HomeMy WebLinkAboutWWP272955(10) Letter of Transmittal
Frank Coluccio Construction Company
9600 Martin Luther King W/ay S. Seattle, WA 98118-5693
Ph. (206) 722-5306 Fax (206) 7254764 H�CEI 1/1'
ED
FRAN-KC-040L7 APR 15 2003
TO: Date: April 14,2003 K ,
Mr. John Hobson Job Name: E.Kennydale Sanitary Sewer
City of Renton
1055 South Grady Way—5`h Floor Job Number: CAG-02-034
Renton,WA 98055 Payroll From: Interwest Development,Inc.
Payroll#: I
Period Ending: 08110102
WE ARE SENDING YOU:
0 Attached ❑ Under separate cover via the following items:
❑Shop Drawings ❑Prints ❑Plans ❑Samples ❑Specifications
❑Copy of letter ❑Change Order ❑Other
REMARKS:
Copies I Date I No. E Description
1 04/14/03 Certified Payroll from Interwest Development,Inc.
THESE ARE TRANSMITTED (as checked below
0 Certified Payroll ❑ Prequalification Information
❑ EEO Reports ❑Check for plans and specifications
❑ EEO/Apprentice Reports
Remarks:
Signature (a G2----------_--�L
Carol Bacon—Contract Administrator
"* Statement of Compliance
Date: APRIL 4,2003 Contract Number:
I,Sharon Kessell,Payroll do hereby state:
(1) That I pay or supervise the payment of the persons employed by Interwest Development NW,Inc.on the City of Renton-Coluccio,that during the payroll period commencing on the 4 day of AUGUST,2002 and ending the 10 day of AUGUST,
2002,all persons employed on said project have been paid the full weekly wages earned,that no rebates have been or will be made either directly or indirectly to or on behalf of said Interwest Development NW,Inc.from the full weekly wages earned by
any person and that no deductions have been made either directly or indirectly from the full wages earned by any person,other than permissible deductions as defined in Regulations,Part 3(29 CFR Subtitle A),issued by the Secretary of Labor under the
Copeland Act,as amended(48 Stat.948.63 Stat.108,72 Stat.967;76 Stat.357;40 U.S.C.276c),and described below:
c
(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 Bureau of Apprenticeship and Training,United States Department of Labor.
(4) That:
(a)WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS,FUNDS,OR PROGRAMS
(X) 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
Sharon Kessell,Payroll
The willful falsification of any of the above statements may subject the contractor or subcontnic for to civil or criminal prosecution. See Section 1001 of Title 18 and Section 231 of Title 31 of the United States Code.
I PR - 2003
FCCC
'Ir.lerwOt Development NW, Inc. Pay Period Date: 08/10/02 Certified Payroll Report Contract#:
"(425 22ND Street NW, Week Ending: 08/10/02 Job No: 02-327
Suite E Payroll No: 1 Job Name: City of Renton-Coluccio
Auburn,WA 98001-3334
253 939-9787
#Exemptions Hours Other Job Pay FICA Local Tot Ded
Social Security SUN MON TUE WED THU FRI SAT Job Gross Fed W/H Union Benefits
Employee Work Class 04 05 06 07 08 09 10 Total Rate Total Gross State Oth Ded Net Chk
ACHI,JEFFREY K Ex: S-01 AM O 0.00 0.00 0.00 0.00 4.50 0.00 0.00 4.50 44.25 0.00 108.54 0.00 435.88
5112 WEST TAPPS DRIVE E 538-70-8857 S 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 199.13 276.45 0.00 0.00
SUMNER,WA 98390 Driver 1,418.89 0.00 42.57 983.01
Check#: 58976
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