HomeMy WebLinkAbout1000679982_519068_2025-08-17_PRRUN2996246PWCR#1000679982 DIR Project ID 519068
CSLB #1045038 Awarding Body
Statement of Non-Performance
System Payroll #PRRUN2996246
CITY OF LAKE ELSINORE
eCPR Sequence #70 Project Name City Hall Building - Concrete
Final Payroll
Payroll Period 08/11/2025 - 08/17/2025 Project Address
Contractor SAS CONSTRUCTION
130 S. MAIN STREET,
LAKE ELSINORE, CA,
92530
Contract With CITY OF LAKE ELSINORE Project County
Employee: SEPULVEDA CARVAJAL, CARLOS ANTONIO
Address 3310 Meeks Avenue , Bakersfield, CA, 93307 SSN 8050 Check # 21898034 Fringe Paid Directly to Worker
Hours Worked
Craft/Classification/Level LABORER AND RELATED CLASSIFICATIONS : OTHER (PLEASE SPECIFY) -
Laborer Group 1 - JOURNEYMAN
Type Mon
08/11
Tue
08/12
Wed
08/13
Thu
08/14
Fri
08/15
Sat
08/16
Sun
08/17
Total
Hours
Base
Hourly
Total
Hourly Rate
S 8.00 8.00 8.00 8.00 8.00 0.00 0.00 40.00 78.00 78.80
Contributions
Vac/Holi H&W Pension Other Training Total Hourly Fringe
0.00 0.00 0.00 0.00 0.80 0.80
Deductions (lump sum/non hourly rates)
Fed Tax FICA
(Soc Sec)
State Tax SDI Fund/
Admin
Savings Dues Other Total
Deductions
542.01 238.68 235.13 37.44 0.00 0.00 0.00 0.00 1053.26
Payments
Travel &
subsistence
0.00
Wages Summary
Gross Wages
for all projects
Gross Wages
for this project
Net Wages
Paid
3120.00 3152.00 2066.74
Employee: SALGADO, JUAN
Address 525 West Grove Street , Rialto, CA , 92376 SSN 3984 Check # 21898033 Fringe Paid Directly to Worker
Hours Worked
Craft/Classification/Level LABORER AND RELATED CLASSIFICATIONS : OTHER (PLEASE SPECIFY) -
Laborer Group 1 - JOURNEYMAN
Type Mon
08/11
Tue
08/12
Wed
08/13
Thu
08/14
Fri
08/15
Sat
08/16
Sun
08/17
Total
Hours
Base
Hourly
Total
Hourly Rate
S 8.00 8.00 8.00 8.00 8.00 0.00 0.00 40.00 78.00 78.80
Contributions
Vac/Holi H&W Pension Other Training Total Hourly Fringe
0.00 0.00 0.00 0.00 0.80 0.80
Deductions (lump sum/non hourly rates)
Fed Tax FICA
(Soc Sec)
State Tax SDI Fund/
Admin
Savings Dues Other Total
Deductions
363.81 238.68 235.13 37.44 0.00 0.00 0.00 0.00 875.06
Payments
Travel &
subsistence
0.00
Wages Summary
Gross Wages
for all projects
Gross Wages
for this project
Net Wages
Paid
3120.00 3152.00 2244.94
Employee: GARCIA IVANEZ, RAMON
Address 1512 East 127th Street Apt 11, Compton, CA, 90222 SSN 3306 Check # 21898032 Fringe Paid Directly to Worker
Hours Worked
Craft/Classification/Level LABORER AND RELATED CLASSIFICATIONS : OTHER (PLEASE SPECIFY) -
Laborer Group 1 - JOURNEYMAN
Type Mon
08/11
Tue
08/12
Wed
08/13
Thu
08/14
Fri
08/15
Sat
08/16
Sun
08/17
Total
Hours
Base
Hourly
Total
Hourly Rate
S 8.00 8.00 8.00 8.00 8.00 0.00 0.00 40.00 78.00 78.80
Contributions
Vac/Holi H&W Pension Other Training Total Hourly Fringe
0.00 0.00 0.00 0.00 0.80 0.80
Deductions (lump sum/non hourly rates)
Fed Tax FICA
(Soc Sec)
State Tax SDI Fund/
Admin
Savings Dues Other Total
Deductions
542.01 238.68 235.13 37.44 0.00 0.00 0.00 0.00 1053.26
Payments
Travel &
subsistence
0.00
Wages Summary
Gross Wages
for all projects
Gross Wages
for this project
Net Wages
Paid
3120.00 3152.00 2066.74
Employee: ARREDONDO, ADRIAN
Address 7905 Jackstraw Street , Bakersfield, CA, 93307 SSN 3146 Check # 21898030 Fringe Paid Directly to Worker
Public Works Electronic Payroll Reporting Form
Public Works Certified Payroll Reporting Form 2025/08/22 Page - 1
Hours Worked
Craft/Classification/Level LABORER AND RELATED CLASSIFICATIONS : OTHER (PLEASE SPECIFY) -
Laborer Group 1 - JOURNEYMAN
Type Mon
08/11
Tue
08/12
Wed
08/13
Thu
08/14
Fri
08/15
Sat
08/16
Sun
08/17
Total
Hours
Base
Hourly
Total
Hourly Rate
S 8.00 8.00 8.00 8.00 8.00 0.00 0.00 40.00 78.00 78.80
Contributions
Vac/Holi H&W Pension Other Training Total Hourly Fringe
0.00 0.00 0.00 0.00 0.80 0.80
Deductions (lump sum/non hourly rates)
Fed Tax FICA
(Soc Sec)
State Tax SDI Fund/
Admin
Savings Dues Other Total
Deductions
542.01 238.68 235.13 37.44 0.00 0.00 0.00 0.00 1053.26
Payments
Travel &
subsistence
0.00
Wages Summary
Gross Wages
for all projects
Gross Wages
for this project
Net Wages
Paid
3120.00 3152.00 2066.74
Employee: ARREDONDO, CESAR ANTONIO
Address 7905 Jackstraw Street , Bakersfield, CA, 93307 SSN Check # 21898031 Fringe Paid Directly to Worker
Hours Worked
Craft/Classification/Level LABORER AND RELATED CLASSIFICATIONS : OTHER (PLEASE SPECIFY) -
Laborer Group 1 - JOURNEYMAN
Type Mon
08/11
Tue
08/12
Wed
08/13
Thu
08/14
Fri
08/15
Sat
08/16
Sun
08/17
Total
Hours
Base
Hourly
Total
Hourly Rate
S 8.00 8.00 8.00 8.00 8.00 0.00 0.00 40.00 78.00 78.80
Contributions
Vac/Holi H&W Pension Other Training Total Hourly Fringe
0.00 0.00 0.00 0.00 0.80 0.80
Deductions (lump sum/non hourly rates)
Fed Tax FICA
(Soc Sec)
State Tax SDI Fund/
Admin
Savings Dues Other Total
Deductions
542.01 238.68 235.13 37.44 0.00 0.00 0.00 0.00 1053.26
Payments
Travel &
subsistence
0.00
Wages Summary
Gross Wages
for all projects
Gross Wages
for this project
Net Wages
Paid
3120.00 3152.00 2066.74
Certification under penalty of perjury:
"I, Joshua Jo, the undersigned, certify on 08/22/2025, 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 08/11/2025 to 08/17/2025
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 2025/08/22 Page - 2