2025-03 - Phase Ia Preston LaborPAYROLL REPORTING FORM Page 1 of 7
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.
6
FOR WEEK ENDING
03/02/2025
SELF-INSURED CERTIFICATE NO:
WORKER'S COMPENSATION POLICY NO: UB1L0302221825D
PROJECT OR CONTRACT NO: 20240543108
PROJECT AND LOCATION: The Rise at Vallco Horizontal Ph1A / 10123 N Wolfe
Rd, Cupertino, 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
24 25 26 27 28 01 02
HOURS WORKED EACH DAY
Carlos B Aguilar
27829 Norwich Way
HAYWARD, CA 94545
xxx-xx-2513
S/0
CA 2024-1
Journeyman
Santa Clara
Laborer And Related
Classifications
Group 3; Group 3 (A)
(Area 1)
S 8.00 8.00 8.00 24.00 37.50 1,265.63
2,142.88
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
1,304.13 DD130413
03/07/2025O2.00 2.50 2.00 6.50 56.25
163.92 347.20 135.18 25.71 3.51 107.06 10.60 323.30 10.46 319.03
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 0.52 15.86 4.82 147.01 166.74 838.75
Carlos B Aguilar
27829 Norwich Way
HAYWARD, CA 94545
xxx-xx-2513
S/0
CA 2024-1
Journeyman
Santa Clara
Laborer And Related
Classifications
Group 3; Group 3 (A)
(Area 1)
S 8.00 8.00 16.00 40.50 708.75
2,142.88
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
1,304.13 DD130413
03/07/2025O0.50 0.50 1.00 60.75
163.92 347.20 135.18 25.71 3.51 59.67 10.60 180.20 10.46 177.82
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 0.52 8.84 4.82 81.94 166.74 838.75
Ivan Arias
40640 HIGH STREET
FREMONT, CA 94538
xxx-xx-0614
M/0
CA 2024-1
Journeyman
Santa Clara
Operating Engineer
(Heavy And Highway
Work)
Group 4 (Area 1)
S 268.92
3,302.70
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
2,044.25 DD204425
03/07/2025O2.00 1.00 3.00 89.64
252.66 422.25 160.33 39.63 6.06 18.18 10.84 32.52 11.28 33.84
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 1.21 3.63 4.11 12.33 383.58 1,258.45
Enrique H Ayala
517 Ward Rd
LOS BANOS, CA 93635
xxx-xx-8916
S/0
CA 2024-1
Journeyman
Santa Clara
Operating Engineer
(Heavy And Highway
Work)
Group 5 (Area 1)
S 4.00 1.00 5.00 58.49 380.19
2,863.39
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
1,470.40 DD147040
03/07/2025O1.00 1.00 87.74
219.05 520.12 208.88 34.36 6.06 36.36 10.84 65.04 11.28 67.68
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 1.21 7.26 4.11 24.66 410.58 1,392.99
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: 4/13/2025 Page 1 of 8
PAYROLL REPORTING FORM Page 2 of 7
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.
6
FOR WEEK ENDING
03/02/2025
SELF-INSURED CERTIFICATE NO:
WORKER'S COMPENSATION POLICY NO: UB1L0302221825D
PROJECT OR CONTRACT NO: 20240543108
PROJECT AND LOCATION: The Rise at Vallco Horizontal Ph1A / 10123 N Wolfe
Rd, Cupertino, 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
24 25 26 27 28 01 02
HOURS WORKED EACH DAY
Faustino Buenrostro
1588 FLANNIGAN DR.
SAN JOSE, CA 95121
xxx-xx-1429
M/0
CA 2024-1
Journeyman
Santa Clara
Laborer And Related
Classifications
Group 1; Group 1(B)
(Area 1)
S 8.00 8.00 8.00 24.00 58.18 2,007.21
3,246.38
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
2,169.41 DD216941
03/07/2025O2.00 2.50 2.50 7.00 87.27
248.35 446.24 174.92 38.96 3.51 108.81 10.60 328.60 10.46 324.26
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 0.52 16.12 4.82 149.42 168.50 1,076.97
