HomeMy WebLinkAbout1000679982_519068_2025-09-28_PRRUN3413124PWCR#1000679982 DIR Project ID 519068
CSLB #1045038 Awarding Body
Statement of Non-Performance
System Payroll #PRRUN3413124
CITY OF LAKE ELSINORE
eCPR Sequence #76 Project Name City Hall Building - Concrete
Final Payroll
Payroll Period 09/22/2025 - 09/28/2025 Project Address
Contractor SAS CONSTRUCTION
130 S. MAIN STREET,
LAKE ELSINORE, CA,
92530
Contract With CITY OF LAKE ELSINORE Project County
Employee: ARREDONDO, CESAR ANTONIO
Address 7905 Jackstraw Street , Bakersfield, CA, 93307 SSN Check # 22037504 Fringe Paid Directly to Worker
Hours Worked
Craft/Classification/Level LABORER AND RELATED CLASSIFICATIONS : OTHER (PLEASE SPECIFY) -
Laborer Group 1 - JOURNEYMAN
Type Mon
09/22
Tue
09/23
Wed
09/24
Thu
09/25
Fri
09/26
Sat
09/27
Sun
09/28
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: GARCIA IVANEZ, RAMON
Address 1512 East 127th Street Apt 11, Compton, CA, 90222 SSN 3306 Check # 22037505 Fringe Paid Directly to Worker
Hours Worked
Craft/Classification/Level LABORER AND RELATED CLASSIFICATIONS : OTHER (PLEASE SPECIFY) -
Laborer Group 1 - JOURNEYMAN
Type Mon
09/22
Tue
09/23
Wed
09/24
Thu
09/25
Fri
09/26
Sat
09/27
Sun
09/28
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: SEPULVEDA CARVAJAL, CARLOS ANTONIO
Address 3310 Meeks Avenue , Bakersfield, CA, 93307 SSN 8050 Check # 22037507 Fringe Paid Directly to Worker
Hours Worked
Craft/Classification/Level LABORER AND RELATED CLASSIFICATIONS : OTHER (PLEASE SPECIFY) -
Laborer Group 1 - JOURNEYMAN
Type Mon
09/22
Tue
09/23
Wed
09/24
Thu
09/25
Fri
09/26
Sat
09/27
Sun
09/28
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 # 22037506 Fringe Paid Directly to Worker
Public Works Electronic Payroll Reporting Form
Public Works Certified Payroll Reporting Form 2025/10/03 Page - 1
Hours Worked
Craft/Classification/Level LABORER AND RELATED CLASSIFICATIONS : OTHER (PLEASE SPECIFY) -
Laborer Group 1 - JOURNEYMAN
Type Mon
09/22
Tue
09/23
Wed
09/24
Thu
09/25
Fri
09/26
Sat
09/27
Sun
09/28
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: ARREDONDO, ADRIAN
Address 7905 Jackstraw Street , Bakersfield, CA, 93307 SSN 3146 Check # 22037503 Fringe Paid Directly to Worker
Hours Worked
Craft/Classification/Level LABORER AND RELATED CLASSIFICATIONS : OTHER (PLEASE SPECIFY) -
Laborer Group 1 - JOURNEYMAN
Type Mon
09/22
Tue
09/23
Wed
09/24
Thu
09/25
Fri
09/26
Sat
09/27
Sun
09/28
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 10/03/2025, 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 09/22/2025 to 09/28/2025
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 2025/10/03 Page - 2