2025-05 - 250510 DeSilva GatesPAYROLL REPORTING FORM Page 1 of 2
NAME OF CONTRACTOR OR SUBCONTRACTOR
DESILVA GATES CONSTRUCTION
CONTRACTOR'S LICENSE NO: 704195
SPECIALITY LICENSE NO:
ADDRESS
11555 Dublin Blvd, DUBLIN, CA 94568
PAYROLL NO.
15
FOR WEEK ENDING
05/10/2025
SELF-INSURED CERTIFICATE NO:
WORKER'S COMPENSATION POLICY NO: 7409465
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.
/DateSunMonTueWedThuFriSat
04 05 06 07 08 09 10
HOURS WORKED EACH DAY
Henriquez
VILLALOBOS, ZAIRD
2629 75TH AVE
OAKLAND, CA 94605
xxx-xx-1911
CA 2024-1
Apprentice
Santa Clara
Operating Engineer
(Heavy And Highway
Work)
Operating Engineer
(Heavy And Highway
Work) (Area 1)
Period 3
S 8.00 8.00 44.37
418.75
2,093.75
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
1,230.09 490640
05/16/2025
O 1.00 1.00 63.79
160.17 299.36 130.15 25.13 5.53 49.77 13.38 120.42 9.68 87.12
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 2.21 19.89 1.60 14.40 248.85 863.66
Jose Arellano
10006 C STREET
OAKLAND, CA 94603
xxx-xx-3688
S/2
CA 2024-1
Journeyman
Santa Clara
Laborer And Related
Classifications
Construction Specialist
(Area 1)
S 8.00 8.00 8.00 8.00 8.00 40.00 45.04 2,328.08
2,329.81
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
1,433.29 490488
05/16/2025O2.00 2.00 1.00 1.00 2.00 8.00 65.81
180.62 359.84 157.49 28.33 3.51 168.48 10.60 508.80 14.96 718.08
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 0.52 24.96 0.32 15.36 170.24 896.52
Steve Cacho
4870 TEAKWOOD DR.
OAKLEY, CA 94561
xxx-xx-4241
S/3
CA 2024-1
Journeyman
Santa Clara
Operating Engineer
(Heavy And Highway
Work)
Group 4 (Area 1)
S 8.00 8.00 8.00 8.00 8.00 40.00 65.79 3,396.96
3,412.04
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
2,029.84 490521
05/16/2025O1.00 2.00 2.00 1.00 2.00 8.00 95.67
278.16 477.41 278.48 43.63 6.03 289.44 13.38 642.24 11.28 541.44
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 1.21 58.08 1.60 76.80 304.52 1,382.20
Cesar Jimenez
1608 36TH AVE.
OAKLAND, CA 94601
xxx-xx-6249
S/99
CA 2024-1
Apprentice
Santa Clara
Laborer And Related
Classifications
Laborer
Period 2
S 8.00 8.00 8.00 24.00 31.76 899.91
899.90
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
725.49 490361
05/16/2025O2.00 0.50 0.50 3.00 45.89
68.84 10.80 3.51 94.77 10.60 286.20 14.96 403.92
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 0.52 14.04 0.32 8.64 94.77 174.41
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: 6/16/2025 Page 1 of 3
PAYROLL REPORTING FORM Page 2 of 2
NAME OF CONTRACTOR OR SUBCONTRACTOR
DESILVA GATES CONSTRUCTION
CONTRACTOR'S LICENSE NO: 704195
SPECIALITY LICENSE NO:
ADDRESS
11555 Dublin Blvd, DUBLIN, CA 94568
PAYROLL NO.
15
FOR WEEK ENDING
05/10/2025
SELF-INSURED CERTIFICATE NO:
WORKER'S COMPENSATION POLICY NO: 7409465
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.
/DateSunMonTueWedThuFriSat
04 05 06 07 08 09 10
HOURS WORKED EACH DAY
Juan C Nieves Jr
1349 53RD AVE
OAKLAND, CA 94601
xxx-xx-3361
CA 2024-1
Apprentice
Santa Clara
Laborer And Related
Classifications
Laborer
Period 3
S 8.00 8.00 16.00 35.51 593.92
593.92
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
442.91 490752
05/16/2025O0.50 0.50 51.51
45.44 32.07 8.45 7.13 3.51 57.92 10.60 174.90 14.96 246.84
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 0.52 8.58 0.32 5.28 57.92 151.01
Erick Rodriguez-topete
16119 VIA MEDIA
SAN LORENZO, CA 94580
xxx-xx-9691
S/99
CA 2024-1
Apprentice
Santa Clara
Operating Engineer
(Heavy And Highway
Work)
Operating Engineer
(Heavy And Highway
Work) (Area 1)
Period 1
S 8.00 8.00 8.00 8.00 32.00 47.98
2,089.04
2,542.06
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
1,437.42 490373
05/16/2025
O 2.00 2.00 2.00 2.00 8.00 69.21
194.46 335.25 123.46 30.50 5.53 221.20 13.38 535.20 9.68 387.20
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 2.21 88.40 1.60 64.00 420.97 1,104.64
David Simons
664 HAPPY VALLEY RD.
PLEASANTON, CA 94566
xxx-xx-7028
S/2
CA 2024-1
Journeyman
Santa Clara
Operating Engineer
(Heavy And Highway
Work)
Group 2 (Area 1)
S 8.00 8.00 8.00 8.00 8.00 40.00 74.65 3,966.64
3,981.72
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
2,129.60 490856
05/16/2025O2.00 2.00 2.00 1.00 2.00 9.00 108.96
324.29 823.10 343.31 50.87 6.03 295.47 13.38 655.62 11.28 552.72
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 1.21 59.29 1.60 78.40 310.55 1,852.12
Brian Spini
917 RUBY ST.
REDWOOD CITY, CA
94061
xxx-xx-0296
S/0
CA 2024-1
Journeyman
Santa Clara
Operating Engineer
(Heavy And Highway
Work)
Group 1 (Area 1)
S 8.00 8.00 8.00 8.00 8.00 40.00 70.18 3,727.54
3,727.54
FICA FED
TAX
STATE
TAX / LT SDI VAC
HOLIDAY
HEALTH
& WELF PENSION
2,077.36 490862
05/16/2025O2.50 2.50 2.50 1.50 9.00 102.26
285.15 727.52 297.30 44.74 6.03 295.47 13.38 655.62 11.28 552.72
TRAING OTHER
REIMB.DUES TRAV
SUBS
OTHER
FRINGE
OTHER
DEDS
TOTAL
DEDUCTS
D 1.21 59.29 1.60 78.40 295.47 1,650.18
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: 6/16/2025 Page 2 of 3
STATE OF CALIFORNIA
STATEMENT OF COMPLIANCE
Date: 5/20/2025
Balvinder Chand Labor Compliance Specialist 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
DESILVA GATES CONSTRUCTION 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 4th day of May 2025 , and ending the 10th day of May 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
DESILVA GATES CONSTRUCTION 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
Balvinder Chand
Labor Compliance Specialist
05/20/2025 13:56:48
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: 6/16/2025 Page 3 of 3