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Home My WebLink AboutCAG-20-065 - Duvall - Subcontractor Green City I - r State of Washington Department of Labor & Industries Prevailing Wage Section - Telephone 360-902-5335 PO Box 44540, Olympia, WA 98504-4540 Statement of Intent to Pay. Prevailing Wage Project Detail - Project Dashboard Document Received Intent ID: Affidavit ID: Status: Approved On Date: 8/24/2021 1171745 8/31/2021 Company Details Company Name: GREEN CITY INC Address: 2224 NE.31ST ST RENTON, WA, .98056 Contractor Registration No. GREENCI105B4 WA UBI Number 601196371 Phone Number 425-228-6488 Industrial Insurance Account ID 45432901 OMWBE Certifications as of 8/24/2021 Disadvantaged Business Enterprise (DBE) Minority Business Enterprise (MBE) Email Address andrewf@greencitywa.com Filed By Rose Falaniko Prime Contractor Company Name REED TRUCKING Et EXCAVATING INC Contractor Registration No. REEDTEI016JW WA UBI Number 601915034 Phone Number 253-841-4837 Project Information Awarding Agency RENTON, CITY OF 1055 S GRADY WAY RENTON, WA- 98055 Awarding Agency Contact flora Lee Awarding Agency Contact Phone Number 425-430-7303 Contract Number CAG-20-065 Project Name Duvall Avenue NE Project Description This project includes but is not limited to: excavation; grading; removal of pavement; plaining pavement; paving with asphalt, curb and gutter; drainage; illumination; HAWK signal; sidewalk; walls; adjustments to utility frames, grates, and covers; property restoration; and other work. Contract Amount $5,218,171.95 Contract Type Description Bid-Build (Traditional) Bid due date 6/22/2021 Award Date 7/21/2021 Project Site Address or Directions Hiring Contractor Company Name REED TRUCKING Et EXCAVATING INC Contractor Registration No. REEDTEI016JW WA UBI Number 601915034 Payment Details Check Number: Transaction Id: 108240694 Intent Details Expected project start date: (MM/DD/YYYY) 9/1/2021 In what county (or counties) will the work be King performed? In what city (or nearest city) will the work be Renton performed? What is the estimated contract amount? OR is $139,480.00 this a time and materials estimate? Does your company intend to hire ANY No subcontractors? Yes Will your company have employees perform - work on this project? Do you intend to use any apprentices? No • (Apprentices are considered employees.) How many owner/operators performing work on 1 the project own 30% or more of the company? First Name Last Name Trade • Frank Falaniko Landscape Construction journey Level Wages County Trade Occupation Wage Fringe # Workers King Landscape Maintenance Groundskeeper $18.00 $0.00 4 King Landscape Construction Landscape Operator $72.28 $0.00 1. King Landscape Construction Landscape • $40.36 $0.00 5 Construction/Landscaping.Or Planting Laborers Public Notes o Show/Hide Existing Notes -- On 8/24/2021:-- Installation and warranty of in ground irrigation system - 18" depth, topsoil - 18" depth max, bark mulch - 3-4" depth, plant materials. One year warranty and maintenance. Installation by small equipment under 35CC. Fringe paid in cash directly to the employees. State of Washington Department of Labor & Industries Prevailing Wage Section - Telephone 360-902-5335 PO Box 44540, Olympia, WA 98504-4540 Affidavit of Wages Paid Project Detail - Project Dashboard Document Received Date: Intent Id: Affidavit Id: 1275587 Status: Approved on 1/5/2024 1171745 1/11/2024 Company Details Name GREEN CITY INC Address 2224 NE 31 ST ST RENTON,WA,98056 WA UBI no. 601196371 Contractor Registration no. GREENCII05B4 Industrial Insurance Account Id 45432901 OMWBE Certifications as of 8/24/2021 Disadvantaged Business Enterprise (DBE) Minority Business Enterprise (MBE) Email Address andrewf@greencitywa.com Filed By Falaniko, Rose Prime Contractor Prime contractor name REED TRUCKING at EXCAVATING INC Prime contractor registration no. REEDTEI016JW Prime contractor Phone Number 253-841-4837 Project Information Awarding agency: RENTON, CITY OF 1055 S GRADY WAY RENTON, WA - 98055 Awarding agency contact: Flora Lee Awarding agency contact phone number: 425-430-7303 Contract no. CAG-20-065 Project name Duvall Avenue NE Project Description This project includes but is not limited to: excavation; grading; removal of pavement; plaining pavement; paving with asphalt, curb and gutter; drainage; illumination; HAWK restoration; and other work. Dollar amount of your contract: $ 139,480.00 Bid due date 6/22/2021 Contract award date 7/21/2021 Job site address/directions: Hiring Contractor Company Name REED TRUCKING Et EXCAVATING INC Contractor Registration No. REEDTEI016JW WA UBI Number 601915034 Payment Details Check Number: Transaction Id: 109762717 Project Details County where work was performed King City where work was performed Renton Prime contractor Intent form Id#for this 1170257 project Intent filed date 8/24/2021 Job start date:MM-DD-YYYY 12/13/2022 Date work completed:MM-DD-YYYY 12/30/2023 Project Completion Did your company hire any subcontractors? No Did your company have employees perform Yes work on this project? Did you use apprentice employees on this No project? Company Owner Information How many owner/operators performed work on 1 the project that own 30% or more of the company? First Name Last Name Trade Frank Falaniko " Landscape Construction Affidavit Subcontractor(s) No subcontractor is selected for this affidavit. Journeylevel Wages - County Trade Occupation Wages Fringes # # Workers Hours King Landscape Landscape 40.36 0.00 12 557.00 Construction Construction/Landscaping Or Planting Laborers King Landscape Landscape 47.84 0.00 1 24.00 Construction Construction/Landscaping Or Planting Laborers Apprentice Wages Public Notes o Show/Hide Existing Notes -- On 1/5/2024:-- Installation and warranty of in ground irrigation system - 18" depth, topsoil - 18" depth max, bark mulch - 3-4" depth, plant materials. One year warranty and maintenance. Installation by small equipment under 35CC. Fringe paid in cash directly to the employees. -- On 1/5/2024:-- Warranty was not included in the contract; contract was completed at physical completion. Certified Payroll Report Department of Labor and �f sT"'t'o Prime Contractor ❑ Project Name County Project or Contract# Industries 4:°" f a;;,; z, Duvall Avenue NE King CAG-20-065 Prevailing Wage Program �'°' i Subcontractor PO Box 44540 .. mg y Project Address Olympia WA 98504-4540 y` 18B9 ao Final Week of (360)902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 7/15/2023 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 Day and Date Deductions p Work Classification Name a Sun Mon Tue Wed Thu Fri Sat Total O~ °au and And m Gross Amount E 7/9 7/10 7/11 7/12 7/13 7/14 7/15 Total Rate Hourly m r Earned/Gross Net Wages E Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address m ; Payroll Benefits" Tax o' O 3 Hours Worked Each Day 0 No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 7/24/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 7/9/2023 7/15/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F)Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. "a)Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and gaining Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature SARAH MICHAEL OFFICE ADMINISTRATOR SARAH MICHAEL MB 8/2/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and +!S ATgp Prime Contractor ❑ 'Project Name County Project or Contract# Industries i, Duvall Avenue NE King CAG-20-065 Prevailing Wage Program f ;;,. ,.y Subcontractor PO Box 44540 :,•jr' v' Project Address Olympia WA 98504-4540 6� aee a� Final Week of (360)902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 7/8/2023 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 Day and Date Deductions H Work Classification Name & o o Sun Mon Tue Wed Thu Fri Sat Total a) Gross Amount and And m E 7/2 7/3 7/4 7/5 7/6 7/7 7/8 Total Rate Earned/Gross Hourly Net Wages m E Hours of Pay y "Usual FICA Wit Ta iding Other Soc Sec#of Employee Address ce o o Hours Worked Each Day Payroll Benefits" 0 No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 7/16/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 7/2/2023 7/8/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side L The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s)have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions,other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. •L$1)Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and .'raining Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature SARAH MICHAEL OFFICE ADMINISTRATOR SARAH MICHAEL MB 8/2/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and a$siAr'� Prime Contractor ❑ Project Name County Project or Contract# Industries : ' 4. ii Duvall Avenue NE King CAG-20-065 Prevailing Wage Program <';;;;, °;;`s Subcontractor PO Box 44540 '•4"1 'v Project Address Olympia WA 98504-4540 y` "B9 ac Final Week of (360)902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 7/1/2023 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 Day and Date Deductions p Work Classification Name c9 b o Sun Mon Tue Wed Thu Fri Sat Total ce O a, Gross Amount and And a) E 6/25.6/26 6/27 6/28 6/29 6/30 7/1 Total Rate Earned/Gross Hourly Net Wages m Hours of Pay y "Usual FICA Wit holding Other Soc Sec#of Employee Address m > Payroll Benefits" Tax W O o Hours Worked Each Day 0 No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 7/9/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 6/25/2023 7/1/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s)have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. '5)Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ,'raining Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature SARAH MICHAEL OFFICE ADMINISTRATOR SARAH MICHAEL MB 8/2/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and *E.ST�Tf Project Name County Project or Contract# ,u. °f Prime Contractor ❑ Industries ;.,::, 4. -��;� -�,�'Iy Duvall Avenue NE King CAG-20-065 Prevailing Wage Program ;;;i:, ;!