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HomeMy WebLinkAboutCAG-20-065 - Duvall - Subcontractor Ground Up 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 1171728 8/27/2021 Company Details Company Name: GROUND UP:ROAD CONST INC Address: PO BOX 1690 MILTON, WA, 98354 Contractor Registration No. GROUNUR929CR WA UBI Number 602790246 Phone Number 253-891-1413 Industrial Insurance Account ID 91560505 OMWBE Certifications as of 8/24/2021 No active certifications existed when Intent was submitted Email Address jackie®gmdup.com Filed By Jacqueline Wanaka Prime Contractor Company Name REED TRUCKING &t 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 1 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: 108240608 Intent Details Expected project start date: (MM/DD/YYYY) 9/27/2021 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 Time and materials this a time and materials estimate? Does your company intend to hire ANY No subcontractors? Will your company have employees perform Yes work on this project? f Do you intend to use any apprentices? No (Apprentices are considered employees.). How many owner/operators performing work on 0 the project own 30% or more of the company? Journey Level Wages County Trade Occupation Wage Fringe # Workers King Power Equipment Operators Roto-mill, Roto-grinder $58.60 $14.24 1 King Power Equipment Operators Brooms . $54.88 $14.24 1 King Truck Drivers Other Trucks $50.31 $14.24 1 Public Notes o Show/Hide.Existing Notes . -- On 8/24/2021:-- GU Job #21242 Truck Driver: Lowboy tractor/trailer to transport equipment to job site. Certified Payroll Report Department of Labor and �t,',�Tf Prime Contractor D Project Name County Project or Contract# ., < Industries 4a:. l: ; s;y Duvall Avenue NE King CAG-20-065 Prevailing Wage Program -i_= e1llt Subcontractor El PO Box 44540 '.;f Project Address Y ''Y Olympia WA 98504-4540 'hH Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 6/3/2023 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions p Work Classification Name c9 ~O o Sun Mon Tue Wed Thu Fri Sat Total a) Gross Amount and And 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 cm a) ID Payroll Benefits" Tax rY 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 Gale L Kirkendoll Payroll 6/7/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST 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 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 ding 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 Gale L Kirkendoll Payroll Gale L Kirkendoll M B 6/8/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and ,_,•�A7F Project Name County Project or Contract# Industries ;,, ,,,,is Prime Contractor E e°s •;G,Y Duvall Avenue NE King CAG-20-065 Prevailing Wage Program Ali: ;•: �� Subcontractor PO Box 44540 ,yIP' Project Address Olympia WA 98504-4540 4 ;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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 5/27/2023 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions p Work Classification Name c9 ~O Sun Mon Tue Wed Thu Fri Sat Total 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 —Dr.„, r a> Payroll Benefits" Tax Soc Sec#of Employee Address 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 Gale L Kirkendoll Payroll 6/7/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST 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. (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 Gale L Kirkendoll Payroll Gale L Kirkendoll MB 6/8/23 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:•r, Prime Contractor ❑ Project Name County Project or Contract# Industries ! "'i '`• Duvall Avenue NE King CAG-20-065 Prevailing Wage Program = ., °°= Subcontractor " , PO Box 44540 ' '`:,)i. ' y° Project Address Olympia WA 98504-4540 y` `"fig',1° Final Week of (360) 902-5335 Payroll ❑ • Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 5/20/2023 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions p Work Classification Name c7 0 -la Sun Mon Tue Wed Thu Fri Sat Total � 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 `m E i Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address a) Payroll Benefits" Tax W 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 Gale L Kirkendoll Payroll 6/7/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST 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 wilt 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 '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 Gale L Kirkendoll Payroll Gale L Kirkendoll MB 6/8/23 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,�T Arf Project Name County Project or Contract# .�,� silt., Prime Contractor ❑ Industries 4„'• "''y ' Duvall Avenue NE King CAG-20-065 Al.Prevailing Wage Program �`� `� 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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 5/13/2023 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions p Work Classification Name c9 b o Sun Mon Tue Wed Thu Fri Sat Total m Gross Amount and And 0 E 5/7 5/8 5/9 5/10 5/11 5/12 5/13 Total Rate Earned/Gross Hourly Net Wages E i - Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address cs m y Benefits" Tax IX 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 Gale L Kirkendoll Payroll 5/20/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: Duvall 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 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 Gale L Kirkendoll Payroll Gale L Kirkendoll MOB 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 ti sT..re Project Name County Project or Contract# k i i,t:°? Prime Contractor ❑ Industries dii "'`-y Duvall Avenue NE King CAG-20-065 Prevailing Wage Program <; l,, =.IJ! Subcontractor _� PO Box 44540 3'y% ;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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 5/6/2023 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions H Work Classification Name 3 ~O C2- 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 E Hours of Pay "Usual FICA Withholding Other fa) Payroll Benefits" Tax Soc Sec#of Employee Address o ct 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 Gale L Kirkendoll Payroll 5/20/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST 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 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 ,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 Gale L Kirkendoll Payroll Gale L Kirkendoll 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 ,�rF. Prime Contractor ❑ Project Name County Project or Contract# ,,?:e =E. Industries 4 d;. likt, Prevailing Wage Program ,,, ;= Duvall Avenue NE King CAG-20-065 `,iiii. 1 Subcontractor El PO Box 44540 ',?.• _: ^,v Project Address Olympia WA 98504-4540 �- it,h9 ` Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone FOf the week ending: RENTON,CITY OF (425)430-7303 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 4/29/2023 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions p Work Classification Name c9 O~ o Sun Mon Tue Wed Thu Fri Sat Total Gross Amount a) E 4/23 4/24 4/25 4/26 4/27 4/28 4/29 Total Rate Hourly and And @ E i= Hours of Pay Earned/Gross "Usual Withholding Net Wages FICA Other Soc Sec#of Employee Address EC O o Hours Worked Each Day Benefits"=• f a) Payroll Tax o 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 Gale L Kirkendoll Payroll 5/5/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: n"vall 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 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 Gale L Kirkendoll Payroll Gale L Kirkendoll 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 t,STAI' { Project Name County Project or Contract# .s.t '•'«..