HomeMy WebLinkAboutVinciguerra Black Bart CPR 1 thru 4_Redacted California 2023 Black Bart Waterline Replacxment Prot 1 BIWA 20-30.8098
dZI Department of
IrWtistrialRelations PUBLIC WORKS PAYROLL REPORTING FORM page 1of2
NAME OF CONTRACTOR:Vlnciguerra Constructlon,lac. CONTRACTORLS LICFNSE NO--358838 ADDRESS.-P.0,Box 157,Sutter Creek,CA,99685
[OR SUBCONTRACTOR: SPECIALTY LICENSE NO.:
PAYROLL NO FOR YYEE-K ENDING: SELF-INSURED CERT- PROJECT DR CONTRACT NO-:Blk8rt 20.310.8US8
j 1 51i3J2023 WORKERS!COUP: PROJECT AND LOCATION:2023 Black Bart Waterline Replacement Project,ELD
(1) (2} 1 (3) (4)DAY (51 (6) (7) {8] (g]
5 >`A T I W I T F S NET
HAME,ADDRESS ntMOURL WAGES
AND SOCIAL I CASE 001® Y RATE DEDUCTIONS.CONTRIBUTIONS ANI7 PAYMENTS PAID
TOTAL GROSS AMOUNT CHECK
$ECIJRftY NUI.IBEft $x j IFiGATidN 5107 5108 5109 5J10 5111 512 5113 Hours OF PAY QED FOR HO-
OF EMPLOYEE �,� ( WEEK
Hours Worked Each Day
THIS ALL Federal FICA& State Vacation HeaI1h 6
S 0.00 0.00 0.00 0.00 5.00 8.00 0.00 13,00 $d8.50 PROJECT PROJECTS Tax Medicare Tax 5DI Homay Welfare Pension
GRIEGO,DAVIO PLUMBER/ S342.00 $169.77 $148-11 $18.98 $0.00 30.00 $D.00
1730 Rock Sprcg° 1 UNDERGROk]
Road Escondido CA 0 I ND LPTILITY D 0.00 0-00 0.00 4.00 2.00 0.00 0.00 2,00 5fi3.45 Admin 1 Travel 8 Total 51.619.32 D!D
42026 PPEF!TTER S75BA0 92.237,08 Training Fringes Dues Sub Sawpas Other Deduct
(
D 0.00 0.00 0.00 0.00 0-00 D.pO 0.4b 0.00 $0.00
86.00 $0.00 S0-00 $80,00 S4.00 $77.94 ;&97.75
k
Other Deduction Nobes:Training tee
THIS ALL Federal FICA& state Vacation Health 3
5 0.00 0.00 0.00 0.00 8.00 6.00 0:0v 1C00 S48.50 PROJECT PROJECTS Tax Medicare Tax SDl HoMay Welfare Pension
SASW MORGAN ( PLUMBER! $40D,00 $191.32 $176,92 $22.51 $0.00 $0.00 SO=
1413 Rancho way E UNDERGROiJ
South Lake Tahoe 0 O 0.00 0.00 0-04 0.00 1-50 9.D0 0.00 1.50 S63-95 520 93 $2 5774 ^s7.T$1.04 CUD
NO UTILITY Adn! Travel& savings Other Total
I PIPEFITTER . . .3! Trairdng mi
Fringes Sub Deduct.
0 0.00 0.00 D 0.00 om 0.00 0.00 0.00 $0-00
� 0.0 $6.20 $0.04 Sv.08 $8U-90 $0.00 $1s.55 $813.30
Other Deductkn Notes:TrainirQ lee
S=STRAIGHT TWIE 'OTHER-Arty+obrerdediebom,DwAr budorrs wwYor paynw Is whe9w er not ixJLdsd ix requkW by rxeva&V wade d8*m'mrl9bDm must oe sBparaleN Gsied. CERTIFICATION M[15T be Dompleled
0:OVERTNK Use extra eheegs]it necessary. (See to-erne sided
Form A-1-131(New 2-�0) p=o0USLETME
SDI=STATE DiSABJUTY d SURANCE