-00 8.00 8.00 8.OD 0.00 40.00 $$2.14 THIS ALL Federal FICA& State PROJECT PROJECTS Tax Medicare Tax SL11 Vacation Heath& Hditay Wefare Pension ZELLERS,JEREMY 8194 MAIN ST PLVMBER! 5432.OD $= 33 S215.22 $32.54 $0.00 $0.00 $0.00 iMWI-IJIVINE HILL 0 UNDERGROU O NDUTILITY O.00 2.00 2-00 2•DD 2-00 2.00 0,00 10.00 S68.79 51.911,58 DfD PiPEFITTSR Adminf - Travel & $2,773.50 $2,979.87 Training FrirNge.S Dries 5¢b Total Savings alter ❑educl. D 0-00 0.00 0.00 0-DO 0.00 0.00 0-00 0-DO $0-00 S20.00 50-00 $0.00 50.OD S0.p0 516220 $1.068.2 Other E7eduotion Notes- Trainir g fee, GarnishM&M S = STRAXIfa TINE 'OTHER- Any offer deduetians, DooLF&Aais arKYor payments whether qr nol indudod or required by prevailing wage dcicrmiiatinrm must 6e separately islee& CERTIFFGATION MUST be completed Farm IH9-731 (New I -80) O = OVERTIME Use extra sheegs) it n� r necessary- � ye _ �OLIBL£TIME l l SIN = STATE UISAIULITY INSURCtrCE JNN California DeWment of Industrial Relations TATE OF CALIFORNIA TATEMENT OF COMPLIANCE ONTRACTOR I SUBCONTRACTOR Vinciguerra Construction, Inc. RST DAY AND DATE OF PAY PERIOD 61912024 Jo hereby certify under penalty of perjury: Herbert Walkup Pipeline Replacement f Herbert Walkup Pipeline PUBLIC WORKS PAYROLL REPORTING FORM Page j:af7 CONTRACT NUMBER Herbert Walkup Pipeline LAST DAY AND DATE OF PAY PERIOD W15f2024 (1) That I pay or supervise payment to employees of the above -referenced conlractor on the above-re#erenced contract. All 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 wi II be made either directly or i ndirecfly 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 it Kflrectly from the full wages eamied by any person other than permissible deductions. (2) That this employer 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 less that the applicable wages rates: (a) �pedfied in the applicable wage determination incorporated into the contract, (b) FX I Determined by the Director of Industrial Relations for the county or counties in which the work is performed; that the dassification 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 to the contract: (a) Have been or will be paid to the approved plan(s), funds(s), or programs) for the benefit of listed employee(&), except as noted below. (b) I X E Have been paid directly to the listed employee(s), except as noted below. (c) F—I See exceptions noted below. EXCEPTION CRAFT EXPLANATION MARKS: Except for Training funds for all crafts paid directly to CAC. 0.ME (PLEASE PRINT.) TITLE ustln Vinciguerra President GNATURE:I DATE tif2712ff24 n federally -funded projects, permissible deductions are defined in We 29, Code of Federal Regulations, part 3, issued by the Secretary of Labor under the Copeland Act, (40 U. S. 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 tifie 18 and section 3729 of title 31 of the United States Code). DA Notice For individuals with sensory disabilities, this document is available in alternate formats. For information call (916) 654-6410 or TDD (916) 854-3880 or write Records and Farms GEM 2FC3 Management, 1120 N Street, MS-89, Sacramento, CA 95814. Department of Herbert Walkup Pipeline Re Iacemet i Herbert Walkup Pipeline Industrial Relations PUBLIC WORKS PAYROLL REPORTING FORM Page IofZ NAME OF CONTRACTOR Vinciguerra Construction, Inc. CONTRACTOR'S LICENSE NO.: 35883a ADDRESS. P, 0, Box 157, Sutter Creek, CA. 95688' IOR SUBCONTRACTOR: SPECIALTY LICENSE NO.: 1 PAYROLL NO. FOR WEEK ENDING I SELF-4NSURED CERT: PROJECT OR CONTRACT NO-. Herbert Walkup Pipeline 11 GO24 r M WDRKERS' COMP: PROJECTAND LOCATION- Herbert Walkup Pipeline Replacement, ELD (1) (2) i (3) (4) DAY (51 (8) S 1 IM I r I l T I F 1 S NAME. ADDRESS AND SOCIAL 2 I o a WORK Date TOTAL riOURL GROSS AMOUNT NET WA E5 CHECK SECURITYR � GLASS- I IFICATIDN 8J76 1 6117 1 6118 1 6119 1 6l20 ! fi121 1 622 rlauRs Y RATE OF PAY EARNED ❑ECIUCTIONS CONTREBIJTIONS A�ib PAYMENTS PAID N❑. FOR EMPLOYEE Hours Wocked Each day WEEK THIS ALL Federal FICA & Stale SDI Vacation Health & Pension I S 0-00 4.00 4,00 4.00 4.00 4-00 0.06 20.00 S90.64 PROJECT PROJECTS Tax Medicare Tax Holiday Welfare AREVALO. JOSHUA I Operating I Engineer $0.00 $.3d729 $0.00 $49.94 so -Do S0.00 SO.OD 155 Hillside Place 5642 4 (Heavy & (Highway work)l O 0.00 0,00 0.00 0,00 0.00 0.00 0.00 0-0L $719,5 8 Admin 1 Travel & $3.752.15 DM Total I Group 3 Area 1 $1.817-80 $4.581.45 Tralning Fridges Dues Sub SaW's Cow Deduct - I I O 0.O0 OBI 0.00 0.00 0.00 0.00 0.00 0-00 $0.00 - -- "- $24.Y0I $D.ODi $O_U01 SO-00I 30.1 $432.071 $829,30 Other p*duction Notes: Training'ee. Gamishmerit. Cal ,Savers f S 0.00 4.00 4,00 4.00 4.00 4-00 0-00 20.DO S52.14 THIS ALL Federal PROJECT PROJECTS Tax FICA & Medicare State Tax SDI Vacation 1 6eatth & Holiday Welfare Pension AREVALO. J05HUA Hillside I PLUMBER! I $O.DD $347.29 $0.00 $43,94 S0,00 $0-00 S0.00 165Place Jackson CA 9 564 2 4 UNDERGROU I ND UTILITY 0 000 2,00 2.00 2-00 Z00 2.00 0.00 10-00 S68-79 S3752.15 DOD - I PIPE -FITTER $1,730,70 $4,591,45 Training AdnNn I DuesSub Trarel8 Savings Other Tofal FnWes Deduct I 0 O.OD 0.00 0.00 0,00 0-00 0,00 CDO 0-00 $0.00 $12.00 $0,00 $D.00 $0.00 SO.00 $432.07 $823,30 Other Deduction Notes: I -fpp- C nr nLChment. C. I T HIS ALL Federal FICA A State SDI Vacation Health & Pension J S D.4D a.00 8.00 8.00 8.00 8,00 0.00 40.00 552.14 PROJECT PROJECTS Tax Medicare Tax Holiday Welfare 3RREA, ERICK Man 1535 Hinman I PLUMBER / I UNDERGROU S176.00 $202-79 S123.73 $29-16 50.00 $0.00 $0.00 Avenue Gardnervilfe 0 I NO UTILITY O 0.00 2.00 2.00 2-00 1.50 0-50 0.00 9-DO S88.79 S2119.24 2347 NV 89410 I PIPEFITTER 52,635.92 $2,670,32 Training Admrn ! Dues Travel R Savings Other Tola1 Fringes Sun Deduct I D 0,00 0.00 0-00 0-00 0-00 0.00 0.00 0.00 $0.00 SIO20 $0.00 $0.00 50.00 SO.00 $19.40 $551.08 Other Deducldn Notes: Train inn fee S - STRAIGKT TIME 'OTHER - Any other deductws odrrnib Li and+or parmerkls whethor or not nduded ar requl red by Vrevain9 wage delem:inalrons tints[ he separately listed. : ERTI FI CATION W.UU be aomplered Font A-1-135 (New 2--al)) = OVERTIME Use extra shae0s] if necessary- ISm ry erw side) 0 = 60UBLETIME SDI = STATE DISABILITY INSURANCE California Herbert VValku Pipeline Replacement 1 Herbert Walku Pipeline Department of p Pe P p Pe Ind u s tri at Re IzUo ns PUBLIC WORKS PAYROLL REPORTING FORM Page 2of7 (1) (2) I (3) (4)DAY 45S 6; (8) [ c9) 81MITIVVITIFIS NAME. ADDRESS I NET AND SOCIAL 6X� I WORK OASES- Date Toros RA�t GR $ AM AUNT DEDUCTIDNS, CONTRIBU71ONS AND PAYMENTS p�pS CHECK NO - OF EMPLOYEE NUMBERSECURtTY 73. i IFICATION 6116 16117 I W18 16flg I WM I W1 16,22 HOURS OF PAY FOR Hwrs Worked Each Day WEEK I THIS ALL Federal FICA & State Vacation Hearth & S 0.00 4,00 4,00 4.00 4.00 4.D0 0,00 20.00 $90•64 PROJECT PROJECTS Tax Medicare Tax Sol Holiday Welfare Penslon COWAN, THOVAS I Operating 12650C I Engineer S597.00 3273-54 52a4.44 $39.33 so. DO $0.00 $0.00 Shenandoah Road 0 (Heavy & 0 0,00 0.00 0.00 O N 0.00 0.00 0.00 p q0 5119.5 I � y1' 0 $1,443, tid DID 9 Highway work)1 $1.312.80 $3,61229 Training Admin 1 Dues Travel & Save xis Other Total I Group 3 Area Deduct I D 0.00 ODD 0.00 0.00 0.00 0.00 0.00 0-00 50.00 668.7- Si 524.20 50.00 j0.00 $0.00 50.O0 $374.44 5 Other Deduction Notes- TTr r_ning fer.. Gamishrrmint --- -- IQ¢ rut fleewi • rIE++et GvtG rdmemrT nennrTn S 0.00 4.00 4.W 4.00 4.00 4.00 O.DO 20-00 $52.14 PROJECT PROJECTS Tax Medicare Tax SDI Holiday Welfare Pension C,ZWAN, THOMAS I PLUMBE3if 12650C I UNOERGROU $697.00 $273,54 $284,44 $30-33 50.00 SO-00 $0.00 Shenandoah Road 0 I NO UTILITY O 0,00 2.00 2.OD 2.00 2.00 1.00 O-DO 9.00 $68.79 $1.943,54 oil) P uth CA 95559 PIPEFI7TER $1.661-91 $3,512,29 Training Admin 1 pugs Travel $ Savings Other Total Fringes Sub Deduct f0 0.0D 0A0 on 0,00 0-00 0.00 0.00 0-00 $0.00 $11,50 so -Do $0.00 S0.00 50A0 $374.44 $16 5 Other Deduction Notes- Trainina lee. Garnishtrent I ~!� THIS ALL Federal FICA & State Vacation Hearth & 1 S 0-00 0.00 8.00 S-W 0.00 8-00 0-00 24.00 $52-14 PROJECT PROJECTS Tax Medicare Tax SDI Holiday Welfare Pension GABREE, PAUL I PLUMBER/ S354.00 $232,22 $220.04 $33.39 SO.00 $0.00 $O.i70 611 Glenbrook Drive 3 I UNDERGROU O 0.00 0.00 2.00 2.00 0.00 2,00 O.DO 6.00 $68.79 Total 0 I ND UTILITY S2195.90 D)D PIPEFITTER S10AA0 $3,D49.75 Training ��n 1 Dues Travel & Savings Other Deduct, I Fringes Sub Deduct, D 0.09 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $0.00 $12.00 $0.00 $0,00 SO.00 30.00 $14.20 $853.85 Other Deduclm Notes: Training fee f THIS ALL Federal I FICAS Stole Vacation Health & S 0.00 &DO 8,00 8.00 8.00 6.00 0.00 40.00 $62-14 PROJECT PROJECTS Tax Medicare Tax SEXVacation Welfare Pension GARIBALANTHON�I I PLUM DER r $573.00 $234,18 S231.81 $33.457 $0.00 $0,00 SO -DO P. 0. Box 8a5 Sutter 0 UNDERGRO{J O 0.00 2.00 2.00 2.00 2.00 1.00 0.00 9.00 568.79 $1 988.60 DIO 5 1 ND UT]LfrY Admin I Travel & Tolal I PIPEFITTER � !� $2,704.71 $3,083.0$ Training Dues Savings Other Deduct. Fringes Suh 0 0,00 0.00 0,00 0.00 0,00 0A0 0.00 C.00 S0.00 S19.80 S0.00 $0.00 S0.00 $0.00 $121.80 S1.*4.44 Other Deduction Noles: Tram ng lee S - STPAIGP T TIME 'OTHER - Any o4rer deductions ❑orrtributions andtor payments whether r not nduded or required try prewa&V wsge deter "tians mrasi be separately Lsied. CERTIFICATION ALM be oom2leted Form I�4-131 {rlaw 2�0] O - OVEF2TIME Usc extra sheegs) it rie s ry- {See reverse side} 8 = DCUK1 TIME SIN =STATE DISABIL" INSURANCE Califor Departnia Department of Herbert Walkup Pipeline Re hacement I Herbert Walkup Pipeline p pe � p p pe Industrial Relations PUBLIC WORKS PAYROLL REPORTING FORM Page 3of7 (1) (2) 1 (3) I (4) DAY {5} {s} (7) {8j {9} 51MITIWITIFIs NAME, ADDRESS AND SOCIAL o � 1 ci91 1 CLASS oar Tprat RA� GRpEA a�IN NET PAID CHECK SECURITY NUMBER IFICATION x3� W16 16117 1 W18 16119 1 6M 1 U21 1 602 emu'' Y OF PAY EARNED D DEDUCTIONS. CONTRIBUTIONS AN❑ PAYMENTS NO, FOR OF EMPLOYE i WEEK Waked Each Day IHours S 0.00 $= 8.00 6A0 6.00 4.5C 0•D0 36.50 $6.2.14 THiS PROJECT ALL Federal PROJECTS Tax FICA& Medicare State Tax sol Vacation Holiday Heath & Welfare Pension GIRARDIN, FLOYD PLUMBER 1 $457,00 $209A7 $196.25 $30.17 50.00 $0.00 SO.00 P. O. Box 102 River 75 1 UNOERGR4ll N©E1 Q 0.00 2.00 2.00 2.00 2.00 0.00 0.00 8.00 W,79 $1 850.i0 ❑1❑ ITTE PfPEFITTEft $2,453.43 $2,782.99 Trainir+g Admin I Dues Travel8l Savings Other Total Fringes Sub Deduct O 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $0.00 S17.80 $0.00 $0.00 50,00 $0.00 $19.60 Sg12.89 Othef Deduclipn Notes' Training S - - .. ++}y qq - 113F, /LL iWtil'Ar' TlWrP" •. �kQiiQ--__.. 