Faustino Buenrostro
1588 FLANNIGAN DR.
SAN JOSE, CA 95121
xxx-xx-1429
M/0
CA 2024-1
Journeyman
Santa Clara
Laborer And Related
Classifications
Group 1; Group 1(B)
(Area 1)
S 8.00 8.00 16.00 61.18 1,070.65
3,246.38
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
2,169.41 DD216941
03/07/2025O0.50 0.50 1.00 91.77
248.35 446.24 174.92 38.96 3.51 59.67 10.60 180.20 10.46 177.82
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 0.52 8.84 4.82 81.94 168.50 1,076.97
Thomas Bunker
7310 N CHANNING WAY
FRESNO, CA 93711
xxx-xx-9777
S/1
CA 2024-1
Journeyman
Santa Clara
Operating Engineer
(Heavy And Highway
Work)
Group 4 (Area 1)
S 92.64
2,774.56
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
1,611.03 DD161103
03/07/2025O1.00 1.00 92.64
212.25 478.95 196.64 33.29 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 1,163.53
Javier Carrillo
177 N. 17TH ST
SAN JOSE, CA 95112
xxx-xx-6836
S/5
CA 2024-1
Journeyman
Santa Clara
Operating Engineer
(Heavy And Highway
Work)
Group 7 (Area 1)
S 2.00 2.00 61.14 122.28
2,688.00
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
1,538.75 DD153875
03/07/2025O
205.63 478.02 190.94 32.26 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 1,149.25
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: 4/13/2025 Page 2 of 8
PAYROLL REPORTING FORM Page 3 of 7
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.
6
FOR WEEK ENDING
03/02/2025
SELF-INSURED CERTIFICATE NO:
WORKER'S COMPENSATION POLICY NO: UB1L0302221825D
PROJECT OR CONTRACT NO: 20240543108
PROJECT AND LOCATION: The Rise at Vallco Horizontal Ph1A / 10123 N Wolfe
Rd, Cupertino, 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
24 25 26 27 28 01 02
HOURS WORKED EACH DAY
Michael J Davis
1220 SUNSET DR.
HOLLISTER, CA 95023
xxx-xx-6205
M/2
CA 2024-1
Journeyman
Santa Clara
Operating Engineer
(Heavy And Highway
Work)
Group 7 (Area 1)
S 4.00 4.00 56.03 224.12
3,339.60
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
2,146.45 DD214645
03/07/2025O
255.48 430.37 167.25 40.08 6.06 24.24 10.84 43.36 11.28 45.12
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 1.21 4.84 4.11 16.44 299.97 1,193.15
Aurelio Garcia
1933 EVERGLADE AVE
SAN JOSE, CA 95122
xxx-xx-8808
S/1
CA 2024-1
Journeyman
Santa Clara
Laborer And Related
Classifications
Group 3; Group 3 (A)
(Area 1)
S 8.00 8.00 38.50 510.13
1,894.82
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
1,574.43 DD157443
03/07/2025O3.50 3.50 57.75
144.96 22.74 3.51 40.37 10.60 121.90 10.46 120.29
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 0.52 5.98 4.82 55.43 152.69 320.39
Isidoro Garcia-valencia
447 EGRET RD
LIVERMORE, CA 94551
xxx-xx-5473
M/4
CA 2024-1
Journeyman
Santa Clara
Laborer And Related
Classifications
Group 3; Group 3 (A)
(Area 1)
S 6.00 6.00 44.70 268.20
456.24
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
384.27 DD38427
03/07/2025O
34.91 5.47 3.51 21.06 10.60 63.60 10.46 62.76
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 0.52 3.12 4.82 28.92 31.59 71.97
Cristian H Gonzalez
800 HILLSDALE AVENUE
#434
SAN JOSE, CA 95136
xxx-xx-5464
M/3
CA 2024-1
Apprentice
Santa Clara
Laborer And Related
Classifications
Laborer
Period 2
S 8.00 8.00 16.00 26.25 439.69
1,007.37
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
757.62 DD75762
03/07/2025O0.50 0.50 39.38
77.07 43.04 3.47 12.09 3.51 57.92 10.60 174.90 10.46 172.59
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 0.52 8.58 4.82 79.53 114.08 249.75
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: 4/13/2025 Page 3 of 8
PAYROLL REPORTING FORM Page 4 of 7
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.