- Prime Contractor ❑ Industries s,= cs4" Duvall Avenue NE King CAG-20-065 Prevailing Wage Program ' ,, ;� Subcontractor PO Box 44540 °'` v4, Project Address Olympia WA 98504-4540 ff'` '""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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 4/22/2023 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions p Work Classification Name c9 0 o Sun Mon Tue Wed Thu Fri Sat Total 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 E H Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address m > .n Payroll 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 Gale L Kirkendoll Payroll 5/5/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: Duvall 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 I ) 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 'r 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 Gale L Kirkendoll Payroll Gale L Kirkendoll 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 ,t, Tjif Project Name County Project or Contract# :.1� ��L'A Prime Contractor ❑ Industries .tt'••�. '�,;y Duvall Avenue NE King CAG-20-065 Prevailing Wage Program �j'i{•. ' 11 ,,,, t,�3 Subcontractor PO Box 44540 ''Y}' . w 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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 4/15/2023 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions p Work Classification Name c9 ~O o Sun Mon Tue Wed Thu Fri Sat Total w Gross Amount and And w E 4/9 4/10 4/11 4/12 4/13 4/14 4/15 Total Rate Earned/Gross Hourly Net Wages Eco Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address Benefits" Tax Et O 0 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 Gale L Kirkendoll Payroll 4/24/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: ^ all Avenue NE 4/9/2023 4/15/2023 "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. (5)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 Gale L Kirkendoll Payroll Gale L Kirkendoll 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 oaf STATE• Project Name County Project or Contract# Industries 4:i i;,4 Prime Contractor ❑ m r Duvall Avenue NE King CAG-20-065 Prevailing Wage Program �iiiii. -'1i`: ��,;;;: •,:�• Subcontractor El PO Box 44540 '' 'i'1/ AC' Final Address Olympia WA 98504-4540 y` teNy Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone FOr the week ending: RENTON,CITY OF (425)430-7303 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 4/8/2023 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions H Work Classification Name c O~ o Sun Mon Tue Wed Thu Fri Sat Gross Amount Total and And �a E Hours of Pay Earned/Gross "Usual Withholding Net Wages Soc Sec#of Employee Address cC O -75 o Hours Worked Each Day Benefits f a) Payroll " FICA Other 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 Gale L Kirkendoll Payroll 4/24/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST 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. (5)Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and l '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 Gale L Kirkendoll Payroll Gale L Kirkendoll 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,STATF Project Name County Project or Contract# ?...5= =«_::, Prime Contractor ❑ Industries �:':" 4 Duvall Avenue NE King CAG-20-065 Prevailing Wage Program :ri=- _ IE ' ,;_.: .'':hi Subcontractor PO Box 44540 ' ' .� �,v' Project Address Olympia WA 98504-4540 y� '"fi° Final Week of (360)902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 4/1/2023 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions p Work Classification Name c9 0 o Sun Mon Tue Wed Thu Fri Sat Total Gross Amount and And a) E 3/26 3/27 3/28 3/29 3/30 3/31 4/1 Total Rate Earned/Gross Hourly Net Wages E i= Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address m ca a Payroll Benefits" Tax ce 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 Gale L Kirkendoll Payroll 4/7/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: n,,vall 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. (5)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 Gale L Kirkendoll Payroll Gale L Kirkendoll MB 4/7/23 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 ,A:Wit F Project Name County Project or Contract# Industries ^l. .r:, Prime Contractor Illy Duvall Avenue NE King CAG-20-065 Prevailing Wage Program f£=i; :'_ Subcontractor Z PO Box 44540 y'�;:, yr Project Address Olympia WA 98504-4540 y� '--"°1 Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 3/25/2023 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions H Work Classification Name c7 ~O -a Sun Mon Tue Wed Thu Fri Sat Total � 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 t r i Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address m a) a 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 Gale L Kirkendoll Payroll 4/7/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: n""vall 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. (5)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 Gale L Kirkendoll Payroll Gale L Kirkendoll MB 4/7/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side a Certified Payroll Report Department of Labor and a�sTAr�,o Project Name County Project or Contract# Industries 4 Prime Contractor ❑ �:iii Duvall Avenue NE King CAG-20-065 PrevailingWage Program l:°::. 'S Subcontractor PO Box 44540 �y�°• v' Project Address Olympia WA 98504-4540 ` '"--89 a0 Final Week of (360)902-5335 Payroll ❑ • Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 3/18/2023 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions 1---- Work Classification Name c9 ~Oa) Sun Mon Tue Wed Thu Fri Sat Total Gross Amount and And cu E 3/12 3/13 3/14 3/15 3/16 3/17 3/18 Total Rate Earned/Gross Hourly Net Wages D rE m Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address Tax CD o rI o Hours Worked Each Day 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 Gale L Kirkendoll Payroll 3/20/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST 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 '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 Gale L Kirkendoll Payroll Gale L Kirkendoll 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_ Project Name County Project or Contract# Industries ;" "`"'F4 Prime Contractor ❑ �_;;. ; Duvall Avenue NE King CAG-20-065 Prevailing Wage Program I "'`. - 'y Subcontractor ►� PO Box 44540 d�.,•�r' v,' Project Address Olympia WA 98504-4540 y` '"A�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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 3/11/2023 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions F= Work Classification Name c7 ~ o Sun Mon Tue Wed Thu Fri Sat Total a� Gross Amount and And E 3/5 3/6 3/7 3/8 3/9 3/10 3/11 Total Rate Earned/Gross Hourly Net Wages j E Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address iu y Benefits" Tax W O 8 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 Gale L Kirkendoll Payroll 3/20/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST 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. 'c5)Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and 17raining 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 Gale L Kirkendoll Payroll Gale L Kirkendoll 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 af,sT"T" Project Name County Project or Contract# Industries ;,;::• ,,s Prime Contractor ❑ ::i;; i.r Duvall Avenue NE King CAG-20-065 Prevailing Wage Program t. .• SubcontractorCZ PO Box 44540 '.?H..k w Project Address Olympia WA 98504-4540 ` '""9 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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 3/4/2023 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions p Work Classification Name c7 ~O O Sun Mon Tue Wed Thu Fri Sat Total Gross Amount and And a) E 2/26 2/27 2/28 3/1 3/2 3/3 3/4 Total Rate Earned/Gross Hourly Net Wages E Hours of Pay Payroll Usual FICA Withholding Other o; °' y Benefits" Tax Soc Sec#of Employee Address CD 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 Gale L Kirkendoll Payroll 3/20/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST 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 '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 Gale L Kirkendoll Payroll Gale L Kirkendoll 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 a.,sur o Project Name County Project or Contract# Industries k Prime Contractor ❑ � Duvall Avenue NE King CAG-20-065 PrevailingWage Program 9 9 Subcontractor PO Box 44540 °,� y° Project Address Olympia WA 98504-4540 y` 18B°ao Final Week of (360)902-5335 Payroll 0 Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 2/25/2023 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions t= Work Classification Name c9 ~O 0 Sun Mon Tue Wed Thu Fri Sat Total a) Gross Amount and And a� E 2/19 2/20 2/21 2/22 2/23 2/24 2/25 Total Rate Hourly @ E I= Hours of PayEarned/Gross "Usual WithholdingNet Wages f a, Payroll FICA Other Soc Sec#of Employee Address cp cc O o Hours Worked Each Day 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 Gale L Kirkendoll Payroll 3/6/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: Duvall 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 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. 