8D1 Ydr,ouul YtxfWlp on Pension 0.00 8.00 3-CID 8.00 8.00 8.00 0.00 40.DD S82.14 PROJECT PROJECTS Tax Medicare Tax Holiday WeNare DAVIO 1730 Rack Springs I FtUM$Eft! UNDERGROU S517.00 $228,96 S224.81 $32.92 SO -CD $0,00 50.00 Road Escondido CA 0 ND UTILITY O 0.00 2.D0 2.00 2.00 2.00 1.50 0,00 9-W $68.79 $1959.18 DID 92026 PIPEFITTER $2.739.11 $3,014.27 Training Ad min 1 Dues Trarel8 Savings Other T(Aal Fringes Sub Deduct D 0.00 0.00 O.OD OAO 0.00 0.00 0-00 0.00 $C.00 $10.80 50.00 $0.D0 S4.00 SO.00 b21.410$1.025.00 Other Deduction Noes: Traislina tee I THIS ALL ' Fedarai FICA 8 State Sol Vacation Heahh & Pension 8 0.00 8.00 8.00 8.00 8.00 8.00 0.00 40.00 S52.14 PROJECT PROJECTS Tax Medicare Tax F"i"y Werare LIMAS, ABRAHAM Hussman PLUMBER)1535 UNDERGROU $186.00 $202.79 S117.63 $29.16 Sam $0.00 50.00 Avenue Gardnenrille 0 NO UTILITY O 0,00 2.00 2M 2.00 1.50 0.50 0.00 8.DC $68,79 52 115,34 234E N PIPEFITTER $2,635,92 $2,670.32 Training Adman 1 Dues Travel & Total Fringes SupS-hp0,6, Deduct. } 0 0.0D 0.00 0.00 0.00 0.00 0,00 O.DO 0.90 $0.00 519,$0 SO.170 $0.00 SO.00 $0,00 $19.40 $554.98 Oilier Deduct on Notes: Training fee S 0.00 B.00 8.00 8_00 8.00 8.00 000 40.00 S52.14 THIS PROJECT ALL Federal PROJECTS Tax FICA d Medicare State Tax SDI Vacation Holiday Heahh B Welfare Pension MERGER, BRANDON PLUMBER! 5493.00 $224.36 $215.62 $322fi 54.04 S4.00 50.00 ar ragrnonC Ce Cameron Park CAA 1 UNDERGROU j N❑ UTILITY O C.OD 1.00 2.II0 2.00 2.00 0.50 0.D0 7.50 568.79 S1 987.58 D)D PIPEFITTER $2.601.53 S2,953.80 Training Ad min 1 Fringes Dues Travel & Sub Savxtgs Total Other Dedu& } ❑ 0.00 0,00 MOD 0.00 0110� 0.00 0.00 0.00 $0.00 S1920 50.00 $0,00 SO-00 90.00 $21.00 $98624 Other ❑eoicboin Nkxes Trainina fee S - STRAIGHT TIME 'OTHER -Any otwdD& iom_ oonlrr`ttntlans ardiv peymenls whether or ml alduded or req� red by pre,ra ling wage delermmaLiom nrusl be separmtoly listed. CERTIFICATION iy,,1j= be mm pkfed Form A-1-131 New 2-80j 0 = CHIT UE use aura sheet(s) if necessary. (Sce rav r w Vie) I O = ❑DUt9tET1 M E SDI - STATE INWILMY INSURANCE California Department of Herbert Walkup Pipeline Replacement I Herbert Walkup Pipeline lndusthatRelations PUBLIC WORKS PAYROLL REPORTING FORM Page�LatZi (1) (2) 1 (3) (4) DAY (5) (5) (7) (6) (9) SIMITIWITFIS NAME,ADDRESS z I ;l NET AND SOCIAL o 6 ° WORK Date HOURL WAGES CLASS -TOTAL GROSS AMOUNT CHECK SECURITY NUMBER i = I IF CA 17 QN 6r1fi EJ17 16118 16119 8I20 18121 6122 Houes OF RATE DEDUCTIONS, CONTR]BllTIdNS AND PAYMENTS FOR NO. OF EMPLOYEE ex 3. I Hours worked Each Day WEEK 11 THIS ALL Federal FICA S Slate Vacation Health 8 Pension I S 0,00 8.00 8.00 8.00 8.00 8.00 U-00 40.00 $52.14 PROJtCT PROJECTS Tax Medicare Tax SDI Holiday welfare PASTEN VELASGUEZ, 1 PLUMBER/ S197.00 $197.57 5173.70 428-40 S0.00 $0.00 S0.00 ELISIO 0 1 UNDERGROU 0 0.00 200 1.50 2.00 1-50 0_DO 0.00 7.p0 568.74 51 9€5.$6 01D 742 Baum Or 1 NO UTILITY Admin 1 Travel8 Total 35778 I PIPEFITTER $2,567.13 $2,801.53 Training Fr'nges Dues Sub Savings 91her Deduct. 1 D ODD 0.00 0.00 0,00 0.00 0.03 0.00 0.00 $0.00 S18.150 SO.00 $0.00 $0.00 $0.00 $19.00 $615-67 I i Other Deduction Notes- Training fee I 71Vi d ID/,A G4 a�� .�� I s onaA 0 am B.00 8.00 8.00 0.00 40.00 $60.00 PROJECT PROJECTS Tax Medicare Tax SDI Holiday Welfare pension PEREZ SERGIO I PLUMBERI 3603.00 $249.85 S249,71 $35.93 30.00 $0-M S0.00 149 Oak Ridge Drtve 1 1 UNDERGRQU 0 0.00 2.00 2.00 2.00 2.00 1.00 O.OD 9.00 $80-58 S2 127.49 DM 1 ND LITILITY Adrnin 1 Travel 8 Total PIPEFITTER $3.t25,22 $3,286,38 Training Fringes Dues Sub Savings Other DedecL - i D O.00 0.00 0.00 0.01) 0.00 0.00 O-DO 0.00 io.00 $19.60 50-00 $0.00 50.00 50.001I $20.40 $1'1 Other Deduction Notes: Training fee THIS ALL Federal FICA & State Vacation (Health & S 0.00 8.00 8.00 8.00 3.00 8-DO 0.00 40.D0 S52.14 PRO.]ECT PROJECTS Tax Madicare Tax SDI Holiday Welfare Pension REYNOSO,LUIS I PLUMBER( BMSteelhead 5451.00 $208.03 $196.83 $29.91 SOAO $0.00 $0.00 Avenue Kings Beach D 1 UNDERGROU ND UTILITY A 0 0.00 2A0 2.00 2.00 2.DO 0.00 O.W 8.00 $68.79 $1 833.54 01D I Fringes I PIPEFITTER E2.635.92 $2,739.11 Training Fringg1 Travel & To1a1 es Ques Sub Savings Other DBdugL 1 D 0.00 0.00 0.00 D-00 0.00 0.00 020 D.0C $10.00 $1920 $0,00 $0.00 $woo s0.00 $19.80 $905.57 I + Other Deduction Notes: Training fee I THIS ALL Federal FICA & Stale Vacatlon Health & 1 S 0.00 8.00 8.00 8.00 8.00 8A0 0.00 40.00 $52.14 PROJECT PROJECTS Tax Medicare Tax SDI Holiday Welfare pension SABIA. MORGAN PLUMBER I 1413 Rancho Way PLUMPLUM GR $484.DO $21SA8 S210.82 $31.42 S0.00 $0.00 $0.00 South Lake Tahoe O [ 0 0.00 2.00 2.00 2.00 ZOO OM 0.00 a.5fl $68.79 $1.911.37 Dlil NO UTILITY Admin 1 Travel & Total I PIPEFITTER $2.670.32 $2,876.69 Training Fringes Dues Sub Savings Other Deduct. I 1 D 0.00 0.00 0.00 0.00 O.DO 0.00 0.00 O.OD SM $19.40 $0.00 $0.00 SO.03 5O-00 $20.60 $965.32 Other Deduction Roles: Trailrrofee S - STRAIGHT TIME 'OTHER -Any other dedLpbn5, conirbutiar s amVor payments whether or net owdAded oe required by pmva wvg wage Bete inaGwm mpiri to separa%* Gs1ed. CERTIFICATION Mt1ST he a p"ed O = OVERTIME USc extra sheens] it necaasary. (See reverse aide) Form A-1-131 [NBw 2-80) D = DOUBLETIME SDI - STATE DISABILITY INSURANCE J=j Department of Heitert Walkup Pipeline Replacement 1 Herbert Walkjjp Pipeline Industrial Relations PUBLIC WORKS PAYROLL REPORTING FORM Page �of� 0) M (3) (4)DAY (5) (6) (7) (8) [gy SIMITIWITIFIS NAME, ADDRESS AND SOCIAL o WORK Date TOTAL F1011RL GR NT NET WAGES CHECK K R SELF CLASS- z fF[CATION 616 16117 I SfiB 16J19 16J20 I srzl I fil22 HOUR' Y RATE of PAY O DEDLICTIONS, CONTRIBUTIONS AND PAYMENTS PAID ND EMPLOYEE 3 FOR WEEK Hours worked Each Day I S O.OD 8.00 8.00 6.00 B.00 6,00 0.00 40.00 $52.14 THIS PROJECT ALL Federal PROJECTS Tax FICA & Medicare State Tax Sol Vacation Holiday Health i4 Wegare PeitsYon VASQUEZ, LUIS 210 Rosa Ave I PLUMBER 1 UNDE RGROU S190.00 5208.03 $187.69 $29,91 S0.00 $0.00 50.00 0 ND LTiLIT'l 0 0.00 1.50 2_DD 2.00 2.00 0.50 0.00 $ 00 $68 79 S2 095.68 DM I PIPEFITTER I $2,635.92 $2,739.11 Training Adrrrn ! Frnges Dues Travel & Sub Savurgs Total Other DeduCL D O.DD OM 0.00 0.00 0.00 0.00 0,00 0.00 $0.00 S19.20 SO-00 $0.00 $0.00 SO -DO $19,80 $643,43 Other {Deduction Notes' Train inq j S 0.00 B.IIO S.00 8.00 8.00 8.00 0.00 40.00 S95.64 PROJECT /-LL r9,1a.6 PROJECTS Tax TILT, G Medicare Tax SDI Tex,- Hot" Welfare Pension V IN CIG U E RRA, operating r-- AUSTI N j Engineer $91690 $414,06 S466,25 $59.54 $0.00 $0.00 $0.00 330 Bodega Court f J Oarado Flits CA 2 [Heavy & O 0.00 2.OD 2,00 2.00 2.00 0.50 0.D0 850 $127.0 0 $3 556.62 DID Highway work)1 Group 3 Area 1 $49051G ,.,.60 $5476Dues Training Adrrrn 1 Fringes Travel & Sub Savings Tatai Other Deduct ❑ 0.00 0.00 0-00 0.00 0.00 0.00 0,00 0.00 $0.00 558.99 $0.40 $0,00 50.00 30.00 S1919.9 3 8 $G4.T, Other Dedudiw Niles: Training Tee I THIS ALL Federal FICA & State SDI Vacation Health & S 0.00 8.00 8.00 RAO 8.00 8.00 D.DO 40.00 S95.54 PROJECT PROJECTS 'tax Medicare Tax Holiday Wehare Per -Sion VINCIGUERRA. Operating CASEY Engineer $610,00 'S327.4415 $344.34 $47.00 SO.00 $0.00 $0.00 470 Brdadmeadows Court Sutter Greek 4 (Heavy& l O 0.00 0.00 0.00 2.00 2.00 0.00 0.00 4.00 S127.0 0 $2.591.46 DID }iighway work) ! Cxow 3 Area 1 S4.333.60 S4.333.80 Training Admin 1 Fringes Dues Travel & Sub Savings Total Other Deduct. Deduct, D 0.44 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $010 W24 $0.00 $0.00 SO.00 $D.00 $31326 S1.642.1 Other Deduction Notes: Trainina fee- Cal Sayers THIS ALL Federal FICA& State Sol Vacarian Health a Pension { S 0.00 8.00 B.00 8.00 8.00 8.OG 0,00 40.00 $52.14 PROJECT PROJECTS Tax Medicare' Tax Holiday Welfare WILLSON. SLOAN 3020 Newton Road PLUMBER I 5473.00 $221.11 5205.18 ;31.79 $0.00 $0.00 $0.00 Sp. 1 Placerville CA UNDE 5 ND UTILITY O 0.00 2.00 2.00 2.00 2.00 1 -.00 00 9.00 %8.79 $1,Sd3.82 DID PIPEFITTEFlTTER - $2,701,71 &2.911.08 Training A[1min1 dues Tavel& Savings Other Tolai JJFringes Sub Deduct, D 0.00I 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $0.00 $19,60 S4.001 $0.00 SO.OD S0.00 5136.18 51.067.22 Other Deduction Notes: jsai nG fee. Garnishment S = STRA03HT TIME 'OTHER - Any other deductions. cor0brAions araor paynw&S whether or rot Muded w "Lored by prevailing wage detemrinaGwrs must be senaratet7 fisted. CERTIFICATICN MUST be oompleled 0 = OVERTIME use exva abeexs] if neceassry. (See reHeree Side; Form A-1-131 {New 2--a0] D = dOUBLETIME S01 = STATE DISABILITY INSURANCE of HeThert Walkup Pipeline Replacement I Herbert Walkup Pipeline CARCaliforniaDepartment Industrial Relations PUBLIC WORKS PAYROLL REPORTING FORM Page 6 of 7 (1) (2) i (3)1 i4) BAY i51 6y (9) ISMITIWITIFI� NAME. ADDRESS i2I WORK I Rate NET AND SOCIAL SECURITYLOYE ER a � I CLASS- zF� TpTAt HOu' YRATE OF GROSSAMOU"T EARNED ❑EOUCTiONS,CONTRIBUTIONS AND PAYMENTS WAGES CHECK PAID NtJ. OF EMPLOYEE I IFICATION 06 OR71 W18 16l19 I W20 16f21 16r22 PAY FOR I � Hours Worked Each Day WEEK I S' 0-00 8A0 8.00 8,00 8-00 8.00 0.00 40-00 595.64 THIS ALL Federal PROJECT PROJECTS T8x FICA & Medicare State Tax Sol Vasa" Health & Holiday Welfare Pension YOUNG, JIMI Operating I Engineer M1.00 $4D925 $462.86 $58,85 $0.00 $0-00 $0.00 P- O, BOX 58 58 Fiddletown CA 9W29 1 I (Heavy $ O 0.00 2,00 2.00 2,00 2-00 100 Q-IX1 9,DL3 S127. 