6
FOR WEEK ENDING
03/02/2025
SELF-INSURED CERTIFICATE NO:
WORKER'S COMPENSATION POLICY NO: UB1L0302221825D
PROJECT OR CONTRACT NO: 20240543108
PROJECT AND LOCATION: The Rise at Vallco Horizontal Ph1A / 10123 N Wolfe
Rd, Cupertino, 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
24 25 26 27 28 01 02
HOURS WORKED EACH DAY
Cristian H Gonzalez
800 HILLSDALE AVENUE
#434
SAN JOSE, CA 95136
xxx-xx-5464
M/3
CA 2024-1
Apprentice
Santa Clara
Laborer And Related
Classifications
Laborer
Period 2
S 8.00 8.00 16.00 28.35 453.60
1,007.37
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
757.62 DD75762
03/07/2025O
77.07 43.04 3.47 12.09 3.51 56.16 10.60 169.60 10.46 167.36
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 0.52 8.32 4.82 77.12 114.08 249.75
Jason Hayes
18393 ALCALA CT.
MORGAN HILL, CA 95037
xxx-xx-8561
S/0
CA 2024-1
Journeyman
Santa Clara
Operating Engineer
(Heavy And Highway
Work)
Group 3 (Area 1)
S 2.00 2.00 75.21 150.42
3,250.80
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
1,859.08 DD185908
03/07/2025O
248.69 613.10 248.52 39.01 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 1,391.72
Wilfredo J Hernandez
Calixto
3243 E. 23RD ST. APT.#3
OAKLAND, CA 94601
xxx-xx-4286
M/4
CA 2024-1
Journeyman
Santa Clara
Laborer And Related
Classifications
Group 3; Group 3 (A)
(Area 1)
S 8.00 8.00 8.00 24.00 43.50 1,837.88
3,059.20
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
2,591.89 DD259189
03/07/2025O4.00 4.00 3.50 11.50 65.25
234.03 36.71 3.51 126.36 10.60 381.60 10.46 376.56
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 0.50 0.50 87.00 0.52 18.72 4.82 173.52 196.57 467.31
Wilfredo J Hernandez
Calixto
3243 E. 23RD ST. APT.#3
OAKLAND, CA 94601
xxx-xx-4286
M/4
CA 2024-1
Journeyman
Santa Clara
Laborer And Related
Classifications
Group 3; Group 3 (A)
(Area 1)
S 8.00 8.00 16.00 46.50 1,023.00
3,059.20
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
2,591.89 DD259189
03/07/2025O2.00 2.00 4.00 69.75
234.03 36.71 3.51 70.20 10.60 212.00 10.46 209.20
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 0.52 10.40 4.82 96.40 196.57 467.31
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: 4/13/2025 Page 4 of 8
PAYROLL REPORTING FORM Page 5 of 7
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.
6
FOR WEEK ENDING
03/02/2025
SELF-INSURED CERTIFICATE NO:
WORKER'S COMPENSATION POLICY NO: UB1L0302221825D
PROJECT OR CONTRACT NO: 20240543108
PROJECT AND LOCATION: The Rise at Vallco Horizontal Ph1A / 10123 N Wolfe
Rd, Cupertino, 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
24 25 26 27 28 01 02
HOURS WORKED EACH DAY
Luis Lopez
1800 STOKES ST APT
#137
SAN JOSE, CA 95126
xxx-xx-8732
CA 2024-1
Journeyman
Santa Clara
Laborer And Related
Classifications
Group 3; Group 3 (A)
(Area 1)
S 8.00 8.00 8.00 24.00 37.50 1,209.38
2,017.09
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
1,461.49 DD146149
03/07/2025O2.00 2.50 1.00 5.50 56.25
154.31 162.74 54.63 24.21 3.51 103.55 10.60 312.70 10.46 308.57
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 0.52 15.34 4.82 142.19 159.71 555.60
Luis Lopez
1800 STOKES ST APT
#137
SAN JOSE, CA 95126
xxx-xx-8732
CA 2024-1
Journeyman
Santa Clara
Laborer And Related
Classifications
Group 3; Group 3 (A)
(Area 1)
S 8.00 8.00 16.00 40.50 648.00
2,017.09
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
1,461.49 DD146149
03/07/2025O
154.31 162.74 54.63 24.21 3.51 56.16 10.60 169.60 10.46 167.36
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 0.52 8.32 4.82 77.12 159.71 555.60
Librado G Martinez
800 RICHMOND AVE
SAN JOSE, CA 95128
xxx-xx-2172
M/0
CA 2024-1
Journeyman
Santa Clara
Laborer And Related
Classifications
Group 3; Group 3 (A)
(Area 1)
S 8.00 8.00 8.00 24.00 37.50 1,209.38
1,641.01
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
1,174.47 DD117447
03/07/2025O2.00 2.50 1.00 5.50 56.25
125.54 148.29 41.39 19.69 3.51 103.55 10.60 312.70 10.46 308.57
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 0.52 15.34 4.82 142.19 131.63 466.54
Israel G Ramos
385 PACHECO DR
TRACY, CA 95376
xxx-xx-0760
M/0
CA 2024-1
Journeyman
Santa Clara
Operating Engineer
(Heavy And Highway
Work)
Group 5 (Area 1)
S 8.00 8.00 8.00 24.00 58.49 1,842.49
2,536.33
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
1,694.39 DD169439
03/07/2025O2.00 2.50 0.50 5.00 87.75
194.03 290.03 103.22 30.44 6.06 175.74 10.84 314.36 11.28 327.12
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 1.21 35.09 4.11 119.19 224.22 841.94
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: 4/13/2025 Page 5 of 8
PAYROLL REPORTING FORM Page 6 of 7
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.
