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2025-05 - 250524 DeSilva GatesPAYROLL REPORTING FORM Page 1 of 3 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. 17 FOR WEEK ENDING 05/24/2025 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 18 19 20 21 22 23 24 HOURS WORKED EACH DAY 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 32.00 45.04 1,836.14 1,836.14 FICA FED TAX STATE TAX / LT SDI VAC HOLIDAY HEALTH & WELF PENSION 1,193.78 491846 05/30/2025O2.00 2.00 2.00 6.00 65.81 140.47 242.68 103.80 22.03 3.51 133.38 10.60 402.80 14.96 568.48 TRAING OTHER REIMB.DUES TRAV SUBS OTHER FRINGE OTHER DEDS TOTAL DEDUCTS D 0.52 19.76 0.32 12.16 133.38 642.36 Matthew Benson 2185 BREAKER CT DISCOVERY BAY, CA 94505 xxx-xx-1748 S/1 CA 2024-1 Journeyman Santa Clara Operating Engineer (Heavy And Highway Work) Group 2 (Area 1) S 8.00 8.00 16.00 68.65 1,298.32 1,827.66 FICA FED TAX STATE TAX / LT SDI VAC HOLIDAY HEALTH & WELF PENSION 834.29 491859 05/30/2025O2.00 2.00 99.96 143.40 269.34 104.58 22.50 6.03 108.54 13.38 240.84 11.28 203.04 TRAING OTHER REIMB.DUES TRAV SUBS OTHER FRINGE OTHER DEDS TOTAL DEDUCTS D 1.21 21.78 1.60 28.80 453.55 993.37 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 3,409.02 FICA FED TAX STATE TAX / LT SDI VAC HOLIDAY HEALTH & WELF PENSION 2,049.48 491881 05/30/2025O2.00 2.00 2.00 2.00 8.00 95.67 274.50 466.89 273.59 43.06 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 76.80 301.50 1,359.54 Anthony Covarrubias 1201 SHEARWATER DR PATTERSON, CA 95363 xxx-xx-6989 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 16.00 39.78 750.30 2,027.82 FICA FED TAX STATE TAX / LT SDI VAC HOLIDAY HEALTH & WELF PENSION 1,302.05 491907 05/30/2025 O 2.00 2.00 56.91 159.06 161.48 128.66 24.95 5.53 99.54 13.38 240.84 9.68 174.24 TRAING OTHER REIMB.DUES TRAV SUBS OTHER FRINGE OTHER DEDS TOTAL DEDUCTS D 2.21 39.78 1.60 28.80 251.62 725.77 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 4 PAYROLL REPORTING FORM Page 2 of 3 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. 17 FOR WEEK ENDING 05/24/2025 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 18 19 20 21 22 23 24 HOURS WORKED EACH DAY Connor French 19 SURREY CT DANVILLE, CA 94526 xxx-xx-8216 CA 2024-1 Apprentice Santa Clara Laborer And Related Classifications Laborer Period 4 S 8.00 8.00 8.00 24.00 37.26 948.38 1,530.13 FICA FED TAX STATE TAX / LT SDI VAC HOLIDAY HEALTH & WELF PENSION 966.58 491955 05/30/2025O0.50 0.50 1.00 54.14 117.05 211.74 72.49 18.36 3.51 87.75 10.60 265.00 14.96 374.00 TRAING OTHER REIMB.DUES TRAV SUBS OTHER FRINGE OTHER DEDS TOTAL DEDUCTS D 0.52 13.00 0.32 8.00 143.91 563.55 Theresa Hahn 4062 CANYON WY. PITTSBURG, CA 94565 xxx-xx-3064 S/0 CA 2024-1 Journeyman Santa Clara Operating Engineer (Heavy And Highway Work) Group 4 (Area 1) S 8.00 8.00 16.00 65.79 1,339.65 3,093.61 FICA FED TAX STATE TAX / LT SDI VAC HOLIDAY HEALTH & WELF PENSION 1,752.73 491996 05/30/2025O2.50 0.50 3.00 95.67 236.66 575.37 232.44 37.12 6.03 114.57 13.38 254.22 11.28 214.32 TRAING OTHER REIMB.DUES TRAV SUBS OTHER FRINGE OTHER DEDS TOTAL DEDUCTS D 1.21 22.99 1.60 30.40 259.29 1,340.88 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 