0 0 33 1 T2-82 O!D Highway work) ! I Group 3 Area 1 $4,968.60 55,413.10 Training Adrrrn 1 Fringes Dues Travel8 Sub Total Savings Other Deduct, D 0.00 0-00 0.00 0.00 0.00 0.00 0.00 0.00 $0-OD $59.29 50.00 g9-00 $0.00 $0.00 $388-32 SP,240.22 Other DeducWn Notes: Training fee. Cal Savers l � n�v - .�►-- ; J9� rl;.�� !;� -• SDI .oY.aimo, rioon�r it Pension S 0,00 6.00 8.00 8A0 8.00 8.00 0.00 4000 S52.14 PROJECT PROJECTS Tax Medicare Tax Holiday Welfare 2ELLFR% .lFRFMY 8194 MAIN ST I PLUMBER! I $448.00 $231.57 $222.22 $33.30 $0.00 $0-00 50.00 L40KELUMNE HILL 0 UNDERGROU I NO UTILITY O 0.00 2.00 2.00 2.00 2.00 1.0[i 0.00 9.D0 S68.79 S1 950.97 00 CA 95245 PIPEFITTER $2,704.71 $3A48.66 Training Adman 1 Fringes Dries Travel 8 Sub Total Savings ou'er DedccL I 1] '1.00 0-00 0.0D 0.00 0-00 0_D0 0 DD 0-00 $0-90 $I9-s0 $o-D0 $4,00 5D.00 S10976 .. 50.Q0 5162,50 9 Ocher Deduction Notes: TrfeR_ f;arrachmwnt S - STRAIGHT TIME 'OTHER -Any other deductions conlrbuli m andlo paymeNs whetroer or wt inducted ar required by preva" wage delerrnrrafions muss pe separately (sled. CERTIFICATION MUST be comploted 0 = OVERT1ME Use extra sheegs) if rie�ry. (See revcrae side) Form A-i-131 (N" 2- 00) 0 = DpvBLE71ME SDI = STATE DISABILITY INSURANCE California Department of Industrial Relations STATE OF CALIFORN[A STATEMENT OF COMPLIANCE CONTRACTOR I SUBCONTRACTOR IVinciguerra Construction, Inc. FIRST DAY AND DATE OF PAY PERIOD 6116 2024 do hereby certify under penalty of perfury: Herbert Walkup Pipeline Replacement! Herbert Walkup Pipeline PUBLIC WORKS PAYROLL REPORTING FORM Page Tof7 CONTRACT NUMBER Herbert Walkup Pipeline LAST DAY AND DATE OF PAY PERIOD 6l22i2824 (1) That I pay or supervise payment to employees of the above -referenced contractor on the above -referenced contract All 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 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 earned by any person ot#rer than permissible deductions. (2) That this employer has complied with the requirements of the California Labor Code Sections. 1771, 1811. and 1815 for all performed an this publioworks project, and that the classifications set forth therein for each trade rate conform with the work performed. (3) That any payrolls otherwise under this controh 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) Q Specified in the applicable wage determination incorporated into the contract; (b) 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) l� 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) r Have been paid directly to the listed employee(s), except as noted below. (c) see exceptions noted below. EXCEPTION CRAFT EXPLANATION REMARKS: Except for Training funds for all crafts paid directly to CAC, NAME (PLEASE PRINT.) TITLE Austin Vinciguerra - - - President SIGNATURE: I DATE 7150124 On federally-fuft&A projects, permissible deductions are defined in title 29, Code of Federal Regulatlons, part 31 issued by the Secretary of Labor under the Copeland Act, (40 U. S. C. 276c). Aiso, the willful falsification 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). ADA Notice For individuals with sensory disabilities, this document is available in alternate formats. For information call (916) 654-E410 or TDD (916) 654-3880 or write Records and Forms ceu 2503 Management, 1120 N Street, MS-59: Sacramento, CA 95814. California Department of Herbert Walkup Pipeline Replacement I Herbert Walkup Pipeline Industrial Relations PUBLIC WORKS PAYROLL REPORTING FORM Page 1 of I NAME OF CONTRACTOR: Vinciguerra Construction, Inc. CONTRACTOR'S LICENSE NO-' 358838 ADDRESS: P. O. Sox 157, Sutter Creek, CA. aSUS IOR SUBCONTRACTOR: SPECIALTY LICENSE NO.: PAYROLL NO. f FOR WEEK ING SELF-INsurtED cr=RT. IWORKERS' PROJECT OR ip (Replacement, COMP: I IPROJECTAND LOCAT�IONLHerbert Walkup Pipeline ELD (1) (2) 1 (3) (4) OAY (5) (6) (7) (3) 19; SIMITIWITIFIS NAME.AVVRES3 AND SOCIAL ii I a_ WORK a ' I Date 1rOTAA.t IiOURI GRASS AkdOUNT NET WAGES CHECK SECURITYNUMBER CLASS- 9111 IFICAT 6123 I &24 16125 I 6r26 1 6127 16f28 I srzs HOURS OF PAY EARNED DEDUCTIONS CONTRIBUTIONS AND PAYMENTS FOB NO EMPLOYEE PLOYEE flours worked Each Gay WEEK I 3 O-DO 4.DO 4.00 4.00 4-00 COO ODD 20.00 W-64 THIS ALL Federal PROJECT PROJECTS Tax FICA d Medicare State Tax SUl Vacation Health $ Holiday Wefare Perarclon AREVALO. uOSHUA # Engineer Ongine r SO -OD $319-92 $0.00 $46.0C S0.00 $0.00 SO.DO 155 Hills;de Pique 5642 4 I (Heavy 8 0 0.00 0.1)0 Q.OD 0.00 a_fl0 0.00 0,00 0.00 $119.a $3.447-35 CND Highway work)! I Group $1.812.80 $41 1.97 Training Admin f aife5 Travel & Savngs Other T0131 3 Area 1 Fringes Sub Deduct I D 0.00 0.t)D O.DO fFW D.DO 0.00 0-00 O.OD ¢o.oal - -- - - - �- V4_2p1 $0.001 $D.001 s0.00 I SO-OO1 - $408,70� $774.62 Other Deduction Notes Training fee. Garnishment Cal Save s S 0-OD 4.00 4.00 4.00 4.00 4,OD O.OD 20.00 S52.14 THIS ALL Federal PROJECT PROJECTS Tax FICA 8 Medicare State tax SDI Vacation Heahh $ Holiday Welfare Pension AREVALO. JOS>-!UA , PLUMBER) I �, $O.Qq $3i9.92 $0,00 $45.p4 SD.DU $0,00 50-00 155 F tillside Fbce Jackson CA95B42 UNOERGROIJ 4 I ND UTILITY a O.DO 2.aa z.00 2-vv 2.v0 z.DD o.DD 1v.oD ssa.7Q 53 447.35 CUD PIPSFITT5K $1.T30.70 $4,221,97 Training Ad min f Dues Travel & Savings Other Tolal Fringes ng Sots Deduct edu I 0 O.OD 0-00 0.00 0Ap 0-00 0.00 0.00 0-00 $0-00 512.00 SO.00 30-00 $0.00 $0.00 S408.70 $774.62 .. Other Deduction Naies. TraDjar ' fno r--mlf!.hmRnr Cal THIS ALL Federal FICA 3 State SDI Vacatign Health 8 pensicn S 0.00 B.00 8.00 8A0 8.00 8.00 0.0C 40-00 $52-14 PROJECT PROJECTS Tax Medic -are Tax Holiday Welfare CORREA, ERICK 1535 Hussrrar: I PLUMBER 1 I UtROU $218.00 $215-88 5141.22 $31-04 50.00 $0.00 $0.00 Avenue GarCnervi� 0 ND UTILITY I O 4.00 2.00 1.50 2_dv 2.IX] 1-5C ti-00 9e -00 568.79 $2.215.76 2350 NV 89410 PIREFITTER I $2.704-71 $Z84229 Training Admin I Fringes Dues Travel & Savings Other Total Sub Deduct. I D 0-00 0-00 0-OD 0-00 0.00 0 00 OX 0.00 Woo $10-$0� 50.60 $0-00 SO.00 SO.00 $20.40 $626Z4 Other Deduction Notes: Training Fee S = STRAIGHT TIME •OTHER -luny other doducGons owvkujws ad+or pe rneAis whether m rkot induded or required by preva&V wage deiwm mal ons must be separatetq listod. CERTIFICATION W^ be ownpk tad O = OVERTIME Use extra sheens} it wol wry- Is- ro'v se} Form A-7-131 {New Z 9()} 0 = DWRLETIME Sit = STATE DISABrITY INSl1RAW E California Department of Herbert Walkup Pipeline Replacement 1 Flerbert Walkup Pi pelna Inau%bialRelations PUBLIC WORKS PAYROLL REPORTING FORM Page 2of7 (1) (2) 1 (3) (4)DAY (5) (6) (7) (gj {8) s I M I T I W I T I F I S NAME, ADDRESS aI I WORK Date NET AND SOCIAL SECURITY NUFASER �QldI 9 CLASS XI IFICATION -- ti123 � w4 16f25 16f26 16I27 I v a I sr29 TOTAL "°t"� HOURL Y RATE OF PAY GROSS AMOUNT EARNED DEDUCTIONS. CONTRI RLITIO NS AND PAYMENTS WAGES CHECK PAID NO. OF EMPLOYEE r x FOR 3 Hours Worked Each Day WEEK I S 0.00 4.00 4.00 4.DOl 4.00 4.00 0.00 20,00 $90.64 THIS PROJECT ALL Federal PROJECTS Tax FICA & Medicare Slate Tax SDI Vacation Holiday Health & Pension Welfare COWAN, THOMAS I Operating 12650 C I Engineer S697.00 $273-54 $284.44 $39.34 SO.DO $0.00 $0.00 Shenandoah Road 0 I (Heavy & 0 9.00 0.00 0.00 O.00 0.00 0.06 0.00 0.00 $179 a -' $1,943.53 IND 9%69 Highway work) I Group 3 Area 1 $1,812.80 $3-61229 Training Adrnin 1 Dues Traver & Savings Other Total Fringes Sob Deduct D 0.00 0.00 0.00 0.00 0.00 ODD 0.00 0.00 30.00 S24.20 $0.00 $O.DO 50.01) $0.00 S374.44 St'85$.6 Other Deduction Notes- Trairdrle fee. Garnishment S OAO 4A0 4.00 4.00 4.00 4.OD 0.00 20.00 $52.14 PROJECT rJEr tt✓.�,/J"" PROJECTS. Tax • I.�>fa Medicare Lwfr. Tax SDI holiday Weli2re Pension COWAN, Tl-N]rYIAS 12650 C I PLUMBER I - - S697.00 $273.54 $284.44 00 $0.00 r SO.Do DQ SO 00 Shenandoah Road UNOERGROU Q I NO UTILITY O ...0 000 200 15 2.00 2.00 2.. 00 0DC 0 9.5689 57 St 943-53 D1D P mouth CA 95669 PIPEFITTER ;1,696-31 '$3,672.29 Training Admin 1 Fringes Dues Travel & sub Sav ngs ToW Other Deduct. I ( D 0.00 0.00 0-00 0-00 0.00 0.00 0.00 0,00 $0-00 $11,80 $0.00 $0.00 50.00 $0.00 $374.44 51,568.7 6 Other Deduction Notes_ LCWD rig tee. Gamisnmenl THIS ALL Federal FICA 8 State SDI Vacation Health & pension S 0.00 0.00 8.00 8.00 AM 0.00 O.DO 24.00 $52.14 PROJECT PROJECT$ Tax Medicare Tax Holiday Welfare GASREE. PAUL I PLUMBER I I $296.00 $211,88 $192.85 $30.47 s0.00 $0.00 $0-00 kDive 611 GlA96640 lone lone CA UNDERGROU 3 ND UTILITY D 0.00 000 2.0Q 2.OQ 2.D0 0.00 0.00 6.00 68. S79 $2.038.52 DID ?IPEFITTER I $1.664_f0 $2,782.92 Training Admin I Dues Dues Travel & 5avNs Total Other Fringe* Deduct. I ! I I D 0.00 0.DD 0.00 0.00 0.00 0.00 0.00 0.00 $0.00 572.00 §0.00 $0.00 SO.QD SQ_QO $13.20 $744.40 Other Deduction Notes: Training Fee S 0.00 8.00 8.00 8,00 8,00 ODD 0.00 40.00 552.14 THIS PROJECT ALL Federal PROJECTS Tax FICA& Medicare State Tax SDI Vacation Holiday Health & Pension Welfare GARIBALDI, ANTHONY I PLUMBER j W65.00 $231-58 S228.31 S33.30 SO -DO i�0.00 $O.DQ P. O. Box 985 Sutter UNDERGROU 0 I ND UTILITY 0 0.00 2.00 2.Q0 2.00 2.D0 2.00 0,00 10.00 $88.79 �� $1.968.87 WO �5 ' PIPEFITTER , S2.773.50 $3,048.66 Training Admin 1 Fringes Dues Travel & Suti Savings Total Other Deduct. I ❑ 0.00 0.00 0-00 0.00 17.00 0.46 0,00 000 $O.OD $1,0793 r Sn-DO $0A0 $0.00 S0.00 $0.00 $21,60 .. O#W Dedmffort Hales: Training fee S = STRAIGHT 111.4E 'OTHER - Any other d=kxi6y a, carrlrbulions arWor payrncNs whether or no; enduded at required by prw aNjq wage detemrirlali ffmas be separataly Fsled, CERTIFICATION MI.Jsr be oompleled Form A-i-131 (New 2-�((IJ 0 = OVERTIME use extra sh"e (S) if necessary. {See reverse sdey D = DOUBLETI ATE Sol = STATE DISABILITY IMSURANCE California Department of Herbert Walkup Pipeline Replacemant 1 Herbert Walkup Pipeline Industrial Relations PUBLIC WORKS PAYROLL REPORTING FORM Pageaof7 (1) (2) 1 (3) (4)DAY (5) i1 ] (7) (8) (9) 1 S I M TIWITIFIs NAME. ADDRESS AND SOCIAL s7 3 70 1 02 6' Date TOTAL Y GROSS AMOUNT NET Ypq pS CHECK SECURITY INIUMBER CLASS- IFICATiON D23 I W24 ! 