6
FOR WEEK ENDING
03/02/2025
SELF-INSURED CERTIFICATE NO:
WORKER'S COMPENSATION POLICY NO: UB1L0302221825D
PROJECT OR CONTRACT NO: 20240543108
PROJECT AND LOCATION: The Rise at Vallco Horizontal Ph1A / 10123 N Wolfe
Rd, Cupertino, 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
24 25 26 27 28 01 02
HOURS WORKED EACH DAY
Michael Roberts
601 SPRING ST
FELTON, CA 95018
xxx-xx-0619
S/0
CA 2024-1
Journeyman
Santa Clara
Operating Engineer
(Heavy And Highway
Work)
Group 4 (Area 1)
S 4.00 4.00 62.62 250.48
3,097.17
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
1,750.43 DD175043
03/07/2025O
236.94 576.22 232.80 37.17 6.06 24.24 10.84 43.36 11.28 45.12
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 1.21 4.84 4.11 16.44 263.61 1,346.74
Orlando H Rodriguez
3200 APTOS RANCHO RD
# 434
APTOS, CA 95003
xxx-xx-3644
S/2
CA 2024-1
Journeyman
Santa Clara
Operating Engineer
(Heavy And Highway
Work)
Group 4 (Area 1)
S 1.00 0.50 1.50 60.76 91.14
2,964.40
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
1,723.89 DD172389
03/07/2025O
226.78 504.67 212.91 35.57 6.06 9.09 10.84 16.26 11.28 16.92
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 1.21 1.82 4.11 6.17 260.58 1,240.51
Juan C Rodriguez Mejia
2417 S. MOUNTAINSIDE
DR.
LOS BANOS, CA 93635
xxx-xx-8587
M/2
CA 2024-1
Journeyman
Santa Clara
Laborer And Related
Classifications
Group 3; Group 3 (A)
(Area 1)
S 2.50 2.50 40.50 101.25
3,118.37
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
2,071.38 DD207138
03/07/2025O
238.56 399.89 158.67 37.42 3.51 8.78 10.60 26.50 10.46 26.15
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 0.52 1.30 4.82 12.05 212.45 1,046.99
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 1.00 1.00 1.00 5.00 101.47 507.35
3,934.68
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
2,575.99 DD257599
03/07/2025O
301.00 543.09 224.98 47.22 6.06 30.30 10.84 54.20 11.28 56.40
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 1.21 6.05 4.11 20.55 242.40 1,358.69
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: 4/13/2025 Page 6 of 8
PAYROLL REPORTING FORM Page 7 of 7
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.
6
FOR WEEK ENDING
03/02/2025
SELF-INSURED CERTIFICATE NO:
WORKER'S COMPENSATION POLICY NO: UB1L0302221825D
PROJECT OR CONTRACT NO: 20240543108
PROJECT AND LOCATION: The Rise at Vallco Horizontal Ph1A / 10123 N Wolfe
Rd, Cupertino, 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
24 25 26 27 28 01 02
HOURS WORKED EACH DAY
Ernest Whisenant
416 LINCOLN ST
SANTA CRUZ, CA 95060
xxx-xx-4808
S/0
CA 2024-1
Journeyman
Santa Clara
Operating Engineer
(Heavy And Highway
Work)
Group 3 (Area 1)
S 8.00 8.00 8.00 24.00 61.14 2,201.04
3,567.92
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
1,991.11 DD199111
03/07/2025O2.00 2.50 3.50 8.00 91.71
272.95 689.20 280.96 42.82 6.06 193.92 10.84 346.88 11.28 360.96
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 1.21 38.72 4.11 131.52 290.88 1,576.81
Ernest Whisenant
416 LINCOLN ST
SANTA CRUZ, CA 95060
xxx-xx-4808
S/0
CA 2024-1
Journeyman
Santa Clara
Operating Engineer
(Heavy And Highway
Work)
Group 3 (Area 1)
S 8.00 8.00 16.00 67.14 1,074.24
3,567.92
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
1,991.11 DD199111
03/07/2025O
272.95 689.20 280.96 42.82 6.06 96.96 10.84 173.44 11.28 180.48
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 1.21 19.36 4.11 65.76 290.88 1,576.81
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: 4/13/2025 Page 7 of 8
STATE OF CALIFORNIA
STATEMENT OF COMPLIANCE
Date: 3/6/2025
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 The Rise at Vallco Horizontal Ph1A
(Contract/Subcontract: 20240543108) : that during the payroll period
(Contractor or Subcontractor) (Building or Work)
commencing on the 24th day of February 2025 , and ending the 2nd day of March 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
03/06/2025 15:31:50
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: 4/13/2025 Page 8 of 8
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.