_`l Subcontractor O. PO Box 44540 '', 4i'�/` 1 Project Address Olympia WA 98504-4540 y` `"""a Final Week of (360)902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 6/24/2023 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 Day and Date Deductions P Work Classification Name a ~ ° Sun Mon Tue Wed Thu Fri Sat Total a� Gross Amount and And a) E 6/18 6/19 6/20 6/21 6/22 6/23 6/24 Total Rate Earned/Gross Hourly Net Wages 03 E H Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address o o Hours Worked Each Day Payroll Benefits" Tax a No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 7/9/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 6/18/2023 6/24/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s)have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. "5)Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ,i raining Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature SARAH MICHAEL OFFICE ADMINISTRATOR SARAH MICHAEL MB 8/2/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and E•;:'.:Ar Prime Contractor ❑ Project Name County Project or Contract# Industries 4, p- y Duvall Avenue NE King CAG 20 065 Prevailing Wage Program �~_+ ::::4 11 r••il!•r Subcontractor PO Box 44540 °', '•�']/ Project Address Olympia WA 98504-4540 y` "ee ac Final Week of (360)902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 6/17/2023 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 Day and Date Deductions p Work Classification Name 0 O 8 o Sun Mon Tue Wed Thu Fri Sat Total o: a, Gross Amount and And a) E 6/11 6/12 6/13 6/14 6/15 6/16 6/17 Total Rate Earned/Gross Hourly Net Wages j E i Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address y Benefits" Tax IX O 'o Hours Worked Each Day a No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 6/26/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 6/11/2023 6/17/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s)have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions,other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. '45)Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and training Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature SARAH MICHAEL OFFICE ADMINISTRATOR SARAH MICHAEL MB 8/2/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and ,A`STAT,'�� prime Contractor ❑ Project Name County Project or Contract# Industries ,,. ;. Duvall Avenue NE King CAG-20-065 Prevailing Wage Program z Subcontractor IZ PO Box 44540 rl .•jr wj7' Project Address Olympia WA 98504-4540 y` '"89 a Final Week of (360)902-5335 Payroll ❑ Awarding Agency Name Phone Company Name •Phone FOr the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 6/10/2023 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 Day and Date Deductions p Work Classification Name C9 b o Sun Mon Tue Wed Thu Fri Sat Total cf O a, Gross Amount and And a) E 6/4 6/5 6/6 6/7 6/8 6/9 6/10 Total Rate Earned/Gross Hourly Net Wages E F Hours of Pay Payroll "Usual FICA• Withholding Other Soc Sec#of Employee Address cc O o Hours Worked Each Day y Benefits" Tax a No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 6/26/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 6/4/2023 6/10/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F)Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s)have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. -15)Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and Training Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature SARAH MICHAEL OFFICE ADMINISTRATOR SARAH MICHAEL • MB 8/2/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �S ATF.G Project Name County Project or Contract# ?:.. Prime Contractor ❑ Industries % ;_:�. i y i� Duvall Avenue NE King CAG-20-065 Prevailing Wage Program i hill �;�:::: :(4�� Subcontractor ►_� PO Box 44540 ,:111 y' Project Address Olympia WA 98504-4540 y` 1889 r, Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 6/3/2023 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 Day and Date Deductions Work Classification Name c9 0 o Sun Mon Tue Wed Thu Fri Sat Total Gross Amount and And o E 5/28 5/29 5/30 5/31 6/1 6/2 6/3 Total Rate Earned/Gross Hourly Net Wages E Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address CD o o Hours Worked Each Day Payroll Benefits" Tax 0 No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 6/12/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 5/28/2023 6/3/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. (5>-4ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and 1' ing Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature SARAH MICHAEL OFFICE ADMINISTRATOR SARAH MICHAEL MB 6/23/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and t ;,37,� Project Name County Project or Contract# :.\`•: ' Prime Contractor ❑ Industries 4 e 1 {:F Duvall Avenue NE King CAG-20-065 Prevailing Wage Program =_ 6" ¢ Subcontractor PO Box 44540 ".y Project Address Olympia WA 98504-4540 Final Week of (360) 902-5335 Payroll E Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 5/27/2023 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 Day and Date Deductions p Work Classification Name C7 O~ o Sun Mon Tue Wed Thu Fri Sat Total a� Gross Amount and And au E 5/21 5/22 5/23 5/24 5/25 5/26 5/27 Total Rate Earned/Gross Hourly Net Wages E Hours of Pay "Usual FICA Withholding Other f Payroll Benefits" Tax Soc Sec#of Employee Address Ct o o Hours Worked Each Day 0 No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 6/4/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 5/21/2023 5/27/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. ('°.Fly apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature SARAH MICHAEL OFFICE ADMINISTRATOR SARAH MICHAEL L _ MB 6/6/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and F `'''rt, Prime Contractor ❑ Project Name County Project or Contract# \ Industries . �: Duvall Avenue NE King CAG-20-065 sr Prevailing Wage Program `'. "a€ Subcontractor PO Box 44540 "�"'� v Project Address ;• Olympia WA 98504-4540 " , Final Week of (360) 902-5335 Payroll E Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 5/20/2023 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 Day and Date Deductions i= Work Classification Name c7 ~O o Sun Mon Tue Wed Thu Fri Sat Total m Gross Amount and And a) E 5/14 5/15 5/16 5/17 5/18 5/19 5/20 Total Rate Earned/Gross Hourly Net Wages E Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address aa) CD a Payroll Benefits" Tax tr O o Hours Worked Each Day 0 No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 5/29/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 5/14/2023 5/20/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. (51 Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and sling Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties.. Printed name of party signing this report Title Signature SARAH MICHAEL OFFICE ADMINISTRATOR SARAH MICHAEL MB 6/6/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �i,s?Atso� Project Name County Project or Contract# 4.... Prime Contractor ❑ Industries ::.