6125 16128 1 6f27 1 @29 8R9 RATE ❑F PAY EARNEfl DEDUCTIONS, CQNTRI8UTIONS AND PAYIAENTS NO - OF EMPLOYEE FOR Worked Each Day WEEK S 0,00 B-00 8,00 8.00 8.00 8.00 0.00 40.00 S52.14 THIS ALL Federal PROJECT PROJECTS Tax FICA & Medicare State Tax 50! Vacation Holiday Health & Welfare Pension G(RARDIN, FLOYD P. Q. PLUMBER/ $492.00 $221.11 S21127 $31.80 50.00 $0.00 $0.00 Box 102 River 75 1 UNDERGROU NO UTILITY O G-00 2.00 2.00 2,00 2.M 0.00 0A0 8.00 568,79 $1,934.10 DIE) PII�'EFITTER $2.W5.92 $2,911.08 Training Adminl Dues Travel& Savings D9her Total Fringas Sub DeducL D 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00 $100 S19.20 50.00 $0.00 50-00 SO,00 $2180 $976.98 Other DeduCtipn Notes Training fee f I S 0.00 8.00 8.00 8-00 8.00 8-00 0-00 40.00 $52.14 - rI Rat PRO.IECT PItOJEGTS Tax Medicare 5-�,.. Tax SDI 1 L ~�.Holiday , � 1 i u- WelfGRIEare -- 1°n , DAVID17" Rock Springs I PLUMBER / S92.00 $221.11 $214.32 $3139 50.00 $0.00� som Road Esoandt& CA fl UNDERGROUI ND UTILITY O 0.00 0.00 2.00 2.00 2.00 1-50 O-DD 7.50 W.79 $1.y31.DG DID PIPEFITTER $2.601.53 $2.911.08 Training Adrnin 1 Fringes Dues Travel & Sub Savings g dtilen Total Deduct I D 0.00 0-00 0.00 0.00 0-00 0,00 C.QO 0.00 50.00 $49.00 SO.00 $0.00 $0.00 $0.00 M-30 $980-02 Other Deducliort Notes: 1(algJ09 fee THIS ALL Federal FICA 9 State SDI Vacation Heafth 8 Parisian S 0.00 8.00 8.D0 8.00 8.00 8.00 O.OU 40-00 S52-14 PROJECT PROJECTS Tax Medicare Tax Holiday Wellare LIMAS, ABRAHAM 1535Hussman I PLUMBER 1 UNDERGROU 1 $227.00 $215,88 S135.12 $31.04 SO.Bp 50.00 SO-00 Avenue GardnerviAe 0 I ND UTILITY O 0.00 2,00 1.50 2A0 2.00 1.a0 0:00 9.00 $Li8.79 S2 212.85 2351 PIPEFITYF-R I $2,709.71 $&1229 Trairrng FiriAd ng / Fringes Dues Travel & Sup Savings Other Total Deduct D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $0.00 $19,60 50 DO $0.00 S0.00 SO.00 $20.40 $629.44 L Other Ded udion Notes- Tr inking fry ! S 0.00 8.00 8.00 8-00 B-00 8-00 0.00 40.00 S52.14 THIS ALL Federal PROJECT PROJECTS Tax FICA & Medicare State Tax SO[ Vacation Health & Holiday Welfare Pension MERCIER. I BRANDON 400 Cragmont Court PLUMBER I 9532,00 $236.80 $232.26 $34A5 50-00 $0.00 $0.001, Cameron Park CA UNDERGROU 1 j ND UTILITY O 0.00 2.00 2 00 2.00 2.00 0.50 0.00 $fill $b8,79 Admire / Travel & al 0BI1.34 pip Tula! PIPEFITTER � $2.6M32 53,117.45 Training Fringes Dues sub Savings Other Deduct. D 0.00 G.GG 1100 0.00 0.00 0.00 0.00 0,00 $011114 S19.40 ;0.00 $0.00 $0.00 $0.00 057 ,. S11 $22.00 1 - Other Deduciinn Notes: Training lee S = STRAIGHT TIME 'OTHER - Arry osier dadudio , caraRmfiom endror payments whether er not ockoded or requred py prerarirg wage delermfnatio rrrd be separately listed. CERTIFICATION MUST be ndupteted Farm A-1-131 (New 2�0] 4 = OVEPWIME Use extra shsar ee}(s) a nece,y. Iscc re,rerse side I D = DOt18LETIME SOr - STATE EASA IlIn y NSk1RANCE California Department of Herbert Walkup Pipeline RBplaCemml I Herbert Walkup Pipeline Industrial Relation. PUBLIC WORKS PAYROLL REPORTING FORM Page 4.of7 (1 i (2) 1 (3) (4) DAY {9J I SIMITIVVITIFIS NAME. ADDRESS a NET AND SOCIAL R SE4F $" 4 i C WORK ZED IFICAm N 6123 I &f24 1 6125 Da* 16m I sw I sloe I sr�s TOTAL HOuRs �RATF OF PAY GRASS AINOGnrT EARNED DEDUCTIONS. CONTRIBUTI.ONS AND PAYMENTS WAGES CHECK NO- OFEMPLOYEE i FOR WEEK Worked Each Day j S 0.00 8.00 8.00 8.00 9.00 8.00 0.00 40,00 S52.14 THIS PROJECT ALL Federal PROJECTS Tax FICA & Medicare State Tax SDI Vacation Holiday Health ,& Welfare Pension PASTEN VELASOUEZ, ELISIO PLUMBER) ( UNOERGROU S242.00 $21326 5194.69 $30.67 $a-00 $0.00 S0.00 742 Baum Or 0 } NO UTILITY O 0.00 2.O1I 1.50 2.00 2.00 1.50 0.00 9.00 $88?9 $2.107.08 DID 95776 PIPEFITTER $2,704.71 $2,907.90 Training Ad nip ! Ones Travel R Savings Other Total i Fringes Sub Deduct- 0 0.00 0.00 0.00 0.00 0 00 0.00 0.00 0.00 30.00 519.60 S0.00 $0.00 50.00 50.00 $20.20 $700.82 Other Deduction Notes' T iru i S 0.04 SAO 8-DD 8.00 8.00 8.00 0.00 40_D0 $W-00 �L II+4 PROJECT '�� r�-4p PROJECTS Tax rlSiiti Medicare i kam Tax SDI L dLQuu�l Holiday I "Plop a Welfare Pension PEREq SERGIO 149Oak RidgeDrive i PLUMBER) 1 $0.00 $268,24 $0.00 $38.57 50.04 �0A0 5D.00 lone CA 95W UNDERGROV 1 j NO UTILITY O 0.00 2.00 2jDO 2-DO 2.00 2.00 0.00 10.00 S80.58 $3.1yy.71 DID - i PIPEFITTER $3.205.00 $3.528.12 Training Adrrdn 1 Dues Travel a. Savings Other Total Fringes Sub Deduct i D 0.00 0,00 0.00 0.00 000 0,00 0.00 0.00 $0.00 $20.00 50.00 $0.00 S0.00 S0.00 $21,60 $328.41 Oilier Oedudior Notes: Training See 1 THIS I ALL Fadaral FICA & State SDI Vacation Heakh 8 Pension i S 0.00 8.00 8.00 8.00 8.00 0.00 0,00 32.00 $52.14 PROJECT PROJECTS Tax Medicare Tax Holiday WeKam REYNOSO, LUIS 8399Steep ead i PLUMi3LJ41 i S3W,00 $178.97 5157,98 $25.74 S0.00 $0.00 S0.00 Avenue Kings Beach UNDERGROU 0 J ND UTILITY a 0.00 2A0 1.50 2.00 2.00 0.00 0,00 7.50 W.79 S7 fii5.89 DlD � PfPEFITTER $2,184,41 $2,355.38 Training AdmJn 1 Fringes Fringes Dues Travel & Sub ►ga Other Total Reducl. Deduct. D 1 0.00 0.00 0.00 0.00 0.00 0,00 O,DO 0.00 $0.00 $0,00 $0.00 50.00 50-00 $16,80 $73949 Other Dedud:on Notes: Training foe THIS ALL Federal FICA state SDI Vacation Health 8 Persian i S 0,00 8.00 8.00 8.00 8.00 8.00 0.00 40.00 $52.141 PROJECT PROJECTS Tax Med.care Tax Holiday Welfare SABIA, MORGAN 1413 Rancho Way i PLUMBER 1 i SW9.00 $226,34 S221.32 S32.54 $0-1)0 $0.00 $0.00I South Lake Tahoe 0 UNDERGROU i ND UTILITY 0 0.00 2.00 2.00 2. 2.00 2.00 0.00 i0.00 568.79 51.989.47 DID PIPEFITTER $2,T73.50 $2,979.87 Training Adnv0 1 Fringes es Dues Travel & Sub Savings Other Total DedtJcl. 0 0.00 0.00 0,00 0.00 0.0111 0.00 0.00 0.00 $0.00 S24.DO S0.00 $0.00 SO.00 90.00 $21.20 S1,010.40 Other Deduction Notes: Training fee S - STRAIGHT TIME 'OTHER -Any of= dedtrliom. oaroibutions anwor payments whother or rot Priduded a required by pmve6rig wage deLewmmarid-Is m*AA be sepa miely listed. CERTIRCATION MUST be oomplefed Form A-1-131 (Now 2-D) 0 = OVERTIME use e+nre dre s) it necessary. )Sec mverse wit') D = DWBt.t TIME S01 - STATE DISABILITY lW-,t;RANCE California Department of Herbert Walkup Pipeline Replacement ! Herbert Walkup Pipeline Industrial Relations PUBLIC WORKS PAYROLL REPORTING FORM Page,�of7 (1) (21 I (3) j4) DAY (51 t6) (7) (8) (9) I S I M I T IIVITIFIS NAME, ADDRESS AND SOCIAL oSo WORK ` Date TOTAL HOLIRL GROSS AMOUNT NT c NET WAGES CHECK SECURITY NUMBER I� CATION Gf23 I &24 16125 I c>r2s 15127 I &f28 1612g HOUR' OF PY "AAY DEDUCTIONS, CONTRIBUTIONS AND PAYMENTS PAJD FOR NO DF EMPLOYEE e 3 � WEEK Hours Worked Each Day j S 0.00 1.00 0.00 8.00 8.00 8-00 0-00 25.00 $52.14 THIS PROJECT ALL Federal PROJECTS Tax FICA & Medicare State Tax SDI Vacation Holiday Health & Welfare Pension VASQUEZ, LUIS 210 Rasa PLUMBER/ 579-00 $154-39 S115.95 $22-20 I $0-00 $0-00 50,00 Ave 0 UNDERGROU NO UTILITY 0 0.00 0-00 0.011 1-50 2.06 2.00 0.00 5.50 $66 79 S1.646-50 DID PIPEFITTER $1,681.85 $2,030.64Tralnhg Adrrdn ! Does Travel8 Savings 001er Total Fringes Sub Deduct I ❑ 6-OD 0-00 0.00 0-00 0.00 0.00 0-00 0.00 SO.00 S12.20 SO.00 $0.00 SO-00 30.00 $12.60 $384.14 Other Deduction Notes Tr@ining S 0,00 8.00 8-DO 800 8,00 8-00 0-00 4A.00 $95.64 PROJECT PROJECTS Tax Madcam Tax SDI �,.a�„� � yHotstay � ��,�� u Pension Welfare VINCIGUERRA, t Operating AUSTIN I Engineer $962.00 $428A8 $485.55 $61-61 SO-00 KOO $0.00 330 aOorF1tEl D s CA 2 (Heavy 0 0,00 2.00 1-50 2-00 2.00 2.00 O.DO g-50 S127.0 O 53.W-51 DID 95762 Highway wark)1 Group 3 Area 1 $5.032.10 $5.667.10 Training Admirt ! Oves Tra•rel $• Savings Other Total Fringes Sob Deduet Q 0.00 D.OD 0.00 0.00 0.00 0-00 0.D0 0.00 $0.00 S-59.90 $0.00 $0.00 SD.00 $0.00 WAS $2.003.5 y Other Deduction Notes: Trai bg fee THIS ALL Federal FICA & State Vacation Heahh & S 0,00 8.00 300 7.00 8.00 8-00 0.00 38.00 $95.64 PROJECT PROJECTS Tax Medicare Tax SDI Holliday i Welfare Pension Vlr[CIGUERRA j OperatingCASEY 4709roadmeadows Engineer $127-0 $W3.00 $325.02 5341.11 $46.74 SO.00 $0.00 SO-00 Court Sutter Creek (Heavy& [ O 0.00 1.00 1.00 0.00 2.D0 0.50 0.00 4-50 O S2.674.85 DID Hghway work) 1 Group 3 Area 1 $4.301-4fi $4,301 46 Training Aring f Dues Travel & Savings Total Other Fringes Sus Deduct. D 0.00 0.00 0.00 0.00 0.00 0.00 D.00 000 SO -OD 552.64 $0.00 $0.00 SO.00 SO.00 S310-73 $1.626.66 Other Deduction Notes: Trainina fee- Cal Saverr, S 0-00 8.00 8.00 8.00 8.00 8-00 0.00 40A0 S52.14 THIS PROJECT ALL Federal PROJECTS Tax FICA& Medicare State Tax SDI Vacation Holiday Health& Pension Welfare WILLSON. SLCAN 3U20 Newton Road, PLUMBER I $473.00 $221,10 52DSA8 $31.79 SO-00 $0.00 $0.00� Sp. 1 Placmile CA 5 UNOERGROU ND UTILITY 0 0.00 2.00 2DO 240 2-00 2.00 0.00 10-OD W-79 $,,a4ass DOPIPEFITTER $2.773.50 $2.911.08 Training Adntin! Dues Travel8 Savings Total Other Fringes &A Deduct. 0 0.00 0,00 0011 0.00 0.00 0-00 0-00 0,00 $0.00 $20DO $0-00 $0-W SO.00 $0.00 5136-18 51,067.5 Other Deduction Noles: Trainino Fee- Garnishment S - STRAIGHT TIME 'OTHER - Any other deductions, contdbuteom ar4or psyrmc whether or non mcluded or required t7y pmiaiing wage dewmirml>ans crust bo sepa jely listed. CERTWICATION MUST be completed Form IF1-131 lNew 2-80) O- OVET"ME Use extra shaeka) if ^etassary• {Sae rgy We) D DNAL-i5TINiE S01= STATE DiWKJTY IHS4RANCE California 401 Department of Herb -oft Walkup Pipeline Replacement ! Herbert 'Walkup Pipeline P p p pe industrial Relations PUBLIC WORKS PAYROLL REPORTING FORM Page Gof? (1) (2) 1 (3) (4)DAY (a) :6r (7) (8) (9) SIMITIWITIFIS NAME. AODRESS AND SOCIAL cs o . I WORK I Date TOTAL HOURL GROSS AMOUNT NET WAGES CkECIS SECURITY NUMBER o� i zr C�`� IFICATION 6123 16124 I am I uA 1 6127 1 6128 16129 HouRs Y RATE OF PAY NeD DEDUCTIONS. CONTRIBUTIONS AND PAYMCNTS PAID NO_ OF EMPLOYEE 37 w i Hours Worked Each pay FOR WEEK I S 0.00 8.00 8.00 8.00 0.00 8.00 0.00 40.00 $95." THIS ALL Federal PROJECT PROJECTS Tax FICA& Medicare State Tax SDI vacation Health & Holiday Welfare Penslon YOUNG. JIM I Operating Engineer $876.00 $394.80 $443,66 $56.77 $0.08 $0-00 S0-00 95629 P. Q- 8o1c 58 1 I (Heavy & O 100 0.00 2-Oil 2.00 2_00 2.00 0.30 a.p0 $127-00 $3,076.40 on Highway work) I Group 3 Area 1 $4,841-SO $5,222.fia Training Admin i Fringes Dues Travel 8 Sub Total Other Deduct f ❑ 0-W 0.00 0.00 0.00 0.00 0.00 000 0.00 $0.00 558.08 50.00 $0.00 50.00 $21462 -OQ 5375.07 0 $a , Other Deduction Notes: Traloino fee. Cal Sav M -- - S - Om 0.00 5.00 8.00 8.00 8.00 0.00 40.DO S52.14 7I6 /LL I4. 