7
FOR WEEK ENDING
03/09/2025
SELF-INSURED CERTIFICATE NO:
WORKER'S COMPENSATION POLICY NO: UB1L0302221825D
PROJECT OR CONTRACT NO: 20240543108
PROJECT AND LOCATION: The Rise at Vallco Horizontal Ph1A / 10123 N Wolfe
Rd, Cupertino, 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
03 04 05 06 07 08 09
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 1.00 1.00 101.47 101.47
4,281.57
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
2,780.37 DD278037
03/14/2025O
327.54 619.41 260.47 51.38 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 1,501.20
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: 4/13/2025 Page 1 of 2
STATE OF CALIFORNIA
STATEMENT OF COMPLIANCE
Date: 3/14/2025
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 The Rise at Vallco Horizontal Ph1A
(Contract/Subcontract: 20240543108) : that during the payroll period
(Contractor or Subcontractor) (Building or Work)
commencing on the 3rd day of March 2025 , and ending the 9th day of March 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
03/14/2025 08:29:22
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: 4/13/2025 Page 2 of 2
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.
8
FOR WEEK ENDING
03/16/2025
SELF-INSURED CERTIFICATE NO:
WORKER'S COMPENSATION POLICY NO: UB1L0302221825D
PROJECT OR CONTRACT NO: 20240543108
PROJECT AND LOCATION: The Rise at Vallco Horizontal Ph1A / 10123 N Wolfe
Rd, Cupertino, 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
10 11 12 13 14 15 16
HOURS WORKED EACH DAY
Ivan Arias
40640 HIGH STREET
FREMONT, CA 94538
xxx-xx-0614
M/0
CA 2024-1
Journeyman
Santa Clara
Operating Engineer
(Heavy And Highway
Work)
Group 4 (Area 1)
S 4.00 4.00 59.76 239.04
2,106.24
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
1,387.58 DD138758
03/21/2025O
161.13 184.27 55.31 25.27 6.06 24.24 10.84 43.36 11.28 45.12
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 1.21 4.84 4.11 16.44 292.68 718.66
Faustino Buenrostro
1588 FLANNIGAN DR.
SAN JOSE, CA 95121
xxx-xx-1429
M/0
CA 2024-1
Journeyman
Santa Clara
Laborer And Related
Classifications
Group 1; Group 1(B)
(Area 1)
S 183.54
2,307.92
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
1,654.76 DD165476
03/21/2025O2.00 2.00 91.77
176.56 239.78 86.27 27.70 3.51 7.02 10.60 21.20 10.46 20.92
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 0.52 1.04 4.82 9.64 122.85 653.16
Jason Hayes
18393 ALCALA CT.
MORGAN HILL, CA 95037
xxx-xx-8561
S/0
CA 2024-1
Journeyman
Santa Clara
Operating Engineer
(Heavy And Highway
Work)
Group 3 (Area 1)
S 2.00 2.00 75.21 150.42
3,250.80
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
1,859.09 DD185909
03/21/2025O
248.68 613.10 248.52 39.01 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 1,391.71
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: 4/13/2025 Page 1 of 2
STATE OF CALIFORNIA
STATEMENT OF COMPLIANCE
Date: 3/24/2025
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 The Rise at Vallco Horizontal Ph1A
(Contract/Subcontract: 20240543108) : that during the payroll period
(Contractor or Subcontractor) (Building or Work)
commencing on the 10th day of March 2025 , and ending the 16th day of March 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
03/24/2025 13:34:42
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: 4/13/2025 Page 2 of 2