3)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 Gale L Kirkendoll Payroll Gale L Kirkendall 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 Project Name County Project or Contract# ?a,= :-% Prime Contractor ❑ Industries ___ _ Prevailing Wage Program 4:... "1;4 Duvall Avenue NE King CAG-20-065 :»__ :;r Subcontractor Z PO Box 44540 ';�144 17' y Project Address Olympia WA 98504-4540 'key' Final Week of (360)902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 2/18/2023 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions Work Classification Name (-5 bo o Sun Mon Tue Wed Thu Fri Sat Total au Gross Amount and And a) E 2/12 2/13 2/14 2/15 2/16 2/17 2/18 Total Rate Earned/Gross Hourly Net Wages 3 E F Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address o Ce o Hours Worked Each Day y 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 Gale L Kirkendoll Payroll 3/6/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: Duvall 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 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 Gale L Kirkendoll Payroll Gale L Kirkendoll r-� 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 ��svcr,- Project Name County Project or Contract# Industries .:::' • . Prime Contractor ❑ PrevailingWage Program Duvall Avenue NE King CAG-20-065 @i€:. 9 9 ::,,z : Z Subcontractor PO Box 44540 T',,;:"A, v° Project Address Olympia WA 98504-4540 y` '"80 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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 2/11/2023 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions p Work Classification Name oo o Sun Mon Tue Wed Thu Fri Sat Total a� Gross Amount and And 0 E 2/5 2/6 2/7 2/8 2/9 2/10 2/11 Total Rate Earned/Gross Hourly Net Wages r Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address cc O -0 Tax o Hours Worked Each Day Benefits" 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 Gale L Kirkendoll Payroll 3/6/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST 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 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 ,Braining 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 Gale L Kirkendoll Payroll Gale L Kirkendoll 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 Project Name County Project or Contract# Industries 4+ a 4 Prime Contractor ❑ Duvall Avenue NE King CAG-20-065 Prevailing Wage Programi Subcontractor @ PO Box 44540 y Project Address Olympia WA 98504-4540 ,t `ow"a0 Final Week of (360)902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 2/4/2023 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date 1 Deductions Work Classification Name c9 ~O o Sun Mon Tue Wed Thu Fri Sat Total a) Gross Amount and And m E 1/29 1/30 1/31 2/1 2/2 2/3 2/4 Total Rate Earned/Gross Hourly Net Wages j E Hours of Pay Payroll "Usual FICA Withholding Other rnf °' y 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 Gale L Kirkendoll Payroll 2/8/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: ''.vall 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 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. ,1, `,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 Gale L Kirkendoll Payroll Gale L Kirkendoll MB 2/15/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side • Certified Payroll Report Department of Labor and STATE• Project Name County Project or Contract# , °, Prime Contractor ❑ Industries _•:-� ii!:4 PrevailingWage Program 4i•••• ,:s Duvall Avenue NE King CAG 20 065 g g �.•., -:: Subcontractor IM PO Box 44540 cP ..'� oy°` Project Address Olympia WA 98504-4540 y`` `d89 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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 1/28/2023 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions p Work Classification Name 6 ~O o Sun Mon Tue Wed Thu Fri Sat Total - E 1/22 1/23 1/24 1/25 1/26 1/27 1/28 Total Rate Hourly Gross Amount and And w E Earned/Gross WithholdingNet Wages f a, Hours of Pay "Usual Usual FICA Other Soc Sec#of Employee Address Er O o Hours Worked Each Day I 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 Gale L Kirkendoll Payroll 1/30/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: Duvall 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 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. .44ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ining 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 Gale L Kirkendoll Payroll Gale L Kirkendoll MB 1/30/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and s A,F Project Name County Project or Contract# +:.. .... Prime Contractor ❑ Industries iii 4 o,,,, � Duvall Avenue NE King CAG-20-065 PrevailingWage Program 4` "" 9 9 x Subcontractor ►� PO Box 44540 ` '� "' Project Address Olympia WA 98504-4540 y` �e8s 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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 1/21/2023 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions F= Work Classification Name c9 ~O o Sun Mon Tue Wed Thu Fri Sat Total w and And Gross Amount a� E 1/15 1/16 1/17 1/18 1/19 1/20 1/21 Total Rate Hourly E Earned/Gross Net Wages 03 Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address m a) z 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 Gale L Kirkendoll Payroll 1/23/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: n'ivall Avenue 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 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 •- t 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. '1)Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and f 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 Gale L Kirkendoll Payroll Gale L Kirkendoll MB 1/30/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and STaTF Project Name County Project or Contract# +... Prime Contractor ❑ Industries ?° `• Duvall Avenue NE King CAG-20-065 ,.,ecii '.,•' Prevailing Wage Program <;::::: Subcontractor IN PO Box 44540 1 ".4i' '`;,s Project Address Olympia WA 98504-4540 ry,/ 1889�� Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 1/14/2023 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions H Work Classification Name O~ o 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 E Hours of Pay "Usual FICA Withholding Other rn r a, Payroll Benefits" Tax Soc Sec#of Employee Address 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 Gale L Kirkendoll Payroll 1/23/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: n"vall 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 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 'ining 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 Gale L Kirkendoll Payroll Gale L Kirkendoll MB 1/30/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �$sTATA. Project Name County Project or Contract# Industries 4,;i: 4 Prime Contractor ❑ o.iiii Duvall Avenue NE King CAG-20-065 PrevailingWage Program "`_ 9 9 ,, .... .,,t Subcontractor El PO Box 44540 °",;ipJr oy) Project Address Olympia WA 98504-4540 y'` tbey 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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 1/7/2023 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions p Work Classification Name & ~O o Sun Mon Tue Wed Thu Fri Sat Total cc a) Gross Amount and And — m E 1/1 1/2 1/3 1/4 1/5 1/6 1/7 Total Rate Earned/Gross Hourly Net Wages Hours of Pay Payroll "Usual FICA Wit Tax Other Soc Sec#of Employee Address CO m a Benefits" 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 Gale L Kirkendoll Payroll 1/23/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: avall 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 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. 4ny 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 Gale L Kirkendoll Payroll Gale L Kirkendoll MB 1/30/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �,i,gTATA• Project Name County Project or Contract# Industries •"•' ' , Prime Contractor ❑ `i �' ill i-, Duvall Avenue NE King CAG-20-065 Prevailing Wage Program 4ium. "ilF:Z. Subcontractor ►� PO Box 44540 4,p•d .w 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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 12/31/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions o Sun Mon Tue Wed Thu Fri Sat Work Classification Name C� Total W o ? 