911 PROJECT PROJECTS Tax /Ili/ J Medicare �Cq{Q Tax SDI Y-11- TdI JT. Holiday Welfare Pemmn -A ZELLERS, JEREMY 8194 hAA1N 5T I PLUM$ER1 I 5487.00 $21 SA9 S204.73 $31-42 $0.00 $0-00 $0,00 L40KELUMHF HILL 0 UNDERGRpU Y O 0.00 2.00 2-00 2-00 2-00 1.00 O.DO 9.00 $66.79 S1 853.45 Dm I -FrrTND PIPEF[TTEI2 $2.704.71 $2.675.69 Training Adorn 1 puss Travel 8 Savings Other Total Frirlgas Sub Deduct. ❑ 0.00 0.00 0.0D 0.00 0.00 0.00 0-DO 0.00 $0.00 S1sG0 $0.00 $0.00 50,00 50.40 5161,54 31023-2 Other Deduction Notes: TraWna fee_ Garnishmmg S - STFMGHT TIME 'OTHER - Arvy other dedmijons oonViitudom arKVor payments whether w not rw*K1cd w regrrred by prevailing wage dntermvlatiom mull be separately fisted. CERTIFICATION hJUH be mmpided 0 = OVERTIkKE Use extra shee7ls) it rmxmg ary- {Sec reverse side] Form A-1-131 (New 2--N1 D=p(K)BLEDUE Sei - STATE 0154e1liTY 64SURAWE California Department of Industrial Relations STATE DF CALIFORNIA STATEMENT OF COMPLIANCE CONTRACTOR I SUBCONTRACTOR Vinciguerra Construction, Inc, FIRST OAY AND DATE OF PAY P ERIDD 612312024 1 do hereby certify under penalty of perfury: Herbert Walkup Pipeline Replacement 1 Herbert Walkup Pipeline PUBLIC WORKS PAYROLL REPORTING FORM Page 7of7 CONTRACT NUMBER Herbert Walkup Pipeline LAST DAY AND DATE OF PAY PERIOD &2912024 (1) That I pay or supervise payment to employees of the above --referenced contractor on the above -referenced contract. All 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 indirec#ly to" 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 earned by any person other than permissible deductions, (2) That this employer has complied with the requirements of the California labor Coda Sections. 1771. 1811, and 1816 for all performed on this public works project, and that the classi ications set forth therein for each trade rate conform with the worts 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) 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 w!JI be paid to the approved plan(s), funds(s), Dr programs) for the benefit of listed employee(s). except as noted below. (b) 0 Have been paid directly to the listed employee(s), except as noted below. (c) © See exoep&ms noted below. EXCEPTION CRAFT REMARKS: Except for Training funds for all crafts paid directlyto CAC. EXPLANATION NAME (PLEASE PRINT.) TITLE i Austln Vinciguerra President JI SIGNATURI=: DATE j 71512024 1 On federally -funded projects, permissible deductions are defined in title 29, {`.ode of Federal ReguW Fr part3, issued by the Secretary of Labor under the Copeland Act, (40 U. S. C. 276c). Also, the willful falsification of any of the above statements may subject the contractor or subcontractor to civil or criminal prosecution (See section 1001 of tide 18 aW section 3729 of title 31 of the United States Code}. J ADA Notice For individuals with sensory disabilities, this document is available in alternate formats. For information call (916) 654-6410 or TOD (916) 654-3580 or write Records and Forms c0.126M fvlarmagement, 1120 Ni Street, MS-89, Sacramento, CA 95814. Department 2024 Herbert Walkup Pipeline Replacement l Herbert Walkup Pipeline Department of IndustrialRelatiom PUBLIC WORKS PAYROLL REPORTING FORM Page 1 of NAME OF CONTRACTOR: Vinciguerra Construction, Inc. CONTRACTOR'S LICENSE NO.: 358838 ADDRESS: P. O. Box 157, Sutter Creek, CA. 95685! IOR SU000NTFRACTOR: SPECIALTY LICENSE NO -- PAYROLL NO. FOR WEEK ENDING SELF -INSURED CERT: PROJECTOR CONTRACT NO. Herbert Walkup Pipeline 13 I 71W2024 (WORKERS' COMP PROJECTANDLOCATION. 2024 Herbert Walkup pipeline Replacement, EL❑ (1) (2) 1 (3) (4) DAY (5) (6) NAME, ADDRESS ag I S f M I T I w l i l F l$ NET AND SOCIAL �a� I LAS i7a� Tr7TAL YMolRATE L GROSS AvauNT DEDUCTIONS CONTRIBUTIONS AiJ❑ PAYMENTS pApGjp CHECK SECURITY NUMBER dx � Fid{�r3 EARNED FOR NO. OF EMPLOYEE z x i tFICATION V30 I T101 17102 1 7f03 1 7I04 1 7/05 1 7fO6 DFPAY Haas Worked Each Day WEEK I THIS ALL Federal FICA& State Vacation Health & Pension S 0.00 4.00 4.00 0.00 0.00 0,00 0,00 8,00 S94.64 PROJECT PROJECTS Tax Medicare Tax SDI Holiday Welfare AIiEVALO, JOSHUA I Operating Engineer $0,00 $118-05 $0.00 $17.12 SO.00 $0-00 S0.00 155 Hillside Place $1252 5b42 4 I {Heavy & O 0.00 0.00 0.00 (>-00 0.00 0.00 0.00 0.00 1 $1.210.33 DID Highway work) l Admin I Travel 6 Tote{ I Group 3 Area 1 S7'67.12 $i1,571.23 Training FrinpS Dues Sub Savings Other DedUct - -I -- - D ZZI 0316 (FAID -0W Q Go 0.W 0 00 0.00 WW- -1 -1 I f -1 1 - $'3 50A0 $0.00 SQ.00 50.00 5224.73 $308.9D Other Deduction NotesTraining fee. Garnishment Cal Save[ THIS ALL Federal FICA & State SDI Vacatior Health & pension I 5 O.DO 4,00 4.00 0.00 0.00 0.00 O.Oo 6.00 $53.61 PROJECT PROJECTS Tax Medicare Tax Holiday Welfare AREVALO, JOSHUA I PLUMBER( $0.00 $119-05 $0.00 S17.12 $0.00 $0.00 $o.00 155 Hillside Plape 4 UNIDERGROU O 0.00 200 2-00 0.00 0-00 0.00 0.00 4.00 S70.8T NEW` 2 I ND UTlt-ITY $1.210.33 ❑D PIPEFITTER $712.36 $1,571.23 Training FruWAdmin i Dues Travel Sub Savings Other Total Fringes Sub Deduct. I D 0.00 0.00 0-00 0,00 0-W 0.00 0,00 0- 0 MOD I $4-90 $OAo $0.00 50.00 50,00 $224.73 $350.90 Other Deduction Notes: Training fee. Garnishment. Cal Savers I THIS ALL Federal FICA 8 Stale Vacation Health & j S 0,00 3-00 7,50 0.00 0.00 0.00 0.00 15-60 $53.61 PROJECT PROJECTS Tax Medicare Tax SDI Holiday Welfare GORREA. ERICK I PLUMBER 1 1535 Hussman $0.00 $79.26 $0.00 $11-40 $0.00 $0.00 SO -DO Avenue Gardnen ilNO UTILITY 0 I U O UTILI TY OU O 0.00 2.0D 0.00 0.00 0.00 0.00 0-00 2-00 S70.87 �--- S94S-51 2355 l Admin 1 Travel8 Total l PIPEFITTER $972.70 $1.043.57 Training Fringes Dues Sub Savings OVter Oedua ❑ 0.0D 0.00 0.00 0.00 D.(X 0.00 0,00 0.00 i0.00 $7.00 $0.00 $0.00 SO-00 50.00 $7.40 $98.06 Other Deduction Notes: Training fee S = STRAkaHT TIME 'OTHER - Any otw deductions, crxrfidutlons anftr paynwts vmMelhef rr ml llduded or mgiirad try Nevailing vrage 6aEe moaLKXZ must he separalety IivL CERTIFICATYON MWEI by complelen 0 = OVERTIME Use exbra shee9{s) 6 necessary. (See reverse side) Form A-1-1aI(New 2-W) ❑-POUBLElJ61E SDI = STATE DISABILITY INSURANCE California Department of 2024 Herbert Walkup Pipeline line Re laaement f Herbert Walkup Pipeline P Industrial Relations PUBLIC WORKS PAYROLL REPORTING FORM Page 2aljQ ',-1; DAY (51 116) IT) M {9) S I M I T I IV I T I F l NAME. ADDRESS AND SOCIAL z s [ 50 0A§ I WORK Dam TOTAL. HOLiRL GROSS AMOUNT NET WAGES CHECK SECURITY NUMBER z CLASS- [ IFICATION 6130 171D1 171D2 17ir0$ 1 7104 1 7105 171fl6 HOURS P RATE OF PAY EARNED DEDUCTIONS. CONTRIBUTIONS AND PAYMENTS FAQ NO. OF EMPLOYEE [ Hours Worked Each Day WEEK THIS ALL Federal FICA & State SDI Vacon ati Heafth 8 Pension [ 5 0.00 4,DO 4.00 0.00 0.00 O.00 0.00 8.00 S94.64 PROJECT PROJECTS Tax Medicare Tax Holiday WelfareCOW THOhAAS Operating 12650 12650 C � Engineer S183.00 3105-56 S60.35 315,18 SO.00 $0.00 50.00 Shenandoah Road 0 I (Heavy & O 0A 0.00 0.00 0.00 0.00 0.00 0.00 0,04 $125.20 1 $678.04 l]tD 9%80 Highway work) I [ Group 3 Area 1 $757.12 $7,394.05 Training Adnrn 1 Fringes Dues Travel & Sub Savings Other Tofal ❑edL aL [ 1) 0.00 0.00 0.00 0.00 0.00 0.0D 0.00 0.00 $0.00 $9.68 S0.00 $0.00 SO.00 $O.0D $351.92 S7 i6.01 Other Deduction Notes: Training fee. Garnishment SDI .wurr iimmrd- - - - Pension [ S O.GO 4.00 4,00 0-00 0.00 0.00 0-00 8-DO S53.61 PROJECT PROJECTS Taut Medicare Tax Hdday Welfare COWAN. THOMAS 12650 C PLUMBER! 5183-DO $105156 S60.35 $15.18 SO-00 10.00 S0.00 Shenandoah Road 0 NO UTILITY UNDERGROU O 0-DO 2.00 0,50 DAD 0.00 0.D0 D-DO 2-50 570.87 $618.P4 DID aim95669 � PIPEFITTER $606.06 57394.05 Training Admin 1 des Travel8. Savings Other Taal Fringes Sub Dedfxt D 0.00 0-00 0-00 0.00 0,00 0.00 0,00 OX $0.00 $4,20 $0,00 $0.00 $0.00 50.00 $351.92 $716.01 Other Deduction Notes: Tra"aS fee. Gamshment [ THIS ALL Federal FICA 8 State 501 Vacation Health 8 Pension S 0.00 8.00 t3.00 0.00 0.00 0.00 0.00 16-00 S53-61 PROJECT PROJECTS Tax Medicare Tax Holiday Welfare GABREE, PAUL [ PLUMBER 1 [ $0,00 $12$-83 $0.00 $18-24 $0.00 $O.DO SO.00 611 Glenbrook Drive UNDERGROU 3 O 0.00 2.00 2A0 D.00 0.00 0.00 0.00 4.00 $70. Si 512.82 DID lone [ NI) UTILITY Ad87 ! Travel & Total [ PIPEFITTER $1,14'..24 $1,566.$9 Training Fringes g Dues Sub Savings Other Detluct. [ � D 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $0.00 I $8-00 50.00 30-W $0-00 50.00 39.00 $154.07 _ Other Deduction Notes: Training fee THIS ALL Federal FICA d State SDI Vacaton Heakh & Pefksi0n [ S 0.00 8.00 B-00 0.00 0.00 0.00 0.00 16.00 S53.61 PROJECT PROJECTS Tax Wdicare Tax Holiday Welfare GARIBALDI. ANTHONY [ PLUTABER 1 [ $12900 $86,69 S38.86 $12.46 S0.00 $0.00 MOO P.O. Box 865 Sutter UNDERGROU 0 [ ND UTILITY U 0.00 2.00 0-`50 0.00 0.00 0.00 0.00 2.50 S70.87 $866.23 DID 5 � [ PIPEFITTER #1,034.9d $1,141.24 Training Admin "n 1 FrirI Dues Travel & Sub Savings Other al Total al L7e uct [ I D 0,00 0.00 0.00 U-00 0,00 0.00 0.00 0.00 $0.00 $7.40 SO 00 $0.00 SO-00 SO-00 E8.00 $275-01 Other Deduction Notes: Training fee S = STRAIGHT 11ME 'OTHER - Any over deductions, mribr lions andlar paymenin wheftr or not indmied or mqured by prev+ "wage deiermiaaliom musl be separately hated. CERTIFICATION III= be mnpWed 0 = OVmnmE use extra she"s) if neceseary. {See reverse Side} Form A-1-131 (New 2-80) D = DOl113LETIME SDI - STATE DISABILITY INSURANCE jM:j Department 2024 Herbert Walkup Pipeline Re lacernant 1 Herbert Walkup Pipeline Department of p Pe p Pe Industrial Relations PUBLIC WORKS PAYROLL REPORTING FORM Page 30f:.Q (1) (2) ' (3) 1,4; DAY iSJ [sJ1 M S I M I T I LV I T I F I S NAME, ADDRESS i i I NET WORK AND SOCIAL o I CLASS- Date TOTAL YRAATE GROSS AMOUNT DEOUCTIDNS, CONTRI3UTIONS AND PAYMENTS WAGES CHECK SECURITY NVMBER i HOURS EARNED FOR NO - OF EMPLOYEE I IFICATIOIt 6130 17101E 7r02 17103E 7)04 j 7105 17ros OF PAY } Horxs Worked Each Day WEEK THIS ALL Federal FICA 8 State 'Vacation Health & f S 0,00 &00 6.00 0,W 0.00 O,DD 0.00 16.00 $53.61 PROJECT PROJECTS Tax Medicare Tax SQI Holiday Welfare Pension GRIEGO, DAVID 7730 Rock SSprinpDogs I PLUMBER) S94.00 $84.00 S36.53 $12.0a S0.00 $0.00 50.00 I Road EscondidoUNDERGROiJ CA 0 ND UTILITY O 0.00 2.00 1,00 0,00 0.00 0.W 0.00 3.00 $70.87 $871 40 DID 92025 I PIPEFITTER $1.070.37 $1.105.81 Training AdmEnI Dues Travel& 9avkvs Other Total - I Fringes Sub Deduct_ D 0.00 0.00 0,00 0.00 0.00 0.00 0.00 0.00 50.00 $7.60 SO.00 $0.00 S0.00 SO.DO $7.80 $234.41 I Other Deduction Notes: Training Fee 177A3 XLL v.l -%.N - Lam. M r .