� Duvall Avenue NE King CAG-20-065 Prevailing Wage Program 2,'`.:. ""_ w�;;; � t::�. Subcontractor ❑x PO Box 44540 ,y l e-4, Project Address Olympia WA 98504-4540 • Final Week of (360)902-5335 Payroll El Awarding Agency Name Phone Company Name - Phone For the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address - Address City State Zip+4 5/13/2023 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 , Day and Date Deductions F= Work Classification Name C. ~o o Sun Mon Tue Wed Thu Fri Sat Total a� Gross Amount and And a) E 5/7 5/8 5/9 5/10 5/11 5/12 5/13 Total Rate Earned/Gross Hourly Net Wages 3 E i= Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address f o Hours Worked Each Day - Payroll Benefits" Tax 0 1. Landscape Construction SOCIAL RG 0.00 0.00 0.00 0.00 0.00 2.00 0.00 2.00 $40.36 $80.72 Landscape SECURITY: Construction/Landscaping Or $87.55,Workers' Planting Laborers OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 Compensation: (King) - - $11.78,Medicare: REYNALDO $20.48, Paid "" AMEZCUA Family Medical 1720 Maple Ln $80.72/ $0.00/hr $0.00 $107.00 Leave:$8.22, $1,060.60 Kent,WA-98030- $1,412.16 PAYROLL 7415 CORRECTION: DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 $79.61,CREDIT UNION:$13.65, • Union Dues: ' $23.27 I 2. Landscape Construction RG 0.00 0.00 0.00 0.00 0.00 2.00 0.00 2.00 $40.36 $80.72 SOCIAL Landscape SECURITY: Construction/Landscaping Or $88.87,Workers' Planting Laborers OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 Compensation: (King) $11.78, Paid BENJAMIN Family Medical "'"'"'""" GARCIA $80.72/ Leave:$8.34, 1315 SW 114th St $1,433.34 $0.00/hr $0.00 $109.54 Medicare:$20.79, $1,075.47 • Seattle,WA-98146 CREDIT UNION: DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 $13.65, Union Dues:$23.27, PAYROLL CORRECTION: $81.63 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side 3. Landscape Construction SOCIAL RG 0.00 0.00 0.00 0.00 0.00 2.00 0.00 2.00 $40.36 $80.72 Landscape SECURITY: Construction/Landscaping Or $82.31,Medicare: Planting Laborers OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 $19.25,Workers' (King) Compensation: $11.78,Paid ADRIAN Family Medical MARTINEZ $80.72/ Leave:$7.73, 11235 1st Ave S $1,327.46 $0.00/hr $0.00 $131.52 401(k):$53.10, $886.90 Seattle,WA-98168 CREDIT UNION: DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 $22.05,Union Dues:$37.59, Payroll Correction: $75.23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 5/29/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: nTall Avenue NE 5/7/2023 5/13/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.REYNALDO AMEZCUA Landscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) • ENJAMIN GARCIA _ Ascape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) 3.ADRIAN MARTINEZ Landscape Construction Landscape $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Construction/Landscaping Or Planting Laborers F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. (c,\4 iy apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ling Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature SARAH MICHAEL OFFICE ADMINISTRATOR SARAH MICHAEL Notes ALL FRINGE BENEFITS PAID DIRECTLY TO THE EMPLOYEE. MB 6/6/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and F,STATE Project Name County Project or Contract# <' i9.(•,, Prime Contractor E Industries _ Prevailing Wage Program �i��. �"::tee=" Duvall Avenue NE King CAG-20-065 fii. .••4. Subcontractor ►� PO Box 44540 4i;9;:.Apil y Project Address Olympia WA 98504-4540 H1 ° Final Week of 1 (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 5/6/2023 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 Day and Date Deductions Work Classification Name C9 ~O 9-I Sun Mon Tue Wed Thu Fri Sat Total a) Gross Amount and And a) E 4/30 5/1 5/2 5/3 5/4 5/5 5/6 Total Rate Earned/Gross Hourly Net Wages m E i= Hours of Pay "Usual FICA Withholding Other r a) Payroll Benefits" Tax Soc Sec#of Employee Address CD O o Hours Worked Each Day IX 0 1. Landscape Construction RG 0.00 4.00 6.00 0.00 0.00 0.00 0.00 10.00 $4�.36 $403.60 SOCIAL Landscape SECURITY: Construction/Landscaping Or $87.39,Workers' Planting Laborers OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 Compensation: (King) JAMIE FONSECA , 4 $11.78,Medicare: ESPARZA $403.60/ $20.44,CREDIT _ _ .. 4030 S 140th St $1,409.50 $0.00/hr $0.00 $106.68 UNION:$9.45, $1,154.08 Tukwila,WA- Paid Family 98168 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 Medical Leave: $3.57, Union Dues:$16.11 indscape Construction SOCIAL RG 0.00 0.00 6.00 0.00 0.00 0.00 0.00 6.00 $40.36 $242.16 Lau uuscape SECURITY: Construction/Landscaping Or $80.13,Workers' Planting Laborers OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 Compensation: (King) $11.78,Medicare: ADRIAN $18.74, Paid MARTINEZ $242.16/ $0.00/hr $0.00 $124.13 Family Medical $940.23 11235 1st Ave S $1,292.46 Leave:$3.27, Seattle,WA-98168 CREDIT UNION: DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 $23.10,401(k): $51.70, Union Dues:$39.38 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 5/19/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 4/30/2023 5/6/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.JAMIE FONSECA ESPARZA Landscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) WRIAN MARTINEZ idscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side r _ The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. (F)Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and Ing Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature SARAH MICHAEL OFFICE ADMINISTRATOR SARAH MICHAEL Notes ALL FRINGE BENEFITS PAID DIRECTLY TO THE EMPLOYEE. MB 5/30/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �t,�,.,rt Project Name County Project or Contract# ,\i 3i °-, Prime Contractor E Industries �`•E' "`s Duvall Avenue NE King CAG-20-065 Prevailing Wage Program `, ; ^ Subcontractor PO Box 44540 '',.. - ;v Project Address Olympia WA 98504-4540 ` `""" Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone FOr the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 4/29/2023 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 Day and Date Deductions p Work Classification Name c 0b o Sun Mon Tue Wed Thu Fri Sat Total a, Gross Amount and And a) E 4/23 4/24 4/25 4/26 4/27 4/28 4/29 Total Rate Earned/Gross Hourly Net Wages E i Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address y Benefits" Tax o_ O o Hours Worked Each Day 0 No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 5/7/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 4/23/2023 4/29/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All-information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person: No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. (5)Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and sing Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature SARAH MICHAEL OFFICE ADMINISTRATOR SARAH MICHAEL MB 5/9/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and � ,. Project Name County Project or Contract# � �. , .t,'', Prime Contractor ❑ Industries 111: ` s Duvall Avenue NE King CAG-20-065 Prevailing Wage Program �,' +_ ,^1 Subcontractor PO Box 44540 ''yj" Project Address Olympia WA 98504-4540 ``rMa' Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 4/22/2023 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 Day and Date Deductions Work Classification Name c9 ~ 9- Sun Mon Tue Wed Thu Fri Sat Total ct O a) Gross Amount and And a) E 4/16 4/17 4/18 4/19 4/20 4/21 4/22 Total Rate Earned/Gross Hourly Net Wages m E Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address C Payroll Benefits" Tax ct O o' Hours Worked Each Day a No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 5/1/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: n-vall Avenue NE 4/16/2023 4/22/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. (RI Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ling Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature SARAH MICHAEL OFFICE ADMINISTRATOR SARAH MICHAEL MB 5/9/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and ��ST"T�o Prime Contractor ❑ Project Name County Project or Contract# Industries 4.::: 4 r Duvall Avenue NE King CAG-20-065 Prevailing Wage Program iif; `•°ieix ,1i� Subcontractor El PO Box 44540 .,..:, ' ov" Project Address Olympia WA 98504-4540 y` 18B"a Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 4/15/2023 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 Day and Date Deductions Work Classification Name c9 ~O la. Sun Mon Tue Wed Thu Fri Sat Total Gross Amount a) 4/9 4/10 4/11 4/12 4/13 4/14 4/15 Total Rate Hourly and And f4 E i Hours of Pay Earned/Gross "Usual Withholding Net Wages r a) Payroll FICA Other Soc Sec#of Employee Address ct O in o Hours Worked Each Day Benefits" Tax 0 1. Landscape Construction SOCIAL RG 0.00 0.00 0.00 0.00 8.00 0.00 0.00 8.00 $40.36 $322.88 Landscape SECURITY: Construction/Landscaping Or $76.68, Paid Planting Laborers OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 Family Medical (King) JAMIE FONSECA ) Leave:$3.13, ESPARZA V Medicare:$17.93, 4030 S 140th St $322.88/ $0.00/hr $0.00 $85.95 Workers' $1,013.23 Tukwila,WA- $1,236.80 Compensation: 98168 $11.48, Union DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 Dues:$17.90, CREDIT UNION: $10.50 3ndscape Construction SOCIAL RG 0.00 0.00 0.00 0.00 8.00 0.00 0.00 8.00 $40.36 $322.88 SECURITY: ECURITY: Construction/Landscaping Or $78.65, Medicare: Planting Laborers OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.45 $0.00 $18.40, Paid (King) RODRIGO Family Medical GARNICA Leave:$3.21, 21800 Pacific Hwy $322.88/ Workers' S $1,268.54 $0.00/hr $0.00 $50.07 Compensation: $1,050.22 Des Moines,WA- $11.19, Union 98198-7753 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.60 $0.00 Dues:$35.80, CREDIT UNION: $21.00 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 4/23/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 4/9/2023 4/15/2023 l "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.JAMIE FONSECA ESPARZA Landscape Construction • Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) ODRIGO GARNICA iscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ling Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature SARAH MICHAEL OFFICE ADMINISTRATOR SARAH MICHAEL Notes ALL FRINGE BENEFITS PAID DIRECTLY TO THE EMPLOYEE. MB 5/1/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and F"ArF Prime Contractor ❑ Project Name County Project or Contract# Industries 4�" _Ott`t"`y Duvall Avenue NE King CAG-20-065 Y Prevailing Wage Program z fit <f ^ Subcontractor El PO Box 44540 '',yJ.