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2025-01 - Vallco MRU Preston Pipe Jan LaborNO WORK PERFORMED REPORT Vallco-Continuation of Make Ready Utilities (DC08272024) CA PAYROLL NO. 23 Preston Pipelines Infrastructure LLC 133 Bothelo Avenue , MILPITAS, CA, 95035 Phone 408-262-1418 Fax Date 1/8/2025 Name of the Contractor/Subcontractor: Preston Pipelines Infrastructure LLC I,Jocelyn Cortes do hereby state that no persons were employed on the construction (Name - print) of the Project Vallco-Continuation of Make Ready Utilities ,DC08272024 (Project Name)(Contract Number) during the payroll period commencing on 12/30/2024 and ending on the 1/5/2025 NAME AND TITLE SIGNATURE Jocelyn Cortes, Payroll Administrator 01/08/2025 15:52:52 Printed Date: 2/25/2025 Page 1 of 1 PAYROLL REPORTING FORM Page 1 of 1 NAME OF CONTRACTOR OR SUBCONTRACTOR Preston Pipelines Infrastructure LLC CONTRACTOR'S LICENSE NO: 1059395 SPECIALITY LICENSE NO: ADDRESS 133 Bothelo Avenue , MILPITAS, CA 95035 PAYROLL NO. 26 FOR WEEK ENDING 01/26/2025 SELF-INSURED CERTIFICATE NO: WORKER'S COMPENSATION POLICY NO: UB1L0302221825D PROJECT OR CONTRACT NO: DC08272024 PROJECT AND LOCATION: Vallco-Continuation of Make Ready Utilities / CA (1) NAME, ADDRESS, AND SOCIAL SECURITY NUMBER OF WORKER (2) NO O F W I T H - HO L D I N G EX E M P T I O N S (3) WORK CLASSIFICATION ST / O T / D T / H T (4) DAY AND DATE (5) TOTAL HOURS (6) RATE OF PAY CASH FRINGE (7) GROSS AMOUNT EARNED (THIS / ALL) (8) DEDUCTIONS, CONTRIBUTIONS AND PAYMENTS (9) NET WAGES PAID FOR WEEK (10) Check No. /DateMonTueWedThuFriSatSun 20 21 22 23 24 25 26 HOURS WORKED EACH DAY Beau A Reynolds 36212 S. CHRISMAN RD. TRACY, CA 95377 xxx-xx-8964 M/3 CA 2024-1 Journeyman Santa Clara Operating Engineer (Heavy And Highway Work) Group 4 (Area 1) S 1.00 1.00 74.62 74.62 3,227.20 FICA FED TAX STATE TAX / LT SDI VAC HOLIDAY HEALTH & WELF PENSION 2,159.14 DD215914 01/31/2025O 246.88 387.45 152.60 38.73 6.06 6.06 10.84 10.84 11.28 11.28 TRAING OTHER REIMB.DUES TRAV SUBS OTHER FRINGE OTHER DEDS TOTAL DEDUCTS D 1.21 1.21 4.11 4.11 242.40 1,068.06 S FICA FED TAX STATE TAX / LT SDI VAC HOLIDAY HEALTH & WELF PENSION O TRAING OTHER REIMB.DUES TRAV SUBS OTHER FRINGE OTHER DEDS TOTAL DEDUCTS D S FICA FED TAX STATE TAX / LT SDI VAC HOLIDAY HEALTH & WELF PENSION O TRAING OTHER REIMB.DUES TRAV SUBS OTHER FRINGE OTHER DEDS TOTAL DEDUCTS D S FICA FED TAX STATE TAX / LT SDI VAC HOLIDAY HEALTH & WELF PENSION O TRAING OTHER REIMB.DUES TRAV SUBS OTHER FRINGE OTHER DEDS TOTAL DEDUCTS D S = STRAIGHT TIME O = OVERTIME D = DOUBLETIME SDI = STATE DISABILITY INSURANCE OTHER-Any other deductions and/or payments whether or not included orrequired by prevailing wage determinations must be separately listed.Use extra sheet(s) if necessary CERTIFICATION MUST be completed (See Statement of Compliance) Printed Date: 2/25/2025 Page 1 of 2 STATE OF CALIFORNIA STATEMENT OF COMPLIANCE Date: 1/31/2025 Jocelyn Cortes Payroll Administrator do hereby certify under penalty of perjury: (Name of Signatory Party)(Title) (1) That I pay or supervise the payment of the persons reported on the Certified Payroll Report by Preston Pipelines Infrastructure LLC on the Vallco-Continuation of Make Ready Utilities (Contract/Subcontract: DC08272024) : that during the payroll period (Contractor or Subcontractor) (Building or Work) commencing on the 20th day of January 2025 , and ending the 26th day of January 2025 , all persons employed on said project have been paid and full weekly wages earned,that no rebates have been or will be made either directly or indirectly to or on behalf of said Preston Pipelines Infrastructure LLC from the full weekly sums earned by any person (Contractor or Subcontractor) and that no deductions have been made either directly or indirectly from the full sums earned by any person, other