� _-r i iaanrr a S 4.t70 8.00 750 0.00 0.00 0.00 0-Op 15.50 W-61 PROJECT PROJECTS Tax Medicare Tax SDI Holiday Wevare Pam' LIMAS, ABRAHAM I PLUMBER 1 1535 Hussman $0.DO $79.27 $0,00 $11.40 SO.00 30.00 SO.OD A rensre Gardnerville p I UNDERGROU O 0.00 2.00 0-00 0.00 0.00 0.00 0.60 2.p0 $70.87 E945.50 2356 I NO UTILITY Adman 1 Travel 8 Total I PIPEFITTER $972,70 $1.043.57 Training Fringes Dues Sub Savings Other Deduct D 0.00 0.00 0.D0 0-00 0.00 0-00 O-D0 0.00 $0-00 $7.00 $0.00 $0.00 $0.00 $0.00 $7.40 $98.OT Other Dedudioa Noses: Training fee I THIS ALL Federal FICA Fr Stale Vacation Health & S 060 a-ov 8.00 0.00 0-00 0.00 0.00 16-00 $53.61 PROJECT PROJECTS Tax Tara Tax SOI Hol" WelfarePension MERGER, BRANDON I PLUMBER 1 $ 4-00 $94.00 S33.49 $12.08 $0.00 SO -DO S0,00 400 Cragmarrt Court 1 I UNDERGROL O 0 0D 200 0.50 0.00 0.00 0.00 0,00 2.50 $70.87 Cameron Park CA I NO UTILITY $W4.44 DM PIPEFITTER $1.034.94 $1.105.81 Training Adman 1 Dues Travelub Savings Other Total Fringes SDeduct. 0 0.00 0 00 0.00 0.00 0.00 O.OD D.D0 0.00 $0.00 $7,40 50.00 $0,00 S0.00 50,00 $7,80 W1.37 I Other Deduction Notes: Training fee THIS ALL Federal FICA & State VaCedon Health & S 0.00 8.00 7.50 0.00 0.00I 0.00 0.00 15-50 $53-61 PROJECT PROJECTS Tax Medicare Tax SDI Holiday Welfare Pension PASTEN VELASOUEZ, I PLUMBER 1 $0.00 $75.56 $20.99 $11,01 S0.00 $0,00 $0.00 ELISIO ; UNDERGROU $892 38 DID 0 0.2,00 0-00 0.00 0.OD 0.00 0.00 2.D0 $70. 742 6axn Or� N❑ UTILITY 0 00 87 Adrrsn 1 Trace! & Woodland CA 95776 I PIPEFITTER --- S972.70 $1.008.14 Tralning'i Fringes Dues Sub Savings Other TOW Deduct 0 0.I1D aA0 0.00 0.00 0.00 0.00 O.Dn 0.30 $0.00 $7.00 SO-00 $0.00 S0.00 30.00 $7.20 $115-76 Other Dedudion Notes_ Tram ina fee S = STRA)GHT TIME -OTHER - AAy other deductions. oonububoru andtdr payments whether or not indoAed or regored by prevairutg wage determinations must be separately Fated_ CERTIFICATION II$bdt be cam *led 0 = OVERTIME use extra sheet(S) it necessary, (See reverse tide) Form A-1-131 (New 2-80) 0 = DDl1BLETIME SDI = STATE DISAB&LITY INSURANCE California Department of 2024 Herbert Walkup Pipeline Re lamnant I Herbert Walkup Pipeline IndusWalRelatiarls PUBLIC WORKS PAYROLL REPORTING FORM Page 4of6 (1 ) (2) 1 (3) f4I DAY (5) .6Y (7) [8} (g) S I M I T I ;V I T I F I S NAM E. ADDRESS SOCIAL 9. ? I v qs WORK Date TOTAL. 110URL GROSS AMOUNT NET WAGESAND CHECK SECURITY NUMBER S CLASS- HOURS Y HATE EARNED DEDUCTIONS, CONTRIBUTIONS AND PAYMENTS PAD ISO. EMPLOYEE i IEICATION 513I1 7101 17102 17M3 1 7104 1 7105 17XI6 OF PAY FOR Hours Worked Each Day WEEK I THIS ALL Federal FICA & State soI Vacation Health & Pension 0.00 8.00 8.00 0,00 0.00 D_DO 0.00 16.D0 W.00 PROJECT PROJECTS Tax Medicare Tax Holiday Welfare PERI_Z. SERGIO 149 Oak Ridge Drive I PLUMBERI UNDERGROU ISOD@ $91,33 $0.00 $13.13 1 $0.00 Km Saw 0 1 ND UTILITY O 0.00 2.00 0.50 0.00 0.00 0.00 0.00 2.50 $80.45 1 $1.085.29 DID PIPEFITTER $1.161.13 $1.201.35 Training � Dues Trav� & SaviSub 01ner Total I iVs DeducL D 0.00 ODD 8.00 DA0 0.00 0.00 0.00 0.00 $0.00 $7.40 S0.00 $0.00 50,00 $0.00 $7-60 $112.06 Other Deduction Notes: Training fee 1 '"]�;. f41► F�,J9,al /'IW,d ,1ia�ti SDI :o..aJ�. ;�rin<<s► Pension S 0,00 8.00 8.00 000 0.00 0.00 0.00 16.00 $53.61 PROJECT PROJECTS , Tax Medicare Tax Hot day Welfare REYNOSO, LUIS 8399 5teelheaa I PLUMBER! $89.00 $61.30 S34.21 $11.69 SO.00 $0.00 50.00 Avenue Kings Beach 0 UNDERGROU � ND UTILITY O 0 0p 2.00 0.00 O.00 0.80 0.00 D.QD 2.00 570.$7 i $846.57 DID PIPEFITTER "99,50 41.070.371 Trairttng Adair 1 Dues Travel & Savings Other Total Fr nges Sub Deduct I D 0.00 0.00 0.00 0.00 0.00 QAO OAD 0.00 $0.00 $7.20 $0.00 $0.00 50.00 $4.40 S7.60 $223.80 Other Deduction Noles: Traialm lee THIS ALL Federal FICA & State SDI Vacation Health 8 Pension S 6.00 8-00 8.00 0.00 0.00 0A0 ODD 16.00 W-61 PROJECT PRCUECTS Tax Medicare Tars Holiday Welfare SASIA, MORRancho Wa Rancho Way PLUMBER 1 S86-00 $1'8,61 S31.88 $11.30 $MDO SO.DO SO.00 SoutAN h South Lake Tahoe UNDERGROU 0 NO UTILITY O OAQ 2.00 0.00 0,00 0,00 0.00 0.00 2.00 $70,87 $820-75 DID PIPEFITTER '$999.50 $1.034.94'Training F�qm Dues Trawl Savings Other TOW Deduct D 0.00 0,00 0.00 OAO 0,00 0.00 D.00 0_0C $0.00 $7.20 $0.00 $0,00 $0.00 SO.00 $7.40 $214.19 Other Deduction Notes: Training fee I THIS ALL Federal FICA & SWe SDI ViacaSm Health & Pension S 0.00 8.00 8.00 0.00 O.DD 0.00 0.00 10_00 S53.61 PROJECT I PROJECTS Tax Medicare Tax Holiday Welfare VASQUEZ, LUIS 210 Rom Ave I PLUMBER( I $O.DO $81.30 M.07 $11.69 SO-00 $0.00 $0.00 UNDERGPOLJ 0 I NO UTILITY O 0.00 2.00 0.00 0.00 QJ10 DAD 0.00 2.00 $70.87 $944.71 DID PIPEFITTER $999.50 $1.070.37 Training Admin 1 Fringes Dues Tra��eE & Sub Savings Other Total Deduct D QJDO 0.00 O.DO 0.OD 0.00 1100 0.00 O.W $0.00 S7.20 SO-00 $0.00 50.00 SO.00 $7.60 $125-66 Other Deduction Notes: Train irg fee S = STRAIGHT TIME 'OTHER -Any alher dedretions. cormbuticns arWar p"ntswhethcr or not indudod or regLmm4 by prevailing wage deberminations must be separately lisieo. CERTIFICATION MUST be mn pklea O = OVERTIME usC extra sneet[s) if nooeasary_ t5cc rcvo xo s doi Fern A-1-131 {New 2-0} D = OOUBLETIME SEA -STATE DISABILITY INSURANCE California Department of 2024 Herbert Walkup Pipeline Replacement 1 Herbert Walkup Pipeline Industrial Relations PUBLIC WORKS PAYROLL REPORTING FORM Pagejof:Q (1) (2) 1 (3) (4) DAY (5) (6) I71 [8� {9} S I M I T I W I T I F I S NAME. ADDRESS a.I a NET AND SOCIAL SEGURfTY NUMBER a o�% I WORK CLASS- I IFICAT1ON 130 81 7101 1 7102 Date 17W 1 7164 1 7105 1 I 71M TOTAL HOURS HOURL Y RATE OF PAY GROSS AMOUNT EARNED DEDUCTIONS. CO�ITRIBLTIONS AND PAYMENTS WAGES CHECK FOR NO OF EMPLOYEE j Hoes Worked Each Day WEEK I S 0.00 8.00 8,00 0.00 0.00 O.DO D.00 16.00 S99.64 THIS PROJECT ALL PROJECTS Federal Tax FICA & Medicare State Tax SDI Vacation Health & Holiday Welfare Pension V INCIGUERRA. I Operating AUSTIN Engineer 5169.00 $149,83 S112.91 $21.55 SO-00 $0.00 $0.00 330 Bodega Court El Dorado Hills CA 2 I {Heavy & ❑ 0.00 2,i)0 0,00 0.00 0.04 0.00 0.00 2.00 S132.7 1 S1,505.26 DM 95762 work}! Grp Group $1,859.66 $1,981.54 Trairnrrg Adng 1 Dues Travel & Savers defter Total 3 At"] Fringes sub Deduce I ❑ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $0.00 521.78 56.00 $OAO SO-W SO.DO $22.99 ;3476.28 Other Deduction Notes' Training ree SDI yHoliday Pension S ODD 8.00 8.00 0.00 O-DD 0.00 O-DO 16.00 $99.64 PROJECT PROJECTS Tax Medicare Tax Welfare VINOIGUE=RRA- pSEY I operating I Engineer S149.00 $149.83 $1D6.82 $21.54 S000 somO SO-00 4 Broadmeadorvs Court Sutter Creek 4 I (Heavy & d OM2.00 D.DO O.DO OX 0-00 0-00 2.00 $132.7 1 51 412.47 DM Highway Area 1 I Group 3 Area 1 $1,859.G6 $1,981.54 Training going 1 Fringes ❑�' Travel & Sub Savings Other Total du Deduct, I D ODD 0-00 ODD 0-00 0.001 0.00 0.00 0.60 SO -DO 521.78 50.00 $0.00 $0.W S0.00 I 5141.88 $569.07 Other Deduction Noses. Traininn Me- Cal Sams ( THIS ALL Federal FICA& State S7I Vacation Heahh& Pension S 0-00 8-00 8.00 0.00 OAO 0.00 D.00 16.00 S53.81 PROJECT PROJECTS Tax Medicare Tax Holiday Welfare WILLSON.3020 Newt n Roof 3020 Newton Road I PLUMBER/ I UNDERGR011 $88A0 $86.69 529.72 $12.47 SO .OQ $0.00 $O-O9 Sp. 1 PEacerville CA $ I ND UTILITY l7 0,00 2.00 1.50 0.00 0.00 6.96 0.00 3.50 $70.87 $8CO,98 ❑ip PIPEFITTER 11,105.81 $1,141.24 Training 1 Dues Travel& Savings Other Total � FringAdrni Fringes Sub Deduce. I O 0.00 0. D0 ODD 0.00 0.00 0.00 0.00 0. 00 $0.00 $7.8Q 50,00 30.00 $U_OD SO.00 $123.38 $.340.26 Other Deducton Notes_ Trainina tee. Garnishmen! 1 THIS ALL Federal FICA& State SDI Vacation Health& Persian S 0.00 8.00 B.00 0.00 0.00 0.00 0.00 16-DO $53,01 PROJECT PROJECTS Tax Medicare Tax Holiday Welfare ZELLERS.JEREMY 8194 MAIN ST I PLUMBER/ 1 I $4,00 $15.91 $23.46 $10.91 SO.00 $0.90 $0.00 MOKELUMNE HILL UNDERGR ❑ I ND UTILITY O 0-00 1.50 0.50 0.00 O.DO 0.00 0.00 2.00 S70.87 $73T.02 DOD PIPEFITTER (I - SM-50 $999-50 Training AdnFringg 1es Dues Travel sub & Savirogs Other Total Deduct. I I 0 ODD 0.00 O.DD 0.D0 O.DO 0.00 0.00 0.00 $0.00 $7.20 $0.00 $0.00 S0,00 SO.00 $148,20 $262-48 Other Deduction Notes, Training fee. Gan-nhmard S = STRAIGHT TIME •OTHER- Any other dedLetcans, cnrRribu6om armor payments wneMer or not inductee ar required by peevaang rrdge de[erminandns mast 6c sepaaicfy fisted. CERTIFICATION fiLM be WMpleted FIXm lt1-131 New 2--SO O = OVERTHdE Uat extra srreeaa3 if necessary. (sec r Srde) I l 0 = 00USLETIME SDI = STATE DISABI LITY INSURANCE 4dF4 California Department of Industiai Relations STATE OF CALIFORNIA STATEMENT OF COMPLIANCE CONTRACTOR ISUBGONTRACTOR VinCiguerra Construction, Inc. FIRST DAY AND DATE OF PAY PERIOD W3012024 do hereby certify under penalty of perjury, 2024 Herbert Walkup Pipeline Repracement 1 Herbert Walkup Pipeline PUBLIC WORKS PAYROLL REPORTING FORM Page 6of6 CONTRACT NUMBER Herbert Walkup Pipeline LAST DAY AND DATE OF PAY PERIOD 1 71612024 (1) That I pay or supervise payment to employees of the above -referenced contractor on the above-referenoed contract. Ali persons employed on said project for the above -referenced time period have been pall 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 earned by any person other than permissible deductions. (2) That this employer has complied with the requirements of the Califomia Labor Code Sections. 