` •y Project Address Olympia WA 98504-4540 =" Final Week of (360)902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 4/8/2023 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 Day and Date Deductions IL- Work Classification Name c9 ~O o Sun Mon Tue Wed Thu Fri Sat Total a) Gross Amount and And a� E 4/2 4/3 4/4 4/5 4/6 4/7 4/8 Total Rate Earned/Gross Hourly Net Wages E Hours of Pay "Usual FICA Withholding Other r a) Payroll Benefits" Tax Soc Sec#of Employee Address O o Hours Worked Each Day 0 No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 4/17/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 4/2/2023 4/8/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. (s)_Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and `ling Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature SARAH MICHAEL OFFICE ADMINISTRATOR SARAH MICHAEL MB 4/20/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and ��`:-?k•�i:F Prime Contractor ❑ Project Name County Project or Contract# Industries =.•4. -: ;r - .,:•:2;y Duvall Avenue NE King CAG-20-065 Prevailing Wage Program <;ilf'. :'_.;�. Subcontractor PO Box 44540 ';� Project Address Olympia WA 98504-4540 ^"" Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 4/1/2023 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 Day and Date Deductions p Work Classification Name c9 ~O o, Sun Mon Tue Wed Thu Fri Sat Total Gross Amount and And am E 3/26 3/27 3/28 3/29 3/30 3/31 4/1 Total Rate Earned/Gross Hourly Net Wages E Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address CD Soc ,—°'o y Benefits" Tax o: O o Hours Worked Each Day 0 No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 4/9/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 3/26/2023 4/1/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. (F)A.ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ;iing Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature SARAH MICHAEL OFFICE ADMINISTRATOR SARAH MICHAEL MB 4/20/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �I,sTATA. Project Name County Project or Contract# Industries mire, Prime Contractor ❑ Prevailing Wage Program 4 • Duvall Avenue NE King CAG-20-065 ,._.... . Subcontractor N PO Box 44540 .a ,,v' Project Address Olympia WA 98504-4540 y� `""y Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 3/25/2023 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 Day and Date Deductions Work Classification Name c9 8 o Sun Mon Tue Wed Thu Fri Sat Total X O a, Gross Amount and And a) E 3/19 3/20 3/21 3/22 3/23 3/24 3/25 Total Rate Earned/Gross Hourly Net Wages j E Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address m a) a y Benefits" Tax ct O o Hours Worked Each Day 0 No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 3/29/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 3/19/2023 3/25/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. Ic\-any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ;ung Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature SARAH MICHAEL OFFICE ADMINISTRATOR SARAH MICHAEL MB 4/20/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and .•,.,,TE Project Name County Project or Contract# ,,,`t: Prime Contractor E Industries -• "'• 's Duvall Avenue NE King CAG-20-065 Prevailing Wage Program j' ' si :: Subcontractor PO Box 44540 '`r'°, °- Project Address Olympia WA 98504-4540 Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 3/18/2023 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 Day and Date Deductions p Work Classification Name c9 O~ o Sun Mon Tue Wed Thu Fri Sat Total ap a� E 3/12 3/13 3/14 3/15 3/16 3/17 3/18 Total Rate Hourly and And i Earned/Gross Gross Amount Net Wages E Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address al a) y Benefits" Tax o! O o' Hours Worked Each Day a No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 3/27/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 3/12/2023 3/18/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. ' 'Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ling Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature SARAH MICHAEL OFFICE ADMINISTRATOR SARAH MICHAEL MB 4/20/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �c,STATT. Prime Contractor ❑ Project Name County Project or Contract# .... i.., Industries ; .... _ f a e::: � Duvall Avenue NE King CAG-20-065 Prevailing Wage Program <;iiiii. . r Subcontractor Z PO Box 44540 s' .2 Project Address Olympia WA 98504-4540 H` 'a$9'� Final Week of (360)902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 3/11/2023 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 Day and Date Deductions p Work Classification Name c9 0 I2. Sun Mon Tue Wed Thu Fri Sat Total Gross Amount and And — a) E 3/5 3/6 3/7 3/8 3/9 3/10 3/11 Total Rate Earned/Gross Hourly Net Wages E Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address c y Benefits" Tax cC O o Hours Worked Each Day a No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 3/19/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 3/5/2023 3/11/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F)Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s)have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible,-have been made by any person either directly or indirectly from the full wages earned. 5)Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and 'raining Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature SARAH MICHAEL OFFICE ADMINISTRATOR SARAH MICHAEL MB 3/23/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and ��F,STATF,'U� Prime Contractor ❑ Project Name County Project or Contract# Industries f. Duvall Avenue NE King CAG-20-065 PrevailingWage Program -...: ""_ 9 9 :::�, Subcontractor PO Box 44540 �d'':•�' v° Project Address Olympia WA 98504-4540 H` ' s ao Final Week of (360)902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 3/4/2023 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 Day and Date Deductions p Work Classification Name & ~ ° Sun Mon Tue Wed Thu Fri Sat Total o_ O cu Gross Amount and And cu E 2/26 2/27 2/28 3/1 3/2 3/3 3/4 Total Rate Earned/Gross Hourly Net Wages Eco Hours of Pay y "Usual FICA Withholding Other Soc Sec#of Employee Address c cu > Payroll Benefits" Tax ce O 3 Hours Worked Each Day a No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 3/13/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 2/26/2023 3/4/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F)Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F ) No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: • • (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s)have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions,other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. ",5)Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and i raining Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature SARAH MICHAEL OFFICE ADMINISTRATOR SARAH MICHAEL MB 3/23/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and TAT;: Project Name County Project or Contract# \\t "i i- Prime Contractor CIIndustries _ i, iE4,y Duvall Avenue NE King CAG-20-065 Prevailing Wage Program �li;. ,+: Subcontractor PO Box 44540 '; '•y",` os2 Project Address Olympia WA 98504-4540 ` '"d"a Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 2/25/2023 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 Day and Date Deductions p Work Classification Name C9 ~O o Sun Mon Tue Wed Thu Fri Sat Total a'and And a) E 2/19 2/20 2/21 2/22 2/23 2/24 2/25 Total Rate Gross Amount Earned/Gross Hourly Net Wages 73 Hours of Pay Payroll "Usual FICA ,',Withholding Other Soc Sec#of Employee Address cp a) a Benefits" Tax O o Hours Worked Each Day 0 No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date Andrew Falaniko Project Manager 2/28/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: n"wall Avenue NE 2/19/2023 2/25/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side .F The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. • (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced projects) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. }" ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ,ning Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature Andrew Falaniko Project Manager Andrew Falaniko MB 2/28/23 • F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side • r Certified Payroll Report Department of Labor and �� STATE�� Project Name County Project or Contract# Industries ,,,: ,f Prime Contractor ❑ �:„, Duvall Avenue NE KingCAG-20-065 Prevailing Wage Program pi;:: ii. Subcontractor ® , "'!1 PO Box 44540 ' y'4' goy,-r Project Address Olympia WA 98504-4540 '"�y Final Week of (360) 902-5335 Payroll El Awarding Agency Name Phone Company Name Phone FOr the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 2/18/2023 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 Day and Date Deductions i= Work Classification Name C0 ~• O o Sun Mon Tue