than permissible deductions, as described below: (2) That any payrolls otherwise under this contract required to be submitted for the above period are correct and complete; that the wage rates for laborers or mechanics contained therein are not less than the applicable wage rates contained in any wage determination Incorporated into the contract; that the classifications set forth therein for each laborer or mechanic conform with the work he performed. (3) That any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with a State apprenticeship agency recognized by the Bureau of Apprenticeship and Training, United States Department of Labor, or if no such recognized agency exists in a State, are registered with the the Bureau of Apprentice and Training, United States Department of Labor. (4) That: (a) WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, FUNDS, OR PROGRAMS In addition to the basic hourly wage rates paid to each laborer or mechanic listed in the above referenced payroll, payments of fringe benefits as listed in the contract have been or will be made to appropriate programs for the benefit of such employees, except as noted in Section 4(c) below., (b) WHERE FRINGE BENEFITS ARE PAID IN CASH Each laborer or mechanic listed in the above referenced payroll has been paid, as indicated on the payroll, an amount not less than the sum of the applicable basic hourly wage rate plus the amount of the required fringe benefits as listed in the contract, except as noted in Section 4(c) below. (c) EXCEPTIONS Exception (craft)EXPLANATION REMARKS: NAME AND TITLE SIGNATURE Jocelyn Cortes Payroll Administrator 01/31/2025 15:37:25 THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEMENTS MAY SUBJECT THE CONTRACTOR OR SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION. SEE SECTION 1001 OF TITLE 18 AND SECTION 3729 OF TITLE 31 OF THE UNITED STATES CODE Signed under penalty of perjury Printed Date: 2/25/2025 Page 2 of 2 NO WORK PERFORMED REPORT Vallco-Continuation of Make Ready Utilities (DC08272024) CA PAYROLL NO. 24 Preston Pipelines Infrastructure LLC 133 Bothelo Avenue , MILPITAS, CA, 95035 Phone 408-262-1418 Fax Date 1/29/2025 Name of the Contractor/Subcontractor: Preston Pipelines Infrastructure LLC I,Jocelyn Cortes do hereby state that no persons were employed on the construction (Name - print) of the Project Vallco-Continuation of Make Ready Utilities ,DC08272024 (Project Name)(Contract Number) during the payroll period commencing on 1/6/2025 and ending on the 1/12/2025 NAME AND TITLE SIGNATURE Jocelyn Cortes, Payroll Administrator 01/29/2025 13:44:57 Printed Date: 2/25/2025 Page 1 of 1 PAYROLL REPORTING FORM Page 1 of 1 NAME OF CONTRACTOR OR SUBCONTRACTOR Preston Pipelines Infrastructure LLC CONTRACTOR'S LICENSE NO: 1059395 SPECIALITY LICENSE NO: ADDRESS 133 Bothelo Avenue , MILPITAS, CA 95035 PAYROLL NO. 25 FOR WEEK ENDING 01/19/2025 SELF-INSURED CERTIFICATE NO: WORKER'S COMPENSATION POLICY NO: UB1L0302221825D PROJECT OR CONTRACT NO: DC08272024 PROJECT AND LOCATION: Vallco-Continuation of Make Ready Utilities / CA (1) NAME, ADDRESS, AND SOCIAL SECURITY NUMBER OF WORKER (2) NO O F W I T H - HO L D I N G EX E M P T I O N S (3) WORK CLASSIFICATION ST / O T / D T / H T (4) DAY AND DATE (5) TOTAL HOURS (6) RATE OF PAY CASH FRINGE (7) GROSS AMOUNT EARNED (THIS / ALL) (8) DEDUCTIONS, CONTRIBUTIONS AND PAYMENTS (9) NET WAGES PAID FOR WEEK (10) Check No. /DateMonTueWedThuFriSatSun 13 14 15 16 17 18 19 HOURS WORKED EACH DAY Tony R Teman 105 RANCHO CORRALITOS WATSONVILLE, CA 95076 xxx-xx-7742 M/3 CA 2024-1 Journeyman Santa Clara Operating Engineer (Heavy And Highway Work) Group 4 (Area 1) S 2.00 2.00 101.47 202.94 4,301.20 FICA FED TAX STATE TAX / LT SDI VAC HOLIDAY HEALTH & WELF PENSION 2,791.96 DD279196 01/24/2025O 329.03 623.73 262.47 51.61 6.06 12.12 10.84 