HomeMy WebLinkAbout1000679982_519068_2024-09-22_PRRUN1498563 Public Works Certified Payroll Reporting Form
Certification under penalty of perjury:
"I,Joshua Jo,the undersigned,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 2024-09-16 to 2024-09-22 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."
Contractor License CSLB
Contractor Name: S.A.S CONSTRUCTIONS PWCR: Type: License
1000679982 Number:
Address: 301 WEST DYER RD UNIT D,SANTA ANA,CA 92707
Insurance Number:
Awarding Body: CITY OF LAKE ELSINORE DIR Project ID: 519068 Project Name: City Hall Building-Concrete
Contract With: S.A.S Constructions County: Address: 130 S.MAIN STREET,,LAKE ELSINORE,CA
92530
#: PRRUN1498563 Payroll Ctr Payroll#: Week Ending:2024-09-22 Statement of Non-Performance? Ely ACCT0025617 El on- er Final payroll for this project.
Employee:JIMENEZ ARIAS,HECTOR
Type Craft/Classification/Level Mon Tue Wed Thu Fri Sat Sun Total Base Total Vac. H&W Pension Other Training Fund/ Savings Dues Total
09/16 09/17 09/18 09/19 09/20 09/21 09/22 Hours Hourly Fringe Holi. Admin Hourly
LABORER AND RELATED
S CLASSIFICATIONS : OTHER 8.00 8.00 0.00 0.00 0.00 0.00 0.00 16.00 80.00 0.80 0.00 0.00 0.00 0.00 0.80 0.00 0.00 0.00 80.80
(PLEASE SPECIFY)-Laborer
Group 1 -JOURNEYMAN
1
Public Works Certified Payroll Reporting Form
LABORER AND RELATED
O CLASSIFICATIONS : OTHER 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
(PLEASE SPECIFY)-Laborer
Group 1 -JOURNEYMAN
LABORER AND RELATED
D CLASSIFICATIONS : OTHER 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
(PLEASE SPECIFY)-Laborer
Group 1 -JOURNEYMAN
Deductions(per payroll): Payments:
Federal Tax: 124.70 Travel&Subsistence: 0.00
Employee Notes(Include other deductions,
FICA(Soc. Sec.): 97.92 Wages Summary: contributions,and/or payments):
State Tax: 51.55 Gross wages for all projects included in this check: 1280.00
SDI: 14.08 Gross Wages for this project: 1292.80
Total Deductions(incl. Other): 288.25 Net Wages for all projects: 991.75
Public Works Certified Payroll Reporting Form 2025/01/31 Page- 2