12/2 12/2 12/2 12/2 12/2 12/3 12/3 Gross Amount and And `m �, Total Rate Hourly 5 6 7 8 9 0 1 Hours of Pay Earned/Gross °Usual FICA Withholding Other Net Wages Soc Sec#of Employee Address m a) a Payroll Benefits" Tax 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 Gale L Kirkendoll Payroll 1/23/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: ^ ,all 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. t71,;\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 Gale L Kirkendoll Payroll Gale L Kirkendoll MB 1/30/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and ��St�Tso Project Name County Project or Contract# Industries 4,ii: 4 Prime Contractor ❑ �::: Duvall Avenue NE King CAG-20-065 Prevailing Wage Program Subcontractor �r °€€:_ PO Box 44540 .2, .yn 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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 12/24/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions Work Classification Name a p o Sun Mon Tue Wed Thu Fri Sat Total ce 2 a) 12/1 12/1 12/2 12/2 12/2 12/2 12/2 Gross Amount and And a' E 8 9 0 1 2 3 4 Total Rate Earned/Gross Hourly Net Wages f0 r a) Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address m B 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 Gale L Kirkendoll Payroll 12/29/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: n""vall 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 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 ining 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 Gale L Kirkendoll Payroll Gale L Kirkendoll • 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 ��,sTAT4 Project Name County Project or Contract# Industries ^ jt «:.4, Prime Contractor ❑ :"""-isr ``:s' Duvall Avenue NE King CAG-20-065 Prevailing Wage Program <>< ET '; `= Subcontractor PO Box 44540 s'.)p ��..2 Project Address fi'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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 12/17/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions c7 o Sun Mon Tue Wed Thu Fri Sat Work Classification Name Total ce m 12/1 12/1 12/1 12/1 12/1 12/1 12/1 Gross Amount Total Rate Hourly and And 7 E 1 2 3 4 5 6 7 Hours of Pay Pa roll Earned/Gross "Usual FICA Withholding g es Other Net Wages Soc Sec#of Employee Address a) j y Benefits" Tax cr 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 Gale L Kirkendoll Payroll 12/29/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: Duvall 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 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 ining 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 Gale L Kirkendoll Payroll Gale L Kirkendoll 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 ��e sTerA. Project Name County Project or Contract# Industries ,,;, ,.,� Prime Contractor ❑ ;;;; :. Duvall Avenue NE KingCAG-20-065 Prevailing Wage Program z Subcontractor IN PO Box 44540 3..'�' ..yamProject Address Olympia WA 98504-4540 y� '"ay 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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 12/10/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions H Work Classification Name c7 ~ Sun Mon Tue Wed Thu Fri Sat Total 12/1 Gross Amount and And co E 12/4 12/5 12/6 12/7 12/8 12/9 Total Rate Earned/Gross Hourly Net Wages E Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address y 0 - Payroll Benefits" Tax W 0 0 Hours Worked Each Day a I 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 Gale L Kirkendoll Payroll 12/15/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: ^.'vall Avenue NE 12/4/2022 12/10/2022 "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. 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 Gale L Kirkendoll Payroll Gale L Kirkendoll r lj MB 12/15/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �i,.sun; Project Name County Project or Contract# ^:;,: 4 Prime Contractor ❑ IndustriesWage Program dx Duvall Avenue NE King CAG-20-065 Prevailing gAl." " Subcontractor El PO Box 44540 4 . ';�` Project Address Olympia WA 98504-4540 y` '&dy 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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 12/3/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions Work Classification Name c i= o Sun Mon Tue Wed Thu Fri Sat Total o a> 11/2 11/2 11/2 11/3 Gross Amount and And °' E 7 8 9 0 12/1 12/2 12/3 Total Rate Earned/Gross Hourly Net Wages r o Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address > ' Tax c2 O 0 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 Gale L Kirkendoll Payroll 12/15/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 11/27/2022 12/3/2022 "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. hi 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 Gale L Kirkendoll Payroll - Gale L Kirkendoll MB 12/15/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and Project Project Name County Project or Contract# Industries ..21, „�4 Prime Contractor ❑ Prevailing Wage Program �`'` �;f ix Duvall Avenue NE King CAG-20-065 PO Box 44540j 't�,= Subcontractor © Project Address Olympia WA 98504-4540 f,� t"�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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 11/26/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions ~ Sun Mon Tue Wed Thu Fri Sat Work Classification Name C7 p Total O ( 11/2 11/2 11/2 11/2 11/2 11/2 11/2 Gross Amount Total Rate Hourly and And m ix E p 0 1 2 3 4 5 6 Hours of Pay Earned/Gross °Usual FICA Withholding Other Net Wages Soc Sec#of Employee Address > 0 Payroll Benefits" Tax CD 0 '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 Gale L Kirkendoll Payroll 12/1/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 11/20/2022 11/26/2022 "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. "','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 Gale L Kirkendoll Payroll Gale L Kirkendoll MB 12/1/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and ,,,y,, Project Name County Project or Contract# ,:':"'.•.<< .,. Prime Contractor ❑ Industries -I `;`; Duvall Avenue NE King CAG-20-065 Prevailing Wage Program Ali, {f r Subcontractor 0PO Box 44540 ':yH°,r w� 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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 11/19/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions o Sun Mon Tue Wed Thu Fri Sat Work Classification Name c7 Total o ) 11/1 11/1 11/1 11/1 11/1 11/1 11/1 Gross Amount a, E Total Rate Hourly and And E 3 4 5 6 7 8 9 Hours of PayEarned/Gross Usual Withholding Net Wages ..Ew Payroll Benefits" FICA Tax Other Soc Sec#of Employee Address a, > IY O E 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 Gale L Kirkendoll Payroll 11/21/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 11/13/2022 11/19/2022 "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. 'F.ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ,Ining 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 Gale L Kirkendoll Payroll Gale L Kirkendoll MB 12/1/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and ��t-�;;^ �,� prime Contractor ❑ Project Name County Project or Contract# Industries 4ai1 iii•4. a.,,, - , ri;r Duvall Avenue NE King CAG-20-065 Prevailing Wage Program ==}it' ;REF s j� 4( f Subcontractor ❑x PO Box 44540 °.;•�°,'� s2 Project Address Olympia WA 98504-4540 yy '"dy 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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 11/12/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions Thu Fri Sat Work Classification Name C7 b •o Sun Mon Tue Wed Total 11/1 11/1 11/1 Gross Amount a) E 11/6 11/7 11/8 11/9 Total Rate Hourly and And E 0 1 2 Hours of Pay Earned/Gross °Usual FICA Withholding Other Net Wages Soc Sec#of Employee Address m f Payroll Benefits" Tax O 8 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 Gale L Kirkendoll Payroll 11/21/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 11/6/2022 11/12/2022 "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. any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ming 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 Gale L Kirkendoll Payroll Gale L Kirkendoll • MB 12/1/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �r�sTATe Project Name County Project or Contract# � :_ l9.6 Prime Contractor ❑ Industries a"•`•' "`:`7 Duvall Avenue NE King CAG-20-065 Prevailing Wage Program 4` L'" Subcontractor ❑x PO Box 44540 f'"'ii' ;yn,. Project Address Olympia WA 98504-4540 `1889�� Final Week of (360)902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 11/5/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 - 1 . _ Day and Date Deductions Work Classification Name o Sun Mon Tue Wed Thu Fri Sat Total EC 2. a) 10/3 10/3 Gross Amount and And E E 0 1 11/1 11/2 11/3 11/4 11/5 Total Rate Earned/Gross Hourly Net Wages E H Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address c a) .