21.68 11.28 22.56 TRAING OTHER REIMB.DUES TRAV SUBS OTHER FRINGE OTHER DEDS TOTAL DEDUCTS D 1.21 2.42 4.11 8.22 242.40 1,509.24 S FICA FED TAX STATE TAX / LT SDI VAC HOLIDAY HEALTH & WELF PENSION O TRAING OTHER REIMB.DUES TRAV SUBS OTHER FRINGE OTHER DEDS TOTAL DEDUCTS D S FICA FED TAX STATE TAX / LT SDI VAC HOLIDAY HEALTH & WELF PENSION O TRAING OTHER REIMB.DUES TRAV SUBS OTHER FRINGE OTHER DEDS TOTAL DEDUCTS D S FICA FED TAX STATE TAX / LT SDI VAC HOLIDAY HEALTH & WELF PENSION O TRAING OTHER REIMB.DUES TRAV SUBS OTHER FRINGE OTHER DEDS TOTAL DEDUCTS D S = STRAIGHT TIME O = OVERTIME D = DOUBLETIME SDI = STATE DISABILITY INSURANCE OTHER-Any other deductions and/or payments whether or not included orrequired by prevailing wage determinations must be separately listed.Use extra sheet(s) if necessary CERTIFICATION MUST be completed (See Statement of Compliance) Printed Date: 2/25/2025 Page 1 of 2 STATE OF CALIFORNIA STATEMENT OF COMPLIANCE Date: 1/29/2025 Jocelyn Cortes Payroll Administrator do hereby certify under penalty of perjury: (Name of Signatory Party)(Title) (1) That I pay or supervise the payment of the persons reported on the Certified Payroll Report by Preston Pipelines Infrastructure LLC on the Vallco-Continuation of Make Ready Utilities (Contract/Subcontract: DC08272024) : that during the payroll period (Contractor or Subcontractor) (Building or Work) commencing on the 13th day of January 2025 , and ending the 19th day of January 2025 , all persons employed on said project have been paid and full weekly wages earned,that no rebates have been or will be made either directly or indirectly to or on behalf of said Preston Pipelines Infrastructure LLC from the full weekly sums earned by any person (Contractor or Subcontractor) and that no deductions have been made either directly or indirectly from the full sums earned by any person, other than permissible deductions, as described below: (2) That any payrolls otherwise under this contract required to be submitted for the above period are correct and complete; that the wage rates for laborers or mechanics contained therein are not less than the applicable wage rates contained in any wage determination Incorporated into the contract; that the classifications set forth therein for each laborer or mechanic conform with the work he performed. (3) That any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with a State apprenticeship agency recognized by the Bureau of Apprenticeship and Training, United States Department of Labor, or if no such recognized agency exists in a State, are registered with the the Bureau of Apprentice and Training, United States Department of Labor. (4) That: (a) WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, FUNDS, OR PROGRAMS In addition to the basic hourly wage rates paid to each laborer or mechanic listed in the above referenced payroll, payments of fringe benefits as listed in the contract have been or will be made to appropriate programs for the benefit of such employees, except as noted in Section 4(c) below., (b) WHERE FRINGE BENEFITS ARE PAID IN CASH Each laborer or mechanic listed in the above referenced payroll has been paid, as indicated on the payroll, an amount not less than the sum of the applicable basic hourly wage rate plus the amount of the required fringe benefits as listed in the contract, except as noted in Section 4(c) below. (c) EXCEPTIONS Exception (craft)EXPLANATION REMARKS: NAME AND TITLE SIGNATURE Jocelyn Cortes Payroll Administrator 01/29/2025 13:48:25 THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEMENTS MAY SUBJECT THE CONTRACTOR OR SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION. SEE SECTION 1001 OF TITLE 18 AND SECTION 3729 OF TITLE 31 OF THE UNITED STATES CODE Signed under penalty of perjury Printed Date: 2/25/2025 Page 2 of 2