Wed Thu Fri Sat Total m Gross Amount and And E 2/12 2/13 2/14 2/15 2/16 2/17 2/18 Total Rate Hourly `m• E Hours of Pay Earned/Gross "Usual FICA Withholding Other Net Wages Soc Sec#of Employee Address • o o Hours Worked Each Day PayrollIX Benefits" Tax o J J 1. Landscape Construction SOCIAL RG 0.00 2.00 0.00 0.00 0.00 0.00 0.00 2.00 $40.36 $80.72 Landscape SECURITY: Construction/Landscaping Or $88.03,Medicare: Planting Laborers OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 j $20.58,Workers' (King) REYNALDO Compensation: AMEZCUA $80.72/ $11.78,Paid Itelr..nt _ ., 1720 Maple Ln $1 419 72 $0.00/hr $0.00 $107.90 Family Medical $1,136.72 Kent,WA-98030- Leave:$3.59, 7415 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 Union Dues: $32.22,CREDIT UNION:$18.90 andscape Construction SOCIAL RG 0.00 2.00 0.00 0.00 0.00 0.00 0.00 2.00 $40.36 $80.72 L SECURITY: Landscape Construction/Landscaping Or $90.37,Medicare: Planting Laborers OT I 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 $21.14,Workers' (King) BENJAMIN I Compensation: GARCIA $80.72/ $11.78, Paid 1315 SW 114th St $1,457.64 $0.00/hr $0.00 $112.46 Family Medical $1,167.08 Seattle,WA-98146 Leave:$3.69, DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 Union Dues: $32.22,CREDIT UNION:$18.90 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 2/26/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: ..vaII Avenue NE 2/12/2023 2/18/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F ) 1.REYNALDO AMEZCUA Landscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) BENJAMIN GARCIA __ndscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. "hs'1ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and fining Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature SARAH MICHAEL OFFICE ADMINISTRATOR SARAH MICHAEL Notes ALL FRINGE BENEFITS PAID DIRECTLY TO THE EMPLOYEE. MB 2/28/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �F,STATe Project Name County Project or Contract# ...i Prime Contractor ❑ Industries ;'•' "`,,r Duvall Avenue NE King CAG-20-065 Prevailing Wage Program 4{::. ,,.i ,, Subcontractor NI PO Box 44540 " i` • _�' Project Address rye 1nau '�v Final Week of Olympia WA 98504-4540 (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 2/11/2023 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 _ Day and Date Deductions ~ - - Work Classification Name C9 ~O o Sun Mon Tue Wed Thu Fri Sat Total m Gross Amount and And a) E 2/5 2/6 2/7 2/8 2/9 2/10 2/11 Total Rate Earned/Gross Hourly Net Wages E iz Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address - > - Benefits" W O o' Hours Worked Each Day 0 No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 2/18/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 2/5/2023 2/11/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side - r The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. ,'=`,,Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and .fining Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature SARAH MICHAEL OFFICE ADMINISTRATOR SARAH MICHAEL MB 2/23/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and t, .T "�ATA,, CI Name County Project or Contract# , Prime Contractor Industries `�."� +" 7 Duvall Avenue NE King CAG-20-065 Prevailing Wage Program 4 =Wi j ,i:!mx Subcontractor PO Box 44540 "�°" w H' r`,` Project Address Olympia WA 98504-4540 ` `""y Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 2/4/2023 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 Day and Date Deductions p Work Classification Name c9 p o Sun Mon Tue Wed Thu Fri Sat Total a) Gross Amount and And a) E 1/29 1/30 1/31 2/1 2/2 2/3 2/4 Total Rate Earned/Gross Hourly Net Wages E i Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address m B y Benefits" Tax O o Hours Worked Each Day a 1. Landscape Construction SOCIAL RG 0.00 0.00 0.00 0.00 0.00 6.00 0.00 6.00 $40.36 $242.16 Landscape SECURITY: Construction/Landscaping Or $86.18, Paid Planting Laborers REYNALDO OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 Family Medical (King) AMEZCUA $242.16/ Leave:$3.52, 1720 Maple Ln $1,389.94 $0.00/hr $0.00 $104.33 Medicare:$20.15, $1,166.34 Kent,WA-98030- Workers' 7415 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 Compensation: $9.42 2. Landscape Construction SOCIAL RG 0.00 0.00 0.00 4.00 0.00 0.00 0.00 4.00 $40.36 $161.44 dscape SECURITY: struction/Landscaping Or $93.14,Paid Planting Laborers JAMIE FONSECA OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 Family Medical (King) ESPARZA $161.44/ Leave:$3.80, 4030 S 140th St $1,502.30 $0.00/hr $0.00 $117.81 Medicare:$21.79, $1,253.98 Tukwila,WA- Workers' 98168 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 Compensation: $11.78 3. Landscape Construction RG 0.00 0.00 0.00-0.00 0.00 6.00 0.00 6.00 $40 36 $242.16 SOCIAL Landscape SECURITY: Construction/Landscaping Or BENJAMIN I $99.76,Medicare: Planting Laborers GARCIA OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 $242.16/ $23.33,Workers' (King) 1315 SW 114th St $1,609.04 $0.00/hr $0.00 $130.62 Compensation: $1,339.48 Seattle,WA-98146 $11.78,Paid « _= DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 Family$4.Medical Leave:$4.07 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side 4. Landscape Construction SOCIAL RG 0.00 0.00 0.00 4.00 0.00 0.00 0.00 4.00 $40.36 $161.44 Landscape SECURITY: Construction/Landscaping Or $79.82,Medicare: Planting Laborers OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 $18.67,Workers' (King) JOSE HERNANDEZ Compensation: 7001 Old Redmond $161.44/ $11.78, Paid Rd $1 287 44 $0.00/hr $0.00 $19.02 Family Medical $1,125.13 Redmond,WA- Leave:$3.26, 98052 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 Union Dues: $25.06,CREDIT UNION:$4.70 5. Landscape Construction RG 0.00 0.00 0.00 8.00 0.00 0.00 0.00 8.00 $40.36 $322.88 SOCIAL Landscape SECURITY: struction/Landscaping Or $83.15,Medicare: iting Laborers OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 $19.45,Workers' (King) Compensation: TIMOTHY TILT $11.78, Paid `" 2113 147th Street Family Medical Ct E $322.88/ $0.00/hr $0.00 $82.11 Leave:$3.39, $896.72 Tacoma,WA- $1,341.12 LOAN PAYBACK: $100.00,401(k): 98445 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 $53 64,CREDIT UNION:$33.60, Union Dues: $57.28 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 2/12/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: ^zvall Avenue NE 1/29/2023 2/4/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.REYNALDO AMEZCUA Landscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) JAMIE FONSECA ESPARZA ,andscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) 3.BENJAMIN GARCIA Landscape Construction Landscape $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Construction/Landscaping Or Planting Laborers F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side (King) 4.JOSE HERNANDEZ Landscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) TIMOTHY TILT ' _c.ndscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side c a The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s)have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. "`. ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and .,fining Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature SARAH MICHAEL OFFICE ADMINISTRATOR SARAH MICHAEL Notes ALL FRINGE BENEFITS PAID DIRECTLY TO THE EMPLOYEE. MB 2/13/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and ��,F_ Project Name County Project or Contract# ,?i, t.6 Prime Contractor ❑ Industries " Ilk 4 tti:, ,;=:r Duvall Avenue NE King CAG-20-065 Prevailing Wage Program 4iiii,. viiii.x Subcontractor ,..11111, 'ig, PO Box 44540 °''i'•', , �;' Project Address Olympia WA 98504-4540 y` ' "'a Final Week of (360) 902-5335 Payroll E Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 1/28/2023 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 Day and Date Deductions p Work Classification Name 0 ~O o Sun Mon Tue Wed Thu Fri Sat Total a)and And a� E 1/22 1/23 1/24 1/25 1/26 1/27 1/28 Total Rate Gross Amount Earned/Gross Hourly Net Wages m E i Hours of Pay "Usual Withholding rn r a, Other Payroll FICA Soc Sec#of Employee Address ET O o Benefits" Tax Hours Worked Each Day 0 1. Landscape Construction J SOCIAL RG 0.00 0.00 0.00 0.00 0.00 4.00 0.00 4.00 $40.36 $161.44 SECURITY: Landscape Construction/Landscaping Or $91.87, Paid Planting Laborers OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 / Family Medical (King) REYNALDO J Leave:$3.75, AMEZCUA Medicare:$21.49, 1720 Maple Ln $161.44/ $0.00/hr $0.00 $115.35 Workers' $1,226.16 Kent,WA-98030 $1,481.76 Compensation: 7415 $11.78,CREDIT DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 UNION:$4.20, Union Dues: $7.16 z. Landscape Construction SOCIAL RG 0.00 0.00 0.00 0.00 0.00 4.00 0.00 4.00 $40.36 $161.44 Landscape SECURITY: Construction/Landscaping Or $100.10, Paid Planting Laborers OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 Family Medical Leave:$4.08, (King) BENJAMIN Medicare:$23.41, GARCIA $161.44/ $0.00/hr $0.00 $131.28 Workers' $1,332.47 1315 SW 114th St $1,614.48 Compensation: Seattle,WA-98146 $11.78,CREDIT DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 