HomeMy WebLinkAbout251027-25022-FBS-Lake Elsinore from 10.06.25-10.19.25 (week 18-19) Fringe Benefit Statement/Statement of Employer Payment
CDBG/SB 821 Lakeshore Drive ADA Sidewalk Improvement
County/location Riverside/City of Lake Elsinore
CONTRACT# CONTRACTOR'S LICENSE#: TODAY'S DATE:
20250580287 896772 10/27/2025
City of Lake Elsinore
IN ORDER THAT THE PROPER FRINGE BENEFIT RATES CAN BE USED FOR CHECKING PAYROLLS OR APPLIED TO FORCE ACCOUNT WORK WHICH MAY BE
DONE ON THE ABOVE CONTRACT,THE HOURLY RATES FOR FRINGE BENEFITS,SUBSISTENCE AND/OR TRAVEL ALLOWANCE PAYMENT(AS REQUIRED BY
COLLECTIVE BARGAINING AGREEMENTS)MADE FOR EMPLOYEES ON THE VARIOUS CLASSES OF WORK ARE TABULATED BELOW
Jose Dejesus Lopez Reynoso
CLASSIFICATION: Operating Engineer Group 3 EFFECTIVE SUBSISTENCE OR TRAVEL
DATE: 7/1/2025 PAY: NONE
CASH ON FRINGE $ 30.97 PAID TO: Paid to Employee on Hourly Rate
TRAINING $ 1.10 PAID TO: California Apprenticeship Council; P.O. Box 511283, Los Angeles,CA 90051-7838
MEDICAL&
ANCILLARIES $ 2.26 PAID TO: California Choice&Choice Builder:721 South Parker,Suite 200, Orange,CA 92868
CONTRIBUTIONS Weekly X Monthly Quarterly Annually
PRIME: PENSION: SIGNATURE/TITLE;
NAME OF Leonida
CONTRACTOR: Builders, Inc.
Fringe Benefit Statement/Statement of Employer Payment
CDBG/SB 821 Lakeshore Drive ADA Sidewalk Improvement
County/location Riverside/City of Lake Elsinore
CONTRACT# CONTRACTOR'S LICENSE#: TODAY'S DATE:
20250580287 896772 10/27/2025
City of Lake Elsinore
IN ORDER THAT THE PROPER FRINGE BENEFIT RATES CAN BE USED FOR CHECKING PAYROLLS OR APPLIED TO FORCE ACCOUNT WORK WHICH MAY BE
DONE ON THE ABOVE CONTRACT,THE HOURLY RATES FOR FRINGE BENEFITS,SUBSISTENCE AND/OR TRAVEL ALLOWANCE PAYMENT(AS REQUIRED BY
COLLECTIVE BARGAINING AGREEMENTS)MADE FOR EMPLOYEES ON THE VARIOUS CLASSES OF WORK ARE TABULATED BELOW
Modesto Salazar
CLASSIFICATION Laborer Group 1 EFFECTIVE SUBSISTENCE OR TRAVEL
DATE: 7/1/2025 PAY: NONE
CASH ON FRINGE $ 27.81 PAID TO: Paid to Employee on Hourly Rate.
TRAINING $ 0.80 PAID TO California Apprenticeship Council; P O. Box 511283, Los Angeles, CA 90051-7838
MEDICAL&
ANCILLARIES $ - PAID TO: California Choice&Choice Builder:721 South Parker,Suite 200, Orange, CA 92868
CONTRIBUTIONS Weekly X Monthly Quarterly Annually
PRIME PENSION. SIGNATURE/TITLE:
NAME OF Leonida
CONTRACTOR: Builders, Inc.
Fringe Benefit Statement/Statement of Employer Payment
CDBG/SB 821 Lakeshore Drive ADA Sidewalk Improvement
County/location I Riverside/City of Lake Elsinore
CONTRACT# CONTRACTOR'S LICENSE# TODAY'S DATE:
20250580287 896772 10/27/2025
City of Lake Elsinore
IN ORDER THAT THE PROPER FRINGE BENEFIT RATES CAN BE USED FOR CHECKING PAYROLLS OR APPLIED TO FORCE ACCOUNT WORK WHICH MAY BE
DONE ON THE ABOVE CONTRACT,THE HOURLY RATES FOR FRINGE BENEFITS,SUBSISTENCE AND/OR TRAVEL ALLOWANCE PAYMENT(AS REQUIRED BY
COLLECTIVE BARGAINING AGREEMENTS)MADE FOR EMPLOYEES ON THE VARIOUS CLASSES OF WORK ARE TABULATED BELOW
Hector Padilla
CLASSIFICATION: Cement Mason EFFECTIVE SUBSISTENCE OR TRAVEL
DATE: 7/1/2025 PAY: [NONE
CASH ON FRINGE $ 27.38 PAID TO: Paid to Employee on Hourly Rate.
TRAINING $ 0.64 PAID TO: California Apprenticeship Council; P.O. Box 511283, Los Angeles,CA 90051-7838
MEDICAL&
ANCILLARIES $ - PAID TO: California Choice&Choice Builder: 721 South Parker, Suite 200,Orange, CA 92868
CLASSIFICATION: Laborer Group 1 EFFECTIVE SUBSISTENCE OR TRAVEL
DATE: 7/1/2025 PAY: [NONE
CASH ON FRINGE $ 27.810 PAID TO: Paid to Employee on Hourly Rate.
TRAINING $ 0.800 PAID TO: California Apprenticeship Council; P O Box 511283, Los Angeles,CA 90051-7838
MEDICAL&
ANCILLARIES $ - PAID TO California Choice&Choice Builder: 721 South Parker, Suite 200,Orange, CA 92868
CONTRIBUTIONS Weekly X Monthly Quarterly FAnnually
PRIME PENSION SIGNATURE/TITLE,
NAME OF Leonida
CONTRACTOR: Builders, Inc