—n y Benefits" Tax O B Hours Worked Each Day 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 Gale L Kirkendoll Payroll 11/21/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 10/30/2022 11/5/2022 "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. -,lny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ,Ining 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 Gale L Kirkendoll Payroll Gale L Kirkendoll f MB 12/1/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and STA1 { Project Name County Project or Contract# �+"u, Prime Contractor ❑ Industries ;F =«,y. "".y Duvall Avenue NE King CAG-20-065 PrevailingWage Program 49ii • ;_�?_ 9 9 w 3t 1 ,,,z Subcontractor x❑ PO Box 44540 °4,- yn Project Address Olympia WA 98504-4540 y� `"ea ap Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 10/29/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions o Sun Mon Tue Wed Thu Fri Sat Work Classification Name C7 Total cC 2 a) 10/2 10/2 10/2 10/2 10/2 10/2 10/2 Gross Amount a) E Total Rate Hourly and And m E i= 3 4 5 6 7 8 9 Hours of Pay Earned/Gross °Usual FICA Withholding Other Net Wages Soc Sec#of Employee Address a) w Payroll Benefits" Tax f 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 Gale L Kirkendoll Payroll 11/4/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: r'•.vaII Avenue NE 10/23/2022 10/29/2022 "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. .' ` My 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 Gale L Kirkendoll Payroll Gale L Kirkendoll MB 11/8/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �,ST^,'F�, Prime Contractor ❑ Project Name County Project or Contract# Industries i«.y. :;, , Duvall Avenue NE King CAG-20-065 PrevailingWage Program d iii. sii:=Y 9 9 �.:;�,,, ;f,•z Subcontractor ❑x PO Box 44540 Q ,,• ,, Project Address Olympia WA 98504-4540 y� '"d"ac Final Week of (360) 902-5335 Payroll III Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 10/22/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions o Sun Mon Tue Wed Thu Fri Sat Work Classification Name 0 Total o 0 10/1 10/1 10/1 10/1 10/2 10/2 10/2 Gross Amount a) E Total Rate Hourly and And Earned/Gross Net Wages `m E 6 7 8 9 0 1 2 Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address > Payroll Benefits" Tax rY 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 Gale L Kirkendoll Payroll 11/4/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: call Avenue NE 10/16/2022 10/22/2022 "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. « 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 Gale L Kirkendoll Payroll Gale L Kirkendoll MB 11/8/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and , ,,, i. Prime Contractor ❑ Project Name County Project or Contract# Industries ``, r Prevailing Wage Program t r 'NI Duvall Avenue NE King CAG-20-065 1p- 41� J` Subcontractor ❑x PO Box 44540 s'e n,. 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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 10/15/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions • Work Classification Name a ° Sun Mon Tue Wed Thu Fri Sat Total cc 9- m 10/1 10/1 10/1 10/1 10/1 10/1 Gross Amount a) E 10/9 Total Rate Hourly and And Earned/Gross Net Wages `3 0 1 2 3 4 5 Hours of Pay y "Usual FICA Wit Taxding Other Soc Sec#of Employee Address - > - Payroll Benefits" W O o Hours Worked Each Day 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 Gale Kirkendoll Payroll 10/17/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 10/9/2022 10/15/2022 "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 mechanicconform.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 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 Gale Kirkendoll Payroll Gale Kirkendoll M8;40/17122 F700-065-000 certified payroll report:05-09 Employee Benefits.Distribution and Signature Certification On Reverse Side Certified Payroll Report Department of Labor and $er.+rt Project Name County Project or Contract# Industries :;�;;• o, Prime Contractor ❑ Duvall Avenue NE King CAG-20-065 Prevailing Wage Program "' Subcontractor PO Box 44540 r Project Address Olympia WA 98504-4540 e�'ad0 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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 10/8/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions p Work Classification Name a ~ Sun Mon Tue Wed Thu Fri Sat Total o_ O a) Gross Amount and And a) E 10/2 10/3 10/4 10/5 10/6 10/7 10/8 Total Rate Earned/Gross Hourly Net Wages E Hours of Pay "Usual Withholding o5 f m Payroll Benefits" FICA Tax Other Soc Sec#of Employee Address CD 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 Gale Kirkendoll Payroll 10/17/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 10/2/2022 10/8/2022 "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'rriade.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,eitherdirectly 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 Training Council. Falsification of=any of-the above statements is a violation of RCW 3932.050'subject to.prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature Gale Kirkendoll' Payroll Gale Kirkendoll 'MB 10/1.7/22-? F700-065-000 certified payroll report 05-09 Employee Benefits.Distribution and.Signature Certification on Reverse Side A Certified Payroll Report Department of Labor and srer�o Project Name County Project or Contract# 11 Prime Contractor ❑ Industries Duvall Avenue NE King CAG-20-065 Prevailing Wage Program 104‘i-iii").1 Subcontractor ❑xPO Box 44540 g Project Address Olympia WA 98504-4540 4 /sed Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 10/1/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions p Work Classification Name C7 ~O 9- Sun Mon Tue Wed Thu Fri Sat Total cC Gross Amount and And E 9/25 9/26 9/27 9/28 9/29 9/30 10/1 Total Rate Earned/Gross Hourly Net Wages .E is Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address cC O o Hours Worked Each Day 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 Gale Kirkendoll Payroll 10/4/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: ^'-all Avenue NE 9/25/2022 10/1/2022 "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. 'any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and Jning 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 Gale Kirkendoll Payroll Gale Kirkendoll MB '1 OZ6/.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 �1,sTerR•o Project Name County Project or Contract# w Prime Contractor CIIndustries �••••;" ,„ Duvall Avenue NE King CAG-20-065 Prevailing Wage Program "" Subcontractor ❑x PO Box 44540 .tii 'd a'4. 