1771. 1311, and 1816 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 less that the applicable wages rates: (a) F-I Specified in the applicable wage determination incorporated into the contract; (b) FX Determined by the i]irector of Industrial Relations for the county or ceun#les in which the work is performed; that the classification set forth therein for each laborer or mechanic nonfarm 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) ❑R Have been paid directly to the listed employee(s), except as noted below. (c) MSee exceptions noted below. EXCEPTION CRAFT REMARKS; Except far Training k mds for all crafts paid directly to CAC. EXPLANATION NAME (PLEASE PRINT.) TITLE Austin Vinciguerra President SIGNATURE: - DATE I W1312024 On federally -funded projeetsr, permissible deductions are defined in title 29, Code of Federal Regulations, part 3, issued by the Secretary of Labor under the Copeland Act, (40 U. S. C. 276c). Also, the willful' falsification 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). ADA Notice For individuals with sensory disabilities, this document is available in alternate formats. For information call (916) 654-6410 or TDD (916) 654--3880 or write Records and Forms GEM 2503 Management, 1120 N Street, MS--89: Sacramento, CA 95814. California pepfornia taf 2024 Helb5e Walkup Pipeline Re lacement ! Herbert VValku Pipeline P Pe p p pe' Idol Industrial Relations PUBLIC WORKS PAYROLL REPORTING FORM Pagel of7 NAME OF CONTRACTOR: Vinelguerra Construction, Inc. CONTRACTOR'S LICENSE NO.. 358838 ADDRESS P. 0. Box 157, Sutter Creek, CA, 95685 OR SUBCONTRACTOR: SPECIALTY LICENSE NO.: PAYROLL 4 D. I FOR WEEK ENDING: SURED iiT. IW LORKER& PROJECT OR CONTRACT NO na CONI IPRDJECTAND LOCATION 2024 Herbert WalkHertmirt up Pipeline Replacement, ELD (1) (2) 1 (3) (4) DAY (5) (6) (7) i3l {el I S I M I T I W I T I F I S NAME, ADDRESS AND SOCIAL `a I W1< �� HOURL NET WAGES SECURITY NUMBER =� CLASS- IFICATION 7107 1710$ 17109 17110 17111 1 1 TOTAL HOURS Y RATE OF PAY GROSS AMOUNT EARNED PAYMENTS DEDUCTIONS. CONTRIBUTIONS AND PAYME CHECK PAID NO OF EMPLOYEE ; 7112 7A3 FOR - WEEK Hours; Worked Each flay S 0.00 4.00 4.00 4-00 4.00 4-DO 0.00 20.00 S94.64 THIS ALL Federal PROJECT PROJECTS Tax FICA & Medicare State Vacation Health & Tax SDl Holiday Welfare Pension AREVALO, JOSHUA I Operating I Engineer 5472-DO $273.22 S28d.02 $39 29 $0.00 $0.0050.00 155 Hillside Place Jackson CA 952 64 ¢ I (Heavy & O 0-00 0.00 0.00 0.00 0,00 0.00 010 0. DO S1252 1 Tr2,171.24 DNp - Highway work)/ I Group 3 Area 1 $1,892.80 SU07.39 Trairrng Admin l Travel & Total Dues Saw" Other Fringes Sub Deduct, - - 0 I 0.00 0-00 0-00 0.00 0.00 0.00 I 0.W U.DO $b.0� - - � - - $24.20 $0.001 f $1,436.1- $00 1 SO-00I _ 50-00 $367.62 5 Other Deduction Notes TrainiRq Fee_ Garnishment Cal Savers S 0.00 4-00 4,00 4.00 4.00 4.00 0.00 20.00 r S53.61 THIS ALL Federal PROJECT PROJECTS Tax FICA & Medicare Stale Vacation Health & Pension Tax SDI Holiday Welfare AREVALO.,jOSHUA I PLUMBER! I $472.00 $273.22 S2".02 $39.29 50.00 $0.00 $0.00 155 H Hs de Place r�5642 VNDERGROU 4 I ND UTILITY 0 0-00 2.00 2.00 0.50 1.50 0.00 0.90 6.00 $70.07 $2.171,24 DID PIPEFITTER , I $1.497-42 $3.807.39 Training Fringe! Dues Travel Savings Other Total Fringes b Sub Deduct D 0-00 0.00 OAO 0.00 0.00 0.00 0.00 0.00 $0.00 S10.40 $0.00 $0.00 SO -DO 50-00 $367-62 57,436.5 S Other Deduction Notes: T in' cAmiSFmpnt._ C.AI..1;wAWr{ S 0.00 8.00 8.00 8.00 0.00 0.00 0.00 24.00 S53.81 THIS ALL Federal PROJECT PROJECTS Tax FICA & Medicare Stale Vacation Health & Tax SDI Holiday Welfare Pension CORREA. ERICK I PLUMBER! 1535Hussman I $o.CO $121-96 $24A5 $17.53 $0.00 i4.00 $0.00 Avenue Gardnervdle UNDERGROU 0 0 I ND UTILITY OX 2,00 2.DD 0.00 0-DO 0.00 0-00 4.00 S70.87 51,430-53 2359 I PIPEFiTTER $1,570.12 $1.fi05.56 Training Admir.! Fringes Travel & To1a1 pees Sub Savngs Other Dedtxa. D I 0.00 0,00 D,00 0.00 4.00 0,00 0,00 D,DO $0,00 $11.20 58,40 $0,00 SO.00 SO.00 $11.40 $175.03 Other Deduction Noles: Twining fee S = STRAIGHT TIME -OTHER - Any other Aedud so . mntribnlidns anwor payments whether or no: rnge,ded or req cared by prcva&V wage dcgemwtations mutt he separaretg hsred- CERTIOCATI4N MUST toe oomplmied 0 - ❑VEI711 ME use extra stx uKs) it ^ . s^ry. (See reverse sole; Fprm A-1-131 (New 2-801 0 = DOUBLE-TIME SDI - 57ATE DMAMMY WSURANCtr 41:1California iePartin ent of 2024 Herbert 4Valku Pipeline Replacement Herbert Walkup Pipains 1nd u stri a I Relatwns PUBLIC WORKS PAYROLL REPORTING FORM Page 2ofI (1) (2) i (3) (4) DAY '5} (6) (7) l S I M I T I LY 1 T F l S NAME.ADDRESS AND SOCIAL a o ° g WORK �5 I pale TOTAL HOURL GRO5SAMOtJ1IT NET WAGES CHECK SECURrrY NUMBER CLASS- IFICATION 7107 171'08 1 7109 17110 1 7111 1 7112 17113 HDURs r+2ATE OF PAY EARNED DEDUCTIONS. CONTRIBUTIONS AND PAYMENTS pvD NO. EMPLOYEE FOR WEEK Hours Worked Each Day I THIS ALL Federal FICA & State S+DI Vacation Health & S 0.00 4.00 4,OD 4.00 4.00 4.00 0.00 20.DO S94.64 PROJECT PROJECTS Tax Medicare Tax Holiday Welfare Poor' THOMAS Operating 12650 C 12650 � Engineer S645.00 $257.05 S262-39 $36.90 $O.DD $0.06 S0.00 Shenandoah Road 0 {Heavy & 0 0.00 0.00 0,00 0.00 0.00 0.00 0.00 0,00 5125.2 $1,820.94 D1T] 956W Highway work) l $1,892.80 $3.3a4.78 Training �n"n I Dues 7rave{ & Savings Olner Totai Group 3 Area 1 Fr•nges Sub Deduct. ! D 0,00 0,00 0,00 0-00 D.DO 0.00 0.00 0.00 $0.00 $24.20 SO.00 $0.00 SO.00 $0.00 $372.44 $1,573.a Other Deduction Notesi Trainina fop. Gamishrnen; S 0,00 4.00 4.00 4.00 4.00 4-DO 0.001 20 00 S53.61 PROJECT PROJECTS' Tax lnw�+• Medicare Tax SDI Holiday Welfare pension GOWAN. THOMAS 12650C I PLUM$ER7 I S645_DO $257.05 $262,39 $36-96 SO.DD $0.00', S0.00 an Shendoah Road 0 UNDERGROU ND UTILITY 0 0.00 1.50 2.00 0.50 '.50 0.50 0.00 6.00 S70-87 S1.8?0.94 DID P mouth GA 95669 PIPEFITTER $1,497.42 $3,394.78 Training Adadri 1 Dues Travel & Total Savings Other Fringes Sub Deduct D 0.00 o.oa 0.00 0.00 0-00 0-00 D-DO O-DO $0.00 $10-40 $0A0 $4900 SO-00 50.00 $372.44 $1.579.88 Other Deduc.{dn Notes. Trairuna fee. Garnishment l THIS ALL Federal FICA & State SDI Vacation Health & Pension S 0.00 6.00 8.00 8.00 8.00 8.00 0.00 37-00 553.61 PROJECT PROJECTS Tax Medicare Tax Holiday Welfare GABREE, PAUL I PLUMBER/ l S224.00 Z187.18 5159.81 326-9 i S0.00 $0.00 $0.00 611 Glenbrook Drive 0 UNDERGROU 3 j ND UTILITY 0 0.00 2,00 1.00 1.00 0.50 0.00 0.00 4-50 $70.87 $7,8d8.82 DID � PIPEFITTER I $2,302-49 $2.463.32 Training ATotal Dues T & Savings. II Other Fririges Sub Deduct D 0.00 0.00 0.00 0.00 0.0D 0.00 OX 0.00 $0.00 $16.60 $0.00 $0.00 S0.00 $0.00 j16.60 $614.50 Other Deduction Notes: Tralning fee THIS ALL Federal FICA & State SDI Varian Health & Pension S 0.00 8.00 8.DO B-00 0.00 D-00 0.00 24.DO S53.61 PROJECT PROJECTS Tax Medicare Tax } � Welfare GARIBALDI. ANTHONY pLi1MBFJ31 UNDERGROU $253.00 $130-04 S92.54 $18.70 $D.DO $0.00 SO.00 P.O.Box 965Sutter 0 ND UTILITY 0 O00 8-00 2.OD 0.50 GOO 0.00 0.00 4.50 $70.67 Si-205.5E p1p �5 � PIPEFITTER $1.605.56 $1,711.✓36 Training Ar f Fririrt+�es Dues Travel 8 Sub TOW Savings Other L7educl, � � D 0.00 0.00 0,00 0_00 0.00 0.00 D.W 0.00 $0.00 311.413 $100 $[1.00 50A0 SO -DO $12.00 $508.28 - Other Deduction Notes: Irani ing fee S = STRAIGHT TIME -OTHER - Any other deductions. wnAwt om andror payments whether oe opt +xi-ded or req cared ty prev ing wacp dueem weal ons r usl he sepaza Loy Iisied. CERTIRCATiON MUST be com *led Form Imo]-131 {New 2�0] O = OVERTIME Use a va she"s l iI necessary. {3ee reverse side) = DOLIBLETIME Sol = STATE CISABILITy IPISURANCE California jml Department of 2p24 Herbert Walkup Pipeline Ilne Re arsrnealt f Herbert Walkup Pipeline Pi Ind ustrialRelations PUBLIC WORKS PAYROLL REPORTING FORM Page 3Df7 (1) (2) 1 (3) I (4, DAY (51 6) (71 i8f (g) SIMITIWITIFIS NAME. ADDRESS AND SOCIAL ? ° I � q � WORK CLASS- Date Tf}rRL HOuRL GROSS AMOUNT NET WAGES CHECK SECURITY NUMBER OF EMPLOYEE o2 $ IF"TION 7107 I V08 17109 17110 17I11 17112 17113 HOURS Y OF PAY EARNEQ DEDUCTIONS. CONTRIBUTIONS AND PAYMENTS PAID NO FOR i Hours worked Each Day WEEK S 0.00 8.00 8,00 8.00 a.00 8.00 0.00 40.00 $53.61 THIS ALL Federal PROJECT PROJECTS Tax FICA $ State Medicare Tax SDI Vacation Health & Holiday Welfare Pension GIRARpIN, FLOYD P. O. I PLUMBER1 S555.00 $240,99 S237.87 $34.66 SO.00 $0.w 50.00 Box 102 River Pen UNDERGROU 1 [ ND LMLITY 0 1D.00 2.00 2,00 2.00 2.00 2.00 0.00 10.00 S70.U7 I 52.081.71 DID PIPEFITTER 52,853.10 j3,172.02 Training Adrlrrn I Travel & Fringes Dues SavQrgs Other Total Sub Deduct D (100 0.00 0.00 0,00 0.00 0.00 0.00 0.00 SO -DO S20.00 SOAO $0.DD $0.00 S0.00 $21,80 sl,dsa.s Other Deduction Notes' Training fee ' S 0.00 B_00 am -- t1A0 8.00 9.00 0.00 4C_00 S53.61 'III: PROJECT ... - ..-✓w�/l PROJECTS Tax .-L:.�f� Medicare Giu:� Tax 501 �..._•.::..