16.00 31.76 554.05 554.05 FICA FED TAX STATE TAX / LT SDI VAC HOLIDAY HEALTH & WELF PENSION 445.34 490433 05/30/2025O0.50 0.50 1.00 45.89 42.39 6.65 3.51 59.67 10.60 180.20 14.96 254.32 TRAING OTHER REIMB.DUES TRAV SUBS OTHER FRINGE OTHER DEDS TOTAL DEDUCTS D 0.52 8.84 0.32 5.44 59.67 108.71 Chad Lampley 6605 FORGET ME NO CMN LIVERMORE, CA 94551 xxx-xx-2300 S/1 CA 2024-1 Journeyman Santa Clara Operating Engineer (Heavy And Highway Work) Group 4 (Area 1) S 8.00 8.00 8.00 24.00 65.79 2,057.31 2,168.34 FICA FED TAX STATE TAX / LT SDI VAC HOLIDAY HEALTH & WELF PENSION 1,278.84 492036 05/30/2025O1.00 2.00 2.00 5.00 95.67 172.73 364.97 143.80 27.10 6.03 174.87 13.38 388.02 11.28 327.12 TRAING OTHER REIMB.DUES TRAV SUBS OTHER FRINGE OTHER DEDS TOTAL DEDUCTS D 1.21 35.09 1.60 46.40 180.90 889.50 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 4 PAYROLL REPORTING FORM Page 3 of 3 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. 17 FOR WEEK ENDING 05/24/2025 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 18 19 20 21 22 23 24 HOURS WORKED EACH DAY Jose Munoz 2649 VILLA CORTONA WAY SAN JOSE, CA 95125 xxx-xx-4260 CA 2024-1 Apprentice Santa Clara Operating Engineer (Heavy And Highway Work) Operating Engineer (Heavy And Highway Work) (Area 1) Period 2 S 8.00 8.00 41.39 420.10 1,978.91 FICA FED TAX STATE TAX / LT SDI VAC HOLIDAY HEALTH & WELF PENSION 1,416.28 492100 05/30/2025 O 1.50 1.50 59.32 151.38 34.07 118.40 23.75 5.53 52.54 13.38 127.11 9.68 91.96 TRAING OTHER REIMB.DUES TRAV SUBS OTHER FRINGE OTHER DEDS TOTAL DEDUCTS D 2.21 21.00 1.60 15.20 235.03 562.63 Carlos Serrano 932 LYNN CT SAN LORENZO, CA 94580 xxx-xx-5095 S/2 CA 2024-1 Journeyman Santa Clara Laborer And Related Classifications Construction Specialist (Area 1) S 8.00 8.00 45.04 426.13 1,867.41 FICA FED TAX STATE TAX / LT SDI VAC HOLIDAY HEALTH & WELF PENSION 1,359.92 492197 05/30/2025O1.00 1.00 65.81 142.86 155.61 42.70 22.41 3.51 31.59 10.60 95.40 14.96 134.64 TRAING OTHER REIMB.DUES TRAV SUBS OTHER FRINGE OTHER DEDS TOTAL DEDUCTS D 0.52 4.68 0.32 2.88 143.91 507.49 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 24.00 74.65 2,445.36 2,454.41 FICA FED TAX STATE TAX / LT SDI VAC HOLIDAY HEALTH & WELF PENSION 1,437.70 492205 05/30/2025O2.00 2.00 2.00 6.00 108.96 199.58 419.33 176.54 31.31 6.03 180.90 13.38 401.40 11.28 338.40 TRAING OTHER REIMB.DUES TRAV SUBS OTHER FRINGE OTHER DEDS TOTAL DEDUCTS D 1.21 36.30 1.60 48.00 189.95 1,016.71 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 32.00 70.18 3,319.49 3,319.49 FICA FED TAX STATE TAX / LT SDI VAC HOLIDAY HEALTH & WELF PENSION 1,884.28 492213 05/30/2025O2.50 2.50 2.50 3.00 10.50 102.26 253.96 629.58 255.55 39.84 6.03 256.28 13.38 568.65 11.28 479.40 TRAING OTHER REIMB.DUES TRAV SUBS OTHER FRINGE OTHER DEDS TOTAL DEDUCTS D 1.21 51.43 1.60 68.00 256.28 1,435.21 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 3 of 4 STATE OF CALIFORNIA STATEMENT OF COMPLIANCE Date: 6/2/2025 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 18th day of May 2025 , and ending the 24th 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 06/02/2025 11:03:29 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 4 of 4