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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 9/24/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions E= Work Classification Name c7 ~• O o Sun Mon Tue Wed Thu Fri Sat Total Gross Amount and And a) E 9/18 9/19 9/20 9/21 9/22 9/23 9/24 Total Rate Earned Gross Hourly Ed/ Net Wages E i Hours of Pay "Usual FICA Withholding Other g 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 Gale Kirkendoll Payroll 10/4/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: ^ —all Avenue NE 9/18/2022 9/24/2022 "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 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. "'.rJkny apprentices employed in the above period are duly registered in a bona fide-apprenticeship program registered with the Washington State Apprenticeship and pining 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 Gale Kirkendoll Payroll Gale Kirkendoll :MB i'I6122`; • F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and sr�rs•' Project Name County Project or Contract# 4�... °� Prime Contractor E Industries 4:333 �iifi � Duvall Avenue NE King CAG-20-065 PrevailingWage Program "' 9 9 i Subcontractor �]PO Box 44540 �.: ' Project Address Olympia WA 98504-4540 94144 Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 9/17/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions Work Classification Name c7 ~O o Sun Mon Tue Wed Thu Fri Sat Total Gross Amount and And E 9/11 9/12 9/13 9/14 9/15 9/16 9/17 Total Rate Hourly `m F Hours of Pay Earned/Gross "Usual Withholding Net Wages a, — Payroll FICA Other Soc Sec#of Employee Address CD o o Hours Worked Each Day Benefits" 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 Gale Kirkendoll Payroll 9/23/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: n""vall Avenue NE 9/11/2022 9/17/2022 "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 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. ';stny 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 Gale Kirkendoll Payroll Gale Kirkendoll :IVIB 9%2$/221 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,arert Project Name County Project or Contract# Industries 4:;:. o£ Prime Contractor ❑ oii g Duvall Avenue NE King CAG-20-065 Prevailing Wage Program ' Subcontractor El PO Box 44540 !!"010' ," Project Address Olympia WA 98504-4540 y` 1eg°NI° Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 9/10/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions E=- Work Classification Name c7 ~O o Sun Mon Tue Wed Thu Fri Sat Total Gross Amount and And E 9/4 9/5 9/6 9/7 9/8 9/9 9/10 Total Rate Earned/Gross Hourly Net Wages E a Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address O o Hours Worked Each Day 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 Gale Kirkendoll Payroll 9/23/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 9/4/2022 9/10/2022 "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. 1-` Any apprentices employed in the above period are duly registered in a bona fide-apprenticeship program registered with the Washington State Apprenticeship and ining 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 Gale Kirkendoll Payroll Gale Kirkendoll MB>:9128/2- F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and srer�. Project Name County Project or Contract# Industries �?;:�• _:� � Prime Contractor ❑ .::.: Duvall Avenue NE King CAG 20 065 Prevailing Wage Program ,1::,. :!is s.3=•i,: .111. Subcontractor IX PO Box 44540 "�.'t` 1° Project Address Olympia WA 98504-4540 y` '��"aJ Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 9/3/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions p Work Classification Name C9 ~O o Sun Mon Tue Wed Thu Fri Sat Total a) Gross Amount and And m E 8/28 8/29 8/30 8/31 9/1 9/2 9/3 Total Rate Earned/Gross Hourly Net Wages m E i Hours of Pay "Usual FICA Withholding Other a, Payroll Benefits" Tax Soc Sec#of Employee Address O o Hours Worked Each Day a 1. Power Equipment RG 0.00 0.00 7.25 0.00 0.00 0.00 0.00 7.25 $58.60 $42 .85 Workers' Operators Camden Schmeck f Compensation: Roto-mill,Roto-grinder 303 Williams Blvd $871.68/ $3.59 (King) NW OT 0.00 0.00 4.75 0.00 0.00 0.00 0.00 4.75 $87.90 $417.53 $871.67 $14.24/hr $66.68 $130.75 $670.65 }k � Orting,WA-98360 $117 J DT 0.00 0.00 0.25 0.00 0.00 0.00 0.00 0.25 0 $29.30 2. Power Equipment Workers' RG 0.00 0.00 7.75 0.00 0.00 0.00 0.00 7.75 $58.60 $454.15 Operators Compensation: Roto-mill,Roto-grinder david Shephard $915.63/ $3.74 (King) P.O.Box 248 OT 0.00 0.00 4.25 0.00 0.00 0.00 0.00 4.25 $87.90 $373.58 $915.63 $14.24/hr $70.05 $137.34 $704.50 Oiling,WA-98360 " DT 0.00 0.00 0.75 0.00 0.00 0.00 0.00 0.75 $10'2 $87.90 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 Gale Kirkendoll Payroll 9/9/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: n,wall Avenue NE 8/28/2022 9/3/2022 "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.Camden Schmeck Power Equipment Operators Roto-mill,Roto-grinder $14.24 J $6.74 $5.50 $1.25 $0.75 $0.00 (King) 2.david Shephard P^wer Equipment Operators to-mill,Roto-grinder $14.24 $6.74 $5.50 $1.25 $0.75 $0.00 (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. !`,f\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 Gale Kirkendoll Payroll Gale Kirkendoll MB 9/9/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and ':',::".'F". Prime Contractor ❑ Project Name County Project or Contract# Industries •=__ __ �:::; - .•'s9 Duvall Avenue NE King CAG-20-065 Prevailing Wage Program <;" =�_��_ a=23t; ��Ig��: Subcontractor PO Box 44540 . • ,y Project Address Olympia WA 98504-4540 yy '"�"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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 8/27/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions �= Work Classification Name C7 b o Sun Mon Tue Wed Thu Fri Sat Total (Y O a) Gross Amount and And E 8/21 8/22 8/23 8/24 8/25 8/26 8/27 Total Rate Earned/Gross Hourly Net Wages `m E i= Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address > Payroll Benefits" Tax 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 Gale Kirkendoll Payroll 9/9/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: n wall Avenue NE 8/21/2022 8/27/2022 "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. 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. toprosecution, sanctions, and penalties. Falsification of any of the above statements is a violation of RCW 39.12.050 subject Printed name of party signing this report Title Signature Gale Kirkendoll Payroll Gale Kirkendoll • MB 9/9/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �.t ;"r�, Prime Contractor ❑ Project Name County Project or Contract# Industries }?:'"t " .0., 0I;;. __:.r Duvall Avenue NE King CAG-20-065 Prevailing Wage Program ii i iIIIII Subcontractor ❑x tj: Project Address PO Box 44540 d oy 1 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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 8/20/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions p Work Classification Name c9 ~O taw Sun Mon Tue Wed Thu Fri Sat Total Gross Amount and And E 8/14 8/15 8/16 8/17 8/18 8/19 8/20 Total Rate Earned/Gross Hourly Net Wages E i Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address - Payroll Benefits" Tax i O 8 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 Gale Kirkendoll Payroll 8/25/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 8/14/2022 8/20/2022 "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 Fhe 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. r,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 Gale Kirkendoll Payroll Gale Kirkendoll MB 9/6/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and FaArf Project Name County Project or Contract# Industries �`'ir .1 ", Prime Contractor El -. P: !mr, Duvall Avenue NE King CAG-20-065 Prevailing Wage Program lilli�" (i�jjry Subcontractor IX PO Box 44540 d';t" y Project Address Olympia WA 98504-4540 I''' '8"""�l Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 8/13/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions H= Work Classification Name c9 ~O GI Sun Mon Tue Wed Thu Fri Sat Total a) Gross Amount and And E 8/7 8/8 8/9 8/10 8/11 8/12 8/13 Total Rate Earned/Gross Hourly Net Wages E Hours of Pay "Usual FICA Withholding Other y Tax Soc Sec#of Employee Address cu O o Hours Worked Each Day Payroll Benefits" a 1. Power Equipment Workers' RG 0.00 0.00 0.00 0.00 4.50 0.00 0.00 4.50 $54.88 $246.96 Operators Timothy Moran Compensation: Brooms 429 Herb Ct SE $347.58/ $1.91 (King) Olympia,WA- OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $82.32 $0.00 $347.57 $14.24/hr $26.59 $52.13 $266.94 98513 $109.7 *. "` ` . DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 6 $0.00 2. Truck Drivers Workers' RG 0.00 0.00 0.00 0.00 2.00 0.00 0.00 2.00 $50.31 $100.62 Other Trucks Timothy Moran Compensation: (King) 429 Herb Ct SE $347.58/ $1.91 Olympia, Ct - OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $75.47 $0.00 $347.57 514.24/hr $26.59 $52.13 $266.94 W98513 $100.6 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2// $0.00 s. rower Equipment NI 4 RG 0.00 0.00 0.00 0.00 6.25 0.00 0.00 6.25 $58.60 $366.25 Workers' Operators J Compensation: Matthew Wilson $1.83 Roto-mill, Roto-grinder 1014 Rodgers St $366.25/ Ni (King) Missoula, MT- OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $87.90 $0.00 $366.25 $14.24/hr $28.02 $54.94 $281.46 59802 $117.2 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0 $0.00 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 Gale Kirkendoll Payroll 8/25/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: niwall Avenue NE 8/7/2022 8/13/2022 "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.Timothy Moran Power Equipment Operators Brooms $14.24 $6.74 $5.50 $1.25 $0.75 $0.00 (King) 2.Timothy Moran Truck Drivers er Trucks $14.24 $6.74 $5.50 $1.25 $0.75 $0.00 (King) 3.Matthew Wilson Power Equipment Operators Rota-mill,Roto-grinder $14.24V $6.74 $5.50 $1.25 $0.75 $0.00 (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 Gale Kirkendoll Payroll Gale Kirkendoll f MB 9/6/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side • Certified Payroll Report Department of Labor and :jsrnrF � Project Name County Project or Contract# �ai Prime Contractor ElIndustries tii.tii ,: ' "F Duvall Avenue NE King CAG-20-065 Prevailing Wage Program _°' 4 Subcontractor 17 PO Box 44540 d'`• ,�` f.' Project Address Olympia WA 98504-4540 �y 'x"�'�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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 8/6/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions 1---- Work Classification Name (� ~O o Sun Mon Tue Wed Thu Fri Sat Total a) Gross Amount and And m E 7/31 8/1 8/2 8/3 8/4 8/5 8/6 Total Rate Earned/Gross Hourly Net Wages r a Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address o o Hours Worked Each Day 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 Gale Kirkendoll Payroll 8/12/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 7/31/2022 8/6/2022 "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. ,ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ,ring 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 Gale Kirkendoll Payroll Gale Kirkendoll MB 8/15/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and a��;`"r..GF Prime Contractor ❑ Project Name County Project or Contract# Industries ,,,r Duvall Avenue NE King CAG-20-065 Prevailing Wage Program ygj1t; +:i i` Subcontractor PO Box 44540 °' �'I„r ,y 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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 7/30/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions P Work Classification Name C7 8o Sun Mon Tue Wed Thu Fri Sat Total a> Gross Amount and And m E 7/24 7/25 7/26 7/27 7/28 7/29 7/30 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 aCD IY 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 Gale L Kirkendoll Payroll 8/4/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: ^,.vall Avenue NE 7/24/2022 7/30/2022 "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. ,'-`;'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 Gale L Kirkendoll Payroll Gale L Kirkendoll MB 8/4/22. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and t,s;�r Project Name County Project or Contract# •."�, E.''' Prime Contractor ❑ Industries .:'• %. Duvall Avenue NE King CAG-20-065 Prevailing Wage Program iiii ,::j'r Subcontractor XI PO Box 44540 " � ° Project Address Olympia WA 98504-4540 yy` '—�'a 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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 7/23/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions _ Work Classification Name rz ~O 9-0 Sun Mon Tue Wed Thu Fri Sat Total Gross Amount and And E 7/17 7/18 7/19 7/20 7/21 7/22 7/23 Total Rate Earned/Gross Hourly Net Wages E i= _ _ Hours of Pay "Usual FICA Withholding Other y Tax Soc Sec#of Employee Address CD O o Hours Worked Each Day Payroll Benefits" 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 Gale L Kirkendoll Payroll 8/4/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: n,,vall Avenue NE 7/17/2022 7/23/2022 "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. \ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ( .ining 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 Gale L Kirkendoll Payroll Gale L Kirkendoll MB 8/4/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side 1 Certified Payroll Report Department of Labor and �F,sur,k ,F Project Name County Project or Contract# � Industries = Prime Contractor ❑ �: Duvall Avenue NE King CAG-20-065 Prevailing Wage Program yj3ji; .:;a'�= Subcontractor N PO Box 44540 °;y=,'` a`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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 7/16/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions IL- Work Classification Name (— ~o - Sun Mon Tue Wed Thu Fri Sat Total a) Gross Amount and And o E 7/10 7/11 7/12 7/13 7/14 7/15 7/16 Total Rate Earned/Gross Hourly Net Wages E I= Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address 12 O la 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 Gale L Kirkendoll Payroll 8/4/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: niivall Avenue NE 7/10/2022 7/16/2022 "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. i t`Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ;ining 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 • Gale L Kirkendoll Payroll Gale L Kirkendoll MB 8/4/22 • F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �t y',:`; .,. Prime Contractor ❑ Project Name County Project or Contract# & is , . Industries 4 '•!' ;'':`:,;y Duvall Avenue NE King CAG-20-065 Prevailing Wage Program 4""• "`!= Subcontractor �'4!i!! a t PO Box 44540 °"���`,�' �;� Project Address Olympia WA 98504-4540 y4 '—"" Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 7/9/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions H Work Classification Name O~ o Sun Mon Tue Wed Thu Fri Sat Gross Amount Total and And a� E 7/3 7/4 7/5 7/6 7/7 7/8 7/9 Total Rate Earned/Gross Hourly Net Wages r Hours of Pay Payroll "Usual FICA Withholding' Other Soc Sec#of Employee Address m > _ Benefits" Tax - O o Hours Worked Each Day o 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 Gale Kirkendoll Payroll 7/15/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: _^&:wall Avenue NE 7/3/2022 7/9/2022 "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. 'g`,,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 Gale Kirkendoll Payroll Gale Kirkendoll • • MB 7/21/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �y,y,A,� Project Name County Project or Contract# Industries ^,i=iit '',1;,y Prime Contractor ❑ -ia:,b ir�i;;, Duvall Avenue NE King CAG-20-065 PrevailingWage Program - .f;13:x 9 9 �;���,; ,{�� Subcontractor El PO Box 44540 °;;",� wn Project Address Olympia WA 98504-4540 �� '"Bye Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 7/2/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions p Work Classification Name C ~O o Sun Mon Tue Wed Thu Fri Sat Total Gross Amount and And @ 6/26 6/27 6/28 6/29 6/30 7/1 7/2 Total Rate Hourly Hours of Pay Earned/Gross "Usual Withholding Net Wages a) Payroll FICA Other Soc Sec#of Employee Address O o cC Hours Worked Each Day 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 Gale Kirkendoll Payroll 7/15/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: ^,rdall Avenue NE 6/26/2022 7/2/2022 "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 • 1. 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 Gale Kirkendoll Payroll Gale Kirkendoll MB 7/2.1/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and t. `"':o. Prime Contractor ❑ Project Name County Project or Contract# Industries .tt. f J.An LI, Duvall Avenue NE King CAG-20-065 PrevailingWage Program <I ;I�;,_ 9 9 ,�ilk#�, 'IV< Subcontractor C7 PO Box 44540 ° i::, ,y Project Address Olympia WA 98504-4540 yy '""" Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 6/25/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions Work Classification Name C9 ~O o Sun Mon Tue Wed Thu Fri Sat Total m Gross Amount and And '�m a y E 6/19 6/20 6/21 6/22 6/23 6/24 6/25 Total Rate Earned/Gross Hourly Net Wages co E i Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address O o Benefits" Tax 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 Gale Kirkendoll Payroll 6/29/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: "wall Avenue NE 6/19/2022 6/25/2022 "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. \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 Gale Kirkendoll Payroll Gale Kirkendoll MB 7/5/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side J • . Certified Payroll Report Department of Labor and rnr,. Project Name County Project or Contract# ,$'.`1.••••ir•°, Prime Contractor ❑ Industries -:; , .t,.;y Duvall Avenue NE King CAG-20-065 Prevailing Wage Program LLilihi' ,4111 Subcontractor IX PO Box 44540 °'yi;� , �,, Project Address Olympia WA 98504-4540 e� '""� Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 6/18/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions Work Classification Name c7 O~ o Sun Mon Tue Wed Thu Fri Sat Total cc a) Gross Amount and And E 6/12 6/13 6/14 6/15 6/16 6/17 6/18 Total Rate Earned/Gross Hourly Net Wages 3 E . Hours of Pay Payroll Net FICA Withholding Other g Soc Sec#of Employee Address aci > 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 Gale L Kirkendoll Payroll 6/22/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 6/12/2022 6/18/2022 "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. 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 Gale L Kirkendoll Payroll Gale L Kirkendoll MB 6/22/22 F700-065-000 certified payroll report 05-09 -Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and rnr, Project Name County Project or Contract# ,$- +e f" ° Prime Contractor ElIndustries . -3 •. - ,,,iii Duvall Avenue NE King CAG-20-065 Prevailing Wage Program u.‘1 t' �E�if , Subcontractor �7 PO Box 44540 ''y P; 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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 6/11/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions Work Classification Name a ~o o Sun Mon Tue Wed Thu Fri Sat Total a) Gross Amount and And E 6/5 6/6 6/7 6/8 6/9 6/10 6/11 Total Rate Earned/Gross Hourly Net Wages E a Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address c > .n Benefits" Tax 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 Gale L Kirkendoll Payroll 6/22/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 6/5/2022 6/11/2022 "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. .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 Gale L Kirkendoll Payroll Gale L Kirkendoll MB 6/22/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �,sTer�� Project Name County Project or Contract# •s+,:li "� Prime Contractor ❑ Industries ,;4 Duvall Avenue NE King CAG 20 065 Prevailing Wage Program f,:::.,F�;.:! Subcontractor PO Box 44540 °'l ',I` ..Y. Project Address Olympia WA 98504-4540 y` '"�°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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 6/4/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions i=7 Work Classification Name C7 b' o Sun Mon Tue Wed Thu Fri Sat Total a� Gross Amount and And 5/29 5/30 5/31 6/1 6/2 6/3 6/4 Total Rate Earned/Gross Hourly Net Wages E i Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address a Payroll Benefits' Tax cC 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 Gale Kirkendoll Payroll 6/6/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 5/29/2022 6/4/2022 "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. F=‘,gny 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 Gale Kirkendoll Payroll Gale Kirkendoll MB 6/6/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and Ask<,SI^;Ft°� Prime Contractor El; ,�s, Project Name County Project or Contract# Industries , - a,4 n Duvall Avenue NE King CAG-20-065 Prevailing Wage Program 2 111jt;' iti =f Subcontractor PO Box 44540 �;H:k w`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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 5/28/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions E= Work Classification Name c3 ~O o Sun Mon Tue Wed Thu Fri Sat Total GrossAmount and And a) E 5/22 5/23 5/24 5/25 5/26 5/27 5/28 Total RateHourly m E i Hours of Pay Earned/Gross "Usual Withholding Net Wages a, Payroll FICA Other Soc Sec#of Employee Address O o Hours Worked Each Day 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 Gale Kirkendoll Payroll 6/6/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: n,,vall Avenue NE 5/22/2022 5/28/2022 "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. \-,\ny 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 Gale Kirkendoll Payroll Gale Kirkendoll MB 6/6/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �� `lti",F° Prime Contractor ❑ Project Name County Project or Contract# Industries ....e: '.; f -qr- ',;;,•g:l;; Duvall Avenue NE King CAG-20-065 ��ill�J "�(i' Prevailing Wage Program ` z Subcontractor PO Box 44540 4,,;,',t1°; �,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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 5/21/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions p Work Classification Name C7 ~O o 'Sun Mon Tue Wed Thu Fri Sat Total a� Gross Amount and And E 5/15 5/16 5/17 5/18 5/19 5/20 5/21 Total Rate Earned/Gross Hourly Net Wages r Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address II O o Hours Worked Each Day 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 Gale Kirkendoll Payroll 6/6/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 5/15/2022 5/21/2022 "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. '-'Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ining 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 Gale Kirkendoll Payroll Gale Kirkendoll MB 6/6/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �f,sT�r�•�� Project Name County Project or Contract# .i Prime Contractor ❑ Industries ,", ';;, Duvall Avenue NE King CAG 20 065 Prevailing Wage Program --..iit, il=ii? Subcontractor IX PO Box 44540 °;4.'� 4, Project Address Olympia WA 98504-4540 y` 'tea°aJ Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 5/14/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions H Work Classification Name c7 8 o Sun Mon Tue Wed Thu Fri Sat Total a) Gross Amount and And E 5/8 5/9 5/10 5/11 5/12 5/13 5/14 Total Rate Earned/Gross Hourly Net Wages f Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address CD cC O o Hours Worked Each Day 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 Gale Kirkendoll Payroll 5/19/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: tall Avenue NE 5/8/2022 5/14/2022 "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. ,1.\`4ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ,ining 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 Gale Kirkendoll Payroll Gale Kirkendoll MB 5/20/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �af.sm"r�'�� Prime Contractor ❑ Project Name County Project or Contract# Industries .= f. i==; __.�� Duvall Avenue NE King CAG-20-065 Prevailing Wage Program 'All, ;sji . Subcontractor PO Box 44540 •y Project Address Olympia WA 98504-4540 ��"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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 5/7/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 Day and Date Deductions p Work Classification Name (1 ~O o Sun Mon Tue Wed Thu Fri Sat Total m Gross Amount E 5/1 5/2 5/3 5/4 5/5 5/6 5/7 Total Rate Hourly and And E Hours of PayEarned/Gross 'Usual Withholding Net Wages f a) Payroll Benefits" FICA Tax Other Soc Sec#of Employee Address CU O o Hours Worked Each Day a 1. Power Equipment Workers' RG 0.00 0.00 0.00 0.00 3.75 0.00 0.00 3.75 $58.60 $219.75 Operators Camden Schmeck Compensation: Roto-mill,Roto-grinder 303 Williams Blvd $912.10/ $3.67 (King) NW OT 0.00 0.00 0.00 0.00 6.00 0.00 0.00 6.00 $87.90 $527.40 $912.10 $14.24/hr $69.78 $136.81 $701.84 ««** « Orting,WA-98360 $117.2 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0 $0.00 2. Power Equipment Workers' RG 0.00 0.00 0.00 0.00 2.75 0.00 0.00 2.75 $59.98 $164.95 Operators Compensation: Mechanics,All(leadmen- Camden Schmeck $3.67 $0.50 Per Hour Over 303 Williams Blvd OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $89.97 $0.00 $912.10/ Mechanic) NW $912.10 $14.24/hr $69.78 $136.81 $701.84 3) Orting,WA-98360 $119.9 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 6 $0.00 3. Power Equipment Workers' RG 0.00 0.00 0.00 0.00 1.00 0.00 0.00 1.00 $58.60 $58.60 Operators Compensation: Roto-mill,Roto-grinder david Shephard $432.18/ $1.54 (King) P.O.Box 248 OT 0.00 0.00 0.00 0.00 4.25 0.00 0.00 4.25 $87.90 $373.58 $432.18 $14.24/hr $33.06 $64.83 $332.75 Orting,WA-98360 ... ..«««. DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $117.2 $010 4. Power Equipment RG 0.00 0.00 0.00 0.00 4.75 0.00 0.00 4.75 $64.10 $304.48 Workers' Operators Matthew Wilson r Compensation: Roto-mill,Roto-grinder 1014 Rodgers St 4 ./ $1,061.45 .l $3.96 (King