HomeMy WebLinkAbout1000679982_519068_2025-08-10_PRRUN2925304PWCR#1000679982 DIR Project ID 519068
CSLB #1045038 Awarding Body
Statement of Non-Performance
System Payroll #PRRUN2925304
CITY OF LAKE ELSINORE
eCPR Sequence #69 Project Name City Hall Building - Concrete
Final Payroll
Payroll Period 08/04/2025 - 08/10/2025 Project Address
Contractor SAS CONSTRUCTION
130 S. MAIN STREET,
LAKE ELSINORE, CA,
92530
Contract With CITY OF LAKE ELSINORE Project County
Certification under penalty of perjury:
"I, Joshua Jo, the undersigned, certify on 08/15/2025, that I have the authority to act for and on behalf of SAS CONSTRUCTION , certify under
penalty of perjury that the records or copies thereof submitted and consisting of certified payroll records for the dates 08/04/2025 to 08/10/2025
are the originals or true, full, and correct copies of the originals which depict the payroll record(s) of the actual disbursements by way of cash,
check, or whatever form to the individual or individuals named."
Public Works Electronic Payroll Reporting Form
Public Works Certified Payroll Reporting Form 2025/08/15 Page - 1