� ...:�w�G Holliday WeHare pension - GRIFG0 OAVS) 1730 Rock Springs E UM$ PLERI I - - - $490.00 $222,12 S215•S8 $31.94 50.00 $0.00 $0 00 Road Escondido CA UAUMB i 0 I ND UTILITY 0 0.00 2.00 2_p0 1.00 200' 2.00 O.DO 9.00 $70 87 51 937.g3 DID PIPEFITiER $2,782.23 $2,923.97 Training Admen 1 Fringes Dues Travel & Sub Savings Other TOW[ Deduct D 0.00 040 0-00 0A0 0A0 0.00 0-00 0-00 $9-00 $19-60 $0.00 30.00 50A0 SO.00 S20.40 5986.14 Other Deduclion Notes: Train ina fee I S THIS All Federal FICA & State SDI Vacation Health & Pension 0.00 8.00 8.00 8.00 0.00 0.00 0.00 24.00 S53.81 PROJECT PROJECTS Tax Medicare Tax H+Nid8yr Welfare LIMAS,ABRAHAM 1535 Hussman [ PLUMBER/ [ $0.00 $121.95 $18.06 $17.54 50.00 $0.00 $0.00 Avenue GardnervAB 0 UNDERGROU ND UTILITY O 0,01) 2.00 2,00 0.00 0.00 0.00 0,00 4.00 $70.87 57,436.61 2380 [ PIPEFITTER 51,570.72 $7.605.56 Training Ad g� Dues Travel & Savngs Other Total Sub [ D 0,00 1OO 0.00 D.00 0.00 0.00 0.00 0.00 $0.00 $1120 50.00 $0.00 SA.400 50.00 $11.40 $165 95 Other Deduction Notes: Trainina fee I THIS ALL federal FICA & state SDI Vacation Health & Pension [ S 0.00 8.00 B-00 8,00 8.00 0,00 O.DD 3200. W.61 PROJECT PROJECTS Tax Medicare Tax HolkW Welfare MERCIER. [ BRANDON PLUMBERI [ i 5301.00 S1fi2.ti0 5133.04 $23.38 $0.00 S0.00 50.00 d00CragmantCourt Cameron Park CA 1 UNOERGRDU [ ND UTILITY 0 0,00 1.50 1.50 1.50 1.50 0.00 0.00 6.00 Su70.87 $1,505.52 D1D PIPEFITTER .� $2.140.74 $2 140.74 Training Fnr�iges Dues T & Savings Other Total Sub Deduct. ❑ 0.00 0.00 0-00 0.00 0.00 0.00 0.00 0.00 $0.00 $15.20 S0.00 S0.00 S0.00 SO. DO $15.20 $635.22 Other Deduction Notes: Trani ❑ fee S = STRAIGHT TIME 'OTHER- Any plhef dedud ans cCnlr�tA ons and o paympX is whc her or ql endudetl or w red dy prevail ng wage deserrninalvxis must be sepa attly lis ed. CERTIFICATION h11JST be oompleied 0 = OVERTIME use extra sha8as) if nccessay. (soa r MMM Ski Form A-1-131 (New 2-W) D DOUELETIME Sal = STATE OISA9ILrrY WSl1RANCE Departme department of 2024 Herbert Walkup Pipeline Re Pe laoement I Herbert Walkup Pi the P p Pet Industrial Relations PUBLIC WORKS PAYROLL REPORTING FORM Pagegof7 (1) (2) 1 (3) (4) DAY (5) (8) (7i I8f {9) I SIMITIWITIF19 NAME. ADDRESS AND SOCIAL SECURITY 9 9 `o a ° 1 WORK I CLASS Date TOTAL HOURU Y RATE GROSS AMOUNT DEDUCTIONS, GONTRI6IJTIONS NET WAGES CHECK AND PAYFAENTS PAID NUMBER S I IFICATION 7107 171M _fffi9 17110 1 7111 17112 17113 �� OF PAY EARNED NO- OFEMPLOYEE FOR � Hours Worked Each Day WEEK I S O,OD 8.00 6.00 6.00 8.00 8-DO 0-00' 40.00 $53.61 THIS PROJECT ALL PROJECTS Federal Tax FICA & Medicare State Tax SDI Vatalmr.. Holiday Health & Welfare Pension PASTEN I VELASOUIEZ, Pl. UMBER 1 I $205-00 $2W-57 $177.70 328-94 30.00 $0-00 Saco ELISIO 742 6a�rn OF D UNDERGROU I NO UTILITY O 0.[10 2.00 1-54 0,08 1.50 2•Qp 0.00 7.00 $70.$7 52,009-58 l]1D J 35778 I PIPEFITTER-- $2,fid0.49 $2,a�4o.4s 7rainirg Adnnin 1 Dues Travel & Savirgs Olher Total - Fringes Sub Deduct - I D ODD 0,00 0.00 0.00 0.00 0-00 0-00 0.00 $0.00 S18_Bd $0.00 50.DO S0.00 SO.00 $1&50 $630,91 Other Deduction Notes Training I 8 0.00 5.00 8.DO 8.00 8.00 8-00 O-DO 40-00 $60.00 'I SL PROJECT ,',:.:r - .-,/.,.✓i- PROJECTS Tax -.-•::..-/I- Mad. -C 'Tuaaxcc -�� or_.� �.- Holiday rioun„ a Welfare Pension PEREZ. SERGIO I PLUMBI_R1 1 $0.00 S237A9 $0-00 $M-15 SO.00 SODD $0.00 149 Oak Ridge Drive l UNDERGROU NO UTILITY 1 U NO UTILITY O 0.00 2.00 2.0D 2A0 150 0AW 0.00 a.W $60-45 S2,a;32-S1 DAO $3,043.60 $3,124.05 Training Admiral p06s Travel& Savings Olher Total Fringes Sub Deduct- I6 0 0.00 0.00 D.00 0.00 Q.00 0A0 QQ0 0.00 i0-OEl 1 619.20 $0.00 $0.00 SO-00 $0.00 $19.60 $291-24 Olher Deduction Notes: TraL0 09 I THIS ALL Federal FICA 9 State SDI Vacation Health & Pension I S 0.00 8.00 SW B-00 0-00 0-00 0.00 24.00 $53.61 PROJECT PROJECTS Tax Medicare Tax H*l;wy Welfare REYNOSO, LUIS 8399 Steelhead I PLUMf9ER! I $202,00 $124.66 S85.33 $17.92 S0.00 $0.00 SO-00 Avenue Kings Beach � 0 UNOERGROU I N❑ UTILITY O 0.00 2.00 1.50 1,50 C.00 0.00 0.00 5.00 S70.87 51.199.48 OID CA 96� PIPEFITTER S7,8d0-99 $f,fi4D.99 Training Ad"ri ! Dues Travel Travel & Other Total Fringes Suta Reouct. D 0.00 0.00 0.00 0.00 0.00 0.00 0-00 000 $0-00' $11,60 50-00 $0.00 S0.00 $0.00 $11.W $441.51 OtherDedudtor. Notes: Training fee f S 0.00 8.00 8.00 8.00 8.00 8-00 0-00 40.00 MAII TFf15 PROJECT ALL Federal PROJECTS Tax FICA& Medicam State Tax SD[ Vacation Hoiday Health & Welfare Pensipn SABIA, MORGAN 1413 Rancho Way I PLUMBER! 1 UNOERGROU $436.00 $203-26 5190.45 $29.23 $0-00 SO-00 50-00, Saulh lake Tahoe } 1 ND UTILITY O 0.00 2.00 2.00 0.00 2-00 1.50 O.Oi] 7.50 570.87 $1_T97.99 i$IO I PIPEFITTER __- $2.675.93 $2,675.93 Training Admin 1 Fringes Dues Travel & Sub Savings Other Total Deduct. 1 I ❑ 0-00 0.00 O.DO GM D.Do O.00 0,00 0.00 $0-00 $19,00 $0.00 $0-00 50.00 SO-00 $19-DO $877-94 Other Dedudlon Notes: Trainin4 [ee S - STRA{GIiT TIME 'OTHER-- Any oDw de&mu dons. contra ans andlor pays. rats whe& r oe not ow*mW or recioree by arawwk�q ways detam,inatbns nksl be sepsra;efy Wad. CERTIFICATION +Qj be canpeted Form r�7-731 (New 2^BQ} O = OVERTIME LAse roam meats) if rmos"ary. 1`_ _ revue Sipe I t ❑ = DOUSLETINIE SDI - STATE DISABILITY INSURANCE Department of 2024 Herbert Walkup Pipeline Replacement 1 Herbert Walkup Pi Wine P P P p pe 4rin(California Industrial RelatiQns PUBLIC WORKS PAYROLL REPORTING FORM Page 5of7 (1) (2) 1 (3) (4) DAY 51?AITIWITIFIS NAME, ADDRESS 1, s 1 NET AND SOCIAL SER o,S s K d 1 I WORCLASS- ', 611 7107 7148 7105 oa6a TOTAL "Ou"' �tr_ Y RATE GROSS AMOUNT EARNED DEDUCTIONS, CONTRIBUTIONS WAGES AND PAYMENTS PAID CHECK No. OF EMPLOYEE � i I FICATlON 11 17110 1 7111 1 7112 17113 OF PAY FOR Hours Worked Each Day WEER S 4.00 6.00 8.40I 8.00 8.00 8.00 O.OD a0.i00 $50.00 THIS PROJECT ALL Federal PROJECTS Tax FICA & Medicare State Tax SDI Vacation Holiday Health & Welfare Pension TAY€.OR, 1 KRISTOPHER PLUMBER 1 1 S414.00 $246.66 5242-42 $35.47 SD.00 $0.00 50.00 1973DCirde Forest Yew CirdlE Pioneer CA 1 U D UTILI DU I NU UTILITY 0 0-00 2,00 2.00 0.50 2.DO 1.60 0,00 .8.00 $60,45 $2,285,96 DID PIPEFITTER $3.043.60 $3.244.73 Training Ad"n 1 Dues Travel & Say" Ocher Tow Fringes sub Deduct I 0 0.00 0.00 D.00 0.00 0.00 0.D0 0.00 0.150 $0.00 $19.20 50.DD $0.00 50.00 S0.00 S2o20 $958.77 Otter [Deduction Nales: 7raini 5 0.00 8.00 8.00 8.00 8.00 6.00 0.00 40.00 $53.fi1 PROJECT PROJECTS Tax I'Lu a Medicare -3w Tax SQI rv.oi�urr FididBy iioo�u�o Pension Welfare VASQUEZ, LUIS PLUMBER/ 1 5161.00 $195.17 $170.50 $28,05 $0_D0 $0,00 SO-00 210 Rosa Ave U OU 0 1 NDO UTILITY C 0-00 2.00 2.00 0.00 1.50 0,50 D-DD 6.00 $70A7 51.996.49 DAD PIPEFITTER 1 $2.569-62 $2,5fi9.62 Training Adorn 1 Dues Travel & Savings Other Total €Tinges Sub (Deduct. 1 D D.00I 0.00 0.00 0.00 0.00 0.D0 0.00 0-00 $0.00 $18.40 $0,00 $0,00 $0.00 50.00 $18.40 $573.13 Other Deduction Notes- Training fee I THIS ALL Federal FICA & I Stale 5D! Vacation Health & pe lion S 0.00 8.00 9.00 8.00 8.00 8.00 0-00 40.00 $99 64 PROJECT PROJECTS Tax Medicare Tax Hdidsy Welfare VINCIGUERRA. AUSTIV OAerat rtg 51.038.0 330 8odega Court El Engineer 5132.7 0 $452,92 $518.22 E65-12 S0.00 $0.00 $0.00 Dorado Hils CA {Heavy A. )Highway 0 0,00 2.00 2.00 2.00 2.00 2.00 0.00 10,00 1 53,84fi_27 DIMGroup Highway work) / &531270 ..,.g 5598708 Trainin Admin I Dues Travel & Savings TOW Other 3 Area 1 Fringes Sub Deduct. D D.00 0.00 0.00 0.00 0.00 0.00 D.DQ 0.010 $0.D0 SSD.50 $0.00 $0.00 $0.00 SO -DO $66.55 S2,140_8 -~ Other 0eductiar. Notes: Training fee 0.00 8.00 8.00 SAO 8-00 8.00 0.00 40.00 599.64 THIS PROJECT ALL Federal PROJECTS Tax FICA & Medicare State Tax Sol Vacation Holiday Health & Welfare Pension VIN=S Qperablg CASEYUERRA ASEY Engineer $730-00 $367.41 S39738 $52.83 $0.00 S0.00 $0.00 Court Sutter Creek Court Broadmeareek 4 (Heavya 1 0 0-DO 1.IJ0 1.00 2.00 2.00 0.50 0.00 fi 50 5132.7 t 52.988.78 pip H 1 Group 3 Area 1 $4.848,22 $4.859.05 Training Adng 1 Dues Travel& Savings Ottler oup3Area}1 Fringes Sub edL Deduct 1 D 0.00 0-00 0-00 0,00 om 0.00 0.00 0.00 $0.00 556.27 $0.00 $0,00 SO-00 S0.00 $1,670.8 S322.87 9 Other Deduction Notes. Tminina fee_ Cal Savers S a STRAIGHT TIME 'OTHER -Any other de&udions. owkibL ons ancVor payments whether or not included a requtw Ay pre m*V weyc dcrermwairo must be sepera6ety fisied. CERTIFICATION MUST be compk4ed Form A-1-131 INew2�D} O `OVERTIME Use extra sheet(s) YT necessary. (See rever�..e side) D= DWBLEIIME 501= STATE DISAMILITY INSURANCE Department of Industrial Relations STATE OF CALIFORNIA STATEMENT OF COMPLIANCE 1CONTRACTOR1SUBCONTRACTOR Vinciguerra Construction, Inc. F[RST DAY AND DATE OF PAY PERIOD W712024 do hereby certify under penalty of perjury_ 2024 Herbert Walkup Pipeline Replacement 1 Herbert Walkup Pipeline PUBLIC WORKS PAYROLL REPORTING FORM Page Zof7 CONTRACT NUMBER Herbert Walkup Pipeline LAST DAY AND DATE OF PAY PEMD 711=024 (1) That I pay or supervise payment to employees of the above --referenced contractor on the above —referenced contracL Al persons employed on said project for the above raferenced Gme 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 earned by any person other than permissible deductions. (2) That this employer 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 dassifications set forth therein for each trade rate oonforrn 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 wades rates: (a) II Specified in the applicable wage determination incorporated into the contract; (b) 0 Delermined 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) F-1 Have been or will be paid to the approved plan(s), funds(s), or program(s) for the bemfit of listed employee(s), except as noted below. (b) Have been paid directly t4 the listed employee(s), except as noted below. (c) ❑ See exceptions noted below. EXCEPTION CRAFT EXPLANATION REMARKS. Except for Training funds for all crafts paid directly to CAC. NAME (PLEASE PRINT.) TITLE Austin Vinciguerra President SIGNATURE- I DATE 811312024 On federally —funded projects, permissible deductions are defined in title A, Code of Federal Regulations, part 3, issued by the Secretary of Labor under the Copeland Act, (40 U. S. C. 275c)_ Also, the willful falsification of any of the above statements may subject the contractor or subcontractor to civil or criminal prosecution (See section 1001 of tifle 18 and section 3729 of title 31 of the United States Code). ADA Notice For individuals with sensory disabilities, this document is available in alternate formats. For information call (916) 654-6410 or TDD (916) 654-3880 or write Records and Farms oEM 25m Management, 1120 N Street, MS-89: Sacrarnenlo, CA 95814.