UNION:$4.20, Union Dues: $7.16 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's, Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 1/31/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: ,bo-,vall Avenue NE 1/22/2023 1/28/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.REYNALDO AMEZCUA Landscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) 3ENJAMIN GARCIA _ -idscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and 'ping Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature SARAH MICHAEL OFFICE ADMINISTRATOR SARAH MICHAEL Notes ALL FRINGE BENEFITS PAID DIRECTLY TO THE EMPLOYEE. MB 2/6/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and ,T�Tt Project Name County Project or Contract# Industries .c �'' `'=i,s Prime Contractor ❑ r.m �3,r Duvall Avenue NE King CAG-20-065 Prevailing Wage Program • Subcontractor XI PO Box 44540 y'", w° Project Address Olympia WA 98504-4540 f�� 1 80 Final Week of (360) 902-5335 Payroll El Awarding Agency Name Phone Company Name Phone FOr the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 1/21/2023 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 Day and Date Deductions P Work Classification Name c9 ~O o Sun Mon Tue Wed Thu Fri Sat Total a) Gross Amount and And a) E 1/15 1/16 1/17 1/18 1/19 1/20 1/21 Total Rate Earned/Gross Hourly Net Wages j E i Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address a) w a y Benefits" Tax ce O o Hours Worked Each Day 0 1. Landscape Construction SOCIAL RG 0.00 0.00 3.00 4.00 0.00 0.00 0.00 7.00 $40.36 $282.52 Landscape SECURITY: Construction/Landscaping Or $82.62, Medicare: Planting Laborers OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 $19.32,Workers' (King) REYNALDO Compensation: AMEZCUA $282.52/ $9.42,Paid _ _ .. 1720 Maple Ln $1,332.60 $0.00/hr $0.00 $97.45 Family Medical $1,100.54 Kent,WA-98030- Leave:$3.37, 7415 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 Union Dues: $12.53,CREDIT UNION:$7.35 andscape Construction SOCIAL RG 0.00 0.00 3.00 4.00 0.00 0.00 0.00 7.00 $40.36 $282.52 Landscape SECURITY: Construction/Landscaping Or $80.41,Medicare: Planting Laborers OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 $18.81, Paid (King) Family Medical BENJAMIN Leave:$3.28, _ _ *. GARCIA $282.52/ $0.00/hr $0.00 $93.18 Workers' $1,052.14 1315 SW 114th St $1,297.00 Compensation: Seattle,WA-98146 $9.42, Union DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 Dues:$25.06, CREDIT UNION: $14.70 3. Landscape Construction RODRIGO SOCIAL RG 0.00 0.00 6.00 0.00 0.00 0.00 0.00 6.00 $40.36 $242.16 GARNICA $242.16/ $0.00/hr $0.00 $24.34 SECURITY: $914.17 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Landscape 21800 Pacific Hwy $1,024.16 $63.50,Medicare: OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.45 $0.00 Construction/Landscaping Or S $14.85,Workers' Planting Laborers Des Moines,WA- Compensation: (King) 98198-7753 $4.71,Paid Family Medical DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.60 $0.00 Leave:$2.59 4. Landscape Construction SOCIAL RG 0.00 0.00 6.00 0.00 0.00 0.00 0.00 6.00 $40.36 $242.16 Landscape _ SECURITY: Construction/Landscaping Or $77.47, Medicare: Planting Laborers OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 $18.12, Paid (King) SERGIO Family Medical HERNANDEZ Leave:$3.16, _ _ 7001 Old Redmond $242.16/ $0.00/hr $0.00 $0.00 Workers' $1,124.39 Rd $1,249.60 Compensation: Redmond,WA- $9.42, Union 98052 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 Dues:$10.74, DCREDIT UNION:$6.30 5. Landscape Construction SOCIAL RG 0.00 0.00 6.00 0.00 0.00 0.00 0.00 6.00 $40.36 $242.16 Landscape SECURITY: Construction/Landscaping Or $75.11, Medicare: Planting Laborers OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 $17.57, Paid (King) Family Medical ADRIAN Leave:$3.06, MARTINEZ $242.16/ Workers' 11235 1st Ave S $1 211 42 $0.00/hr $0.00 $107.01 Compensation: $911.03 Seattle,WA-98168 $9.42,CREDIT DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 UNION:$14.70, 401(k):$48.46, Union Dues: $25.06 6. Landscape Construction RG 0.00 0.00 6.00 0.00 0.00 0.00 0.00 6.00 $40.36 $242.16 SOCIAL Landscape SECURITY: 3truction/Landscaping Or $81.83,Medicare: ting Laborers ANTONIO OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 " $19.14,Workers' knit ig) RODRIGUEZ $242.16/ $0.00/hr $0.00 $159.70 Compensation: $1,046.33 3709 Jones Ave NE $1,319.76 $9.42,Paid _ _ .. Renton,WA-98056 Family Medical DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 Leave:$3.34 7. Landscape Construction SOCIAL RG 0.00 0.00 6.00 0.00 4.00 0.00 0.00 10.00 $40.36 $403.60 Landscape SECURITY: Construction/Landscaping Or $82.74, Paid Planting Laborers TIMOTHY TILT OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 Family Medical (King) 2113 147th Street $403.60/ Leave:$3.38, Ct E $1,334.54 $0.00/hr $0.00 $81.35 Medicare:$19.35, $936.64 Tacoma,WA- Workers' 98445 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 Compensation: $9.42,CREDIT UNION:$17.85, 401(k):$53.38, F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Union Dues: $30.43,LOAN PAYBACK: $100.00 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 1/31/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: +vallAvenue NE 1/15/2023 1/21/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.REYNALDO AMEZCUA Landscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) BENJAMIN GARCIA Tndscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) 3.RODRIGO GARNICA Landscape Construction Landscape $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Construction/Landscaping Or Planting Laborers F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side (King) 4.SERGIO HERNANDEZ Landscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) `,DRIAN MARTINEZ _J.iscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) 6.ANTONIO RODRIGUEZ Landscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting,Laborers (King) 'r1MOTHY TILT Iidscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. ,Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ning Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature SARAH MICHAEL OFFICE ADMINISTRATOR SARAH MICHAEL Notes ALL FRINGE BENEFITS PAID DIRECTLY TO THE EMPLOYEE. MB 2/6/23 • F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �sTaTF,� Project Name County Project or Contract# i =9A Prime Contractor ❑ Industries �::.: k o_::: `ii,� Duvall Avenue NE King CAG-20-065 PrevailingWage Program ~'°°° ""_ 9 9 ,::2 Subcontractor IZI PO Box 44540 ", ► oyn Project Address Olympia WA 98504-4540 ` �888 Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 • 1/14/2023 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 Day and Date Deductions p Work Classification Name 6 O~ E Sun Mon Tue Wed Thu Fri Sat Gross Amount Total and And a) E 1/8 1/9 1/10 1/11 1/12 1/13 1/14 Total Rate Earned/Gross Hourly Net Wages j E i- Hours of Pay Payroll "Usual FICA Withholding Other rn Benefits" Tax Soc Sec#of Employee Address IY O o Hours Worked Each Day 0 1. Landscape Construction Medicare:$20.00, RG 0.00 0.00 0.00 5.00 0.00 0.00 0.00 5.00 $40.36 $201.80 SOCIAL Landscape SOCIAL Construction/Landscaping Or SECURITY: Planting Laborers OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 $85.49,Workers' (King) Compensation: RAUL ALEJANDRE $11.48, Paid '. 18822 77th Avenue Family Medical Ct E $201.80/ $0.00/hr $0.00 $0.00 Leave:$3.49, $1,155.18 Puyallup,WA- $1,378.78 CREDIT UNION: 98375 $9.45,401(k): DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 $27.58, Union Dues:$16.11, LOAN PAYBACK: $50.00 2. Landscape Construction SOCIAL RG 0.00 6.00 6.00 0.00 0.00 0.00 0.00 12.00 $40.36 $484.32 Landscape SECURITY: Construction/Landscaping Or $77.91, Medicare: Planting Laborers OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 $18.22,Workers' (King) REYNALDO Compensation: AMEZCUA $484.32/ $11.19, Paid t _ _lc*** 1720 Maple Ln $1,256.54 $0.00/hr $0.00 $88.32 Family Medical $998.08 Kent,WA-98030- Leave:$3.18, 7415 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 Union Dues: $37.59,CREDIT UNION:$22.05 3. Landscape Construction AARON FALANIKO SOCIAL 2224 NE 31st St RG 0.00 0.00 0.00 0.00 8.00 8.00 0.00 16.00 $47.84 $765.44 $765.44/ $0.00/hr $0.00 $255.05 SECURITY: $1,340.49 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Landscape Renton,WA-98056 $1,845.44 $114.42, Construction/Landscaping Or OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $71.76 $0.00 Medicare:$26.76, Planting Laborers Paid Family (King) Medical Leave: $4.67,Workers' DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $95.68 $0.00 Compensation: $11.78,401(k): $92.27 4. Landscape Construction RG 0.00 0.00 0.00 0.00 7.00 7.00 0.00 14.00 $40.36 $565.04 SOCIAL Landscape SECURITY: Construction/Landscaping Or JAMIE FONSECA $89.82,Medicare: Planting Laborers ESPARZA OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 $21.00,Workers' (King) 4030 S 140th St $565.04/ $0.00/hr $0.00 $111.38 Compensation: $1,211.58 Tukwila,WA- $1,448.64 $11.19,Paid 98168 Family Medical DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 Leave:$3.67 5. Landscape Construction RG 0.00 6.00 6.00 0.00 0.00 0.00 0.00 12.00 $40.36 $484.32 SOCIAL Landscape _ SECURITY: Construction/Landscaping Or $77.91, Paid Planting Laborers OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 Family Medical (King) BENJAMIN J Leave:$3.18, Workers' _ _ .. GARCIA $484.32/ 1315 SW 114th St $0.00/hr $0.00 $88.32 Compensation: $998.08 $1,256.54 $11.19,Medicare: Seattle,WA-98146 $18.22, Union DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 Dues:$37.59, CREDIT UNTO: $22.05 6. Landscape Construction $1,089.7 SOCIAL RG 0.00 0.00 6.00 7.00 7.00 7.00 0.00 27.00 $40.36 Landscape 2 SECURITY: Construction/Landscaping Or RODRIGO $71.84,Medicare: Planting Laborers GARNICA OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.45 $0.00 $16.80,Paid (King) 21800 Pacific Hwy $1,089.72 Family Medical S / $0.00/hr $0.00 $37.80 Leave:$2.93, $1,020.52 Des Moines,WA- $1,158.72 Workers' 98198-7753 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.60 $0.00 Compensation: $8.83 7. Landscape Construction RG 0.00 0.00 0.00 0.00 7.00 0.00 0.00 7.00 $40.36 $282.52 SOCIAL Landscape SECURITY: Construction/Landscaping Or $88.06, Paid Planting Laborers JOSE HERNANDEZ OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 Family Medical (King) 7001 Old Redmond Leave:$3.59, $282.52/ Rd $0.00/hr $0.00 $48.26 Medicare:$20.60, $1,248.68 +. Redmond,WA- $1,420.38 _ _ Paid Family 98052 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 Medical Leave: $11.19 8. Landscape Construction SERGIO SOCIAL HERNANDEZ RG 0.00 0.00 0.00 0.00 7.00 7.00 0.00 14.00 $40.36 $565.04 $565.04/ $0.00/hr $0.00 $0.00 SECURITY: $1,286.43 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side 1 _. Landscape 7001 Old Redmond $1,408.64 $87.34, Paid Construction/Landscaping Or Rd OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 Family Medical Planting Laborers Redmond,WA- Leave:$3.56, (King) 98052 Workers' Compensation: ....jar_3*** DT 0.00 0.00- 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 $10.89,Medicare: $20.42 9. Landscape Construction $1,331.8 SOCIAL • RG 0.00 6.00 6.00 7.00 7.00 7.00 0.00 33.00 $40.36 Landscape 8 SECURITY: Construction/Landscaping Or $88.03,Paid Planting Laborers OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 Family Medical Kin ADRIAN Leave:$3.59, ( 9) $1,331.88 MARTINEZ / $0.00/hr $0.00 $151.04 Medicare:$20.59, $1,088.94 ...««.«.* 11235 1st Ave S $1,419.88 Workers' Seattle,WA-98168 Compensation: DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 $10.89,401(k): $56.80 • • 10. Landscape Construction SOCIAL RG 0.00 6.00 0.00 0.00 7.00 0.00 0.00 13.00 $40.36 $524.68 SECURITY: Landscape Construction/Landscaping Or $90.36,Paid Planting Laborers OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 Family Medical (King) OSVALDO PEREZ Leave:$3.69,Medicare:$21.14, ALFARO $524.68/ *Or*' `*" 3123 S 268th PI $1,457.46 $0.00/hr $0.00 $184.43 Workers' $996.83 Kent,WA-98032 Compensation: DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 $11.48,CHILD SUPPORT: $149.53 11. Landscape Construction $1,251.1 SOCIAL Landscape RG 0.00 6.00 6.00 5.00 7.00 7.00 0.00 31.00 $40.36 6 SECURITY: Construction/Landscaping Or $85.38,Paid Planting Laborers ANTONIO OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 Family Medical (King) RODRIGUEZ $1,251.16 Leave:$3.48, 3709 Jones Ave NE / $0.00/hr $0.00 $172.33 Medicare:$19.97, $1,085.11 ***-**«**« Renton,WA-98056 $1,377.16 Workers' DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 Compensation: $10.89 12. Landscape Construction $1,372.2 SOCIAL Landscape RG 0.00 6.00 8.00 8.00 5.00 7.00 0.00 34.00 $40.36 4 SECURITY: Construction/Landscaping Or $92.52,Medicare: Planting Laborers OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 $21.63,Paid (King) TIMOTHY TILT Family Medical 2113 147th Street $1,372.24 Leave:$3.78, **•* **** Ct E / $0.00/hr $0.00 $99.52 Workers' $1,103.91 Tacoma,WA- $1,492.24 Compensation: 98445 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 $11.19,LOAN PAYBACK: $100.00,401(k): $59.69 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side A of Affirmation Department of Labor and Industries - Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 1/23/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: �tuvall Avenue NE 1/8/2023 1/14/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.RAUL ALEJANDRE Landscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) REYNALDO AMEZCUA • Landscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) 3.AARON FALANIKO Landscape Construction Landscape $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Construction/Landscaping Or Planting Laborers F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side (King) 4.JAMIE FONSECA ESPARZA Landscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) BENJAMIN GARCIA indscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) 6.RODRIGO GARNICA Landscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) JOSE HERNANDEZ 3ndscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) 8.SERGIO HERNANDEZ Landscape Construction Landscape $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Construction/Landscaping Or Planting Laborers F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side (King) 9.ADRIAN MARTINEZ Landscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) OSVALDO PEREZ ALFARO {indscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) 11.ANTONIO RODRIGUEZ Landscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) TIMOTHY TILT ndscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) • F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. «�Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and fining Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature SARAH MICHAEL OFFICE ADMINISTRATOR SARAH MICHAEL Notes ALL FRINGE BENEFITS PAID DIRECTLY TO THE EMPLOYEE. MB 1/3.0/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �w STAr� Project Name County Project or Contract# Prime Contractor ❑ Industries o`` „,y Duvall Avenue NE King CAG-20-065 a••• tiix Prevailing Wage Program 4...: ,::,2) Subcontractor ZI PO Box 44540 •AP ,,, Project Address Olympia WA 98504-4540 yy 1888 a Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 1/7/2023 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 Day and Date Deductions Work Classification Name & o -(;---1 Sun Mon Tue Wed Thu Fri Sat Total a) Gross Amount and And a) E 1/1 1/2 1/3 1/4 1/5 1/6 1/7 Total Rate Earned/Gross Hourly Net Wages E Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address aa)- a Payroll Benefits" Tax o O aHours Worked Each Day 0 1. Landscape Construction si $1,049.3 SOCIAL RG 0.00 0.00 7.00 6.00 7.00 6.00 0.00 26.00 $40.36 6J SECURITY: Landscape __ Construction/Landscaping Or REYNALDO J $80.56,Workers' Planting Laborers AMEZCUA OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 $1,049.36 Compensation: (King) 1720 Maple Ln I $0.00/hr $0.00 $93.46 $8.24,Paid $1,094.97 Kent,WA-98030- $1,299.36 Family Medical `. 7415 Leave:$3.29, DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 Medicare:$18.84 2. Landscape Construction $1,049.3 SOCIAL RG 0.00 0.00 7.00 6.00 7.00 6.00 0.00 26.00 $40.36 Landscape 6 SECURITY: nstruction/Landscaping Or $80.56,Workers' inting Laborers BENJAMIN OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 $1,049.36 Compensation: (King) GARCIA - - / $0.00/hr $0.00 $93.46 $8.24,Paid $1,094.97 1315 SW 114th St Family Medical Seattle,WA-98146 $1,299.36 Leave:$3.29, DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 Medicare:$18.84 3. Landscape Construction $1,049.3 SOCIAL RG 0.00 0.00 7.00 6.00 7.00 6.00 0.00 26.00 $40.36 Landscape 6 SECURITY: Construction/Landscaping Or $78.70, Medicare: Planting Laborers ADRIAN OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 $18.40, Paid (King) MARTINEZ $1,049.36 Family Medical 11235 1st Ave S / $0.00/hr $0.00 $119.25 Leave:$3.21, $990.79 Seattle,WA-98168 $1,269.36 401(k):$50.77, DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 Workers' Compensation: $8.24 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Sick 4. Landscape Construction SOCIAL RG 0.00 0.00 0.00 6.00 7.00 6.00 0.00 19.00 $40.36 $766.84 SECURITY: Landscape _ Construction/Landscaping Or $68.01,Medicare: Planting Laborers OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 $15.91, Paid (King) TIMOTHY TILT Family Medical 2113 147th Street Leave:$2.78, Ct E $766.84/ $0.00/hr $0.00 $53.97 Workers' $805.82 Tacoma,WA $1,096.84 Compensation: 98445 $6.48,401(k): DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 $43.87,LOAN PAYBACK: $100.00 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side • Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 1/16/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: 'jvall Avenue NE / 1/1/2023 1/7/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms) Work Classification. Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F - 1.REYNALDOAMEZCUA Landscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers • • (King) BENJAMIN GARCIA i.3ndscape Construction - Landscape Construction/Landscaping Or $0.00 ($0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) - 3.ADRIAN MARTINEZ Landscape Construction Landscape $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Construction/Landscaping Or Planting Laborers F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side (King) 4.TIMOTHY TILT Landscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) L. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any y person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and lining Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature SARAH MICHAEL OFFICE ADMINISTRATOR SARAH MICHAEL Notes ALL FRINGE BENEFITS PAID DIRECTLY TO THE EMPLOYEE. MB 1/23/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and ��,STATR Project Name County Project or Contract# Industries 4 Prime Contractor ❑ a:::; , Duvall Avenue NE King CAG-20-065 Prevailing Wage Program _- x Subcontractor ►_� PO Box 44540 �'�' o4' Project Address Olympia WA 98504-4540 y` `�e�a Final Week of (360)902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 12/31/2022 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 Day and Date Deductions o Sun Mon Tue Wed Thu Fri Sat Work Classification Name c7 Total i: 2. a) 12/2 12/2 12/2 12/2 12/2 12/3 12/3 Gross Amount a) E Total Rate Hourly and And `m E i= 5 6 7 8 9 0 1 Hours of PayEarned/Gross °Usual Withholding Net Wages enr a, - Payroll Benefits" FICA Tax Other Soc Sec#of Employee Address a, a) a o_ O o' Hours Worked Each Day 0 No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 1/8/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: ^..vall Avenue NE 12/25/2022 12/31/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each Worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. 'RN,Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and lining Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature SARAH MICHAEL - OFFICE ADMINISTRATOR SARAH MICHAEL MB 1/10/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side r Certified Payroll Report Department of Labor and ,TA Tr: Project Name County Project or Contract# Industries �;,s'1'••"�4 Prime Contractor ❑ r,' ,i 7 Duvall Avenue NE King CAG-20-065 Prevailing Wage Program •"° Subcontractor PO Box 44540 ^�' wz Project Address Olympia WA 98504-4540 y` 'day c Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 12/24/2022 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 Day and Date Deductions o Sun Mon Tue Wed Thu Fri Sat Work Classification Name C� Total c 2 a 12/1 12/1 12/2 12/2 12/2 12/2 12/2 Gross Amount a) E Total Rate Hourly and And ER. g 9 0 1 2 3 4 Hours of Pay Earned/Gross "Usual FICA Withholding Other Net Wages Soc Sec#of Employee Address a) a Payroll Benefits" Tax cK 0 o Hours Worked Each Day 0 1. Landscape Construction SOCIAL RG 0.00 7.00 5.00 0.00 0.00 0.00 0.00 12.00 $40.36 $484.32 Landscape SECURITY: Construction/Landscaping Or $64.38,Workers' Planting Laborers OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 Compensation: (King) REYNALDO _ $5.66,Medicare: AMEZCUA $484.32/ $15.06, Paid _ _ <. 1720 Maple Ln $0.00/hr $0.00 $66.86 Family Medical $869.63 Kent,WA-98030- $1,038.42 Leave:$2.63, 7415 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 Union Dues: $8.95,CREDIT UNION:$5.25 2. Landscape Construction J `� SOCIAL RG 0.00 0.00 8.00 0.00 0.00 0.00 0.00 8.00 $47.84 $382.72 SECURITY: Landscape Construction/Landscaping Or $113.88, Planting Laborers OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $71.76 $0.00 / Workers' (King) AARON FALANIKO �J Compensation: 2224 NE 31st St $382.72/ $0.00/hr $0.00 $263.03 $7.36,Paid $1,329.51 .' Renton,WA-98056 $1,836.92 Family Medical Leave:$4.65, DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $95.68 $0.00 Medicare:$26.64, 401(k):$91.85 3. Landscape Construction BENJAMIN SOCIAL RG 0.00 7.00 5.00 0.00 0.00 0.00 0.00 12.00 $40.36 $484.32 Landscape GARCIA $484.32/ SECURITY: Construction/Landscaping Or 1315 SW 114th St $713.42 $0.00/hr $0.00 $29.80 $44.23,Workers' $607.39 Planting Laborers Seattle,WA-98146 OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 Compensation: F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side (King) $5.66, Paid Family Medical Leave:$1.80, Medicare:$10.34, DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 Union Dues: $8.95,CREDIT UNION:$5.25 4. Landscape Construction RG 0.00 7.00 5.00 0.00 0.00 0.00 0.00 12.00 $40.36 $484.32 SOCIAL Landscape SECURITY: Construction/Landscaping Or $43.37, Medicare: Planting Laborers OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 $10.14, Paid (King) Family Medical ADRIAN Leave:$1.77, ' **** MARTINEZ $484.32/ Workers' 11235 1st Ave S $699.42 $0.00/hr $0.00 $46.74 Compensation: $549.56 Seattle,WA-98168 $5.66, Union DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 Dues:$8.95, CREDIT UNION: $5.25,401(k): $27.98 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 12/27/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: Avenue NE 12/18/2022 12/24/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.REYNALDO AMEZCUA Landscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) ' ,AARON FALANIKO -,andscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) 3.BENJAMIN GARCIA Landscape Construction Landscape $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Construction/Landscaping Or Planting Laborers F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side (King) 4.ADRIAN MARTINEZ Landscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. "`,Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and dining Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to'prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature SARAH MICHAEL OFFICE ADMINISTRATOR SARAH MICHAEL Notes ALL FRINGE BENEFITS PAID DIRECTLY TO THE EMPLOYEE. • I � MB.1/10/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution.and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and ��$.s'AT a Project Name County Project or Contract# Industries ,,.,,,, s Prime Contractor ❑ o,::, z Duvall Avenue NE King CAG-20-065 Prevailing Wage Program �....: ";:x Subcontractor ►4 PO Box 44540 '11' Tw'z Project Address Olympia WA 98504-4540 ` 18ey Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone FOr the week ending: RENTON,CITY OF (425)430-7303 GREEN CITY INC (425)228-6488 Month Day Year Awarding Agency Address Address City State Zip+4 12/17/2022 1055 S GRADY WAY RENTON,WA-98055 2224 NE 31ST ST RENTON WA 98056 Day and Date Deductions ~ Sun Mon Tue Wed Thu Fri Sat Work Classification Name 0 I- o Total cc o w 12/1 12/1 12/1 12/1 12/1 12/1 12/1 Total Rate Gross Amount Hourly m E Earned/Gross Net Wages and And `m E 1 2 3 4 5 6 7 Hours of Pay "Usual FICA Withholding Other g Soc Sec#of Employee Address m a) z Payroll Benefits" Tax ix O 'o Hours Worked Each Day 0 J 1. Landscape Construction RG 0.00 0.00 7.00 7.00 7.00 0.00 0.00 21.00 $40.36 $847.56 SOCIAL Landscape SECURITY: Construction/Landscaping Or REYNALDO $94.30,Workers' Planting Laborers AMEZCUA OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 Compensation: $847.56/ $11.33, Paid (King) 1720 Maple Ln $1 521 08 $0.00/hr $0.00 $124.78 Family Medical $1,264.77 Kent,WA-98030- 7415 Leave:$3.85, DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 Medicare:$22.05 2. Landscape Construction SOCIAL RG 0.00 0.00 7.00 7.00 7.00 0.00 0.00 21.00 $40.36 $847.56 idscape SECURITY: istruction/Landscaping Or $96.57, Medicare: Planting Laborers BENJAMIN OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 J $22.58, Paid (King) GARCIA $847.56/ Family Medical 1315 SW 114th St $1,557.48 $0.00/hr $0.00 $129.15 Leave:$3.94, $1,293.91 Seattle,WA-98146 Workers' DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 Compensation: $11.33 3. Landscape Construction `/I \/ SOCIAL RG 0.00 0.00 7.00 7.00 7.00 0.00 0.00 21.00 $40.36 $847.56 SECURITY: Landscape Construction/Landscaping Or ADRIAN V $93.39, Medicare: Planting Laborers MARTINEZ OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $60.54 $0.00 $847.56/ $21.84, Paid (King) 11235 1st Ave S $1,506.30 $0.00/hr $0.00 $179.05 Family Medical $1,136.63 Seattle,WA-98168 Leave:$3.81, "` DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.72 $0.00 Workers' Compensation: $11.33,401(k): F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side $60.25 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date SARAH MICHAEL OFFICE ADMINISTRATOR 12/23/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GREEN CITY INC employed by: Project Name: For the week starting: For the week ending: " wall Avenue NE 12/11/2022 12/17/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.REYNALDO AMEZCUA Landscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) BENJAMIN GARCIA Landscape Construction Landscape Construction/Landscaping Or $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Planting Laborers (King) 3.ADRIAN MARTINEZ Landscape Construction Landscape $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Construction/Landscaping Or Planting Laborers F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. .-)Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and lining Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature SARAH MICHAEL OFFICE ADMINISTRATOR SARAH MICHAEL Notes ALL FRINGE BENEFITS PAID DIRECTLY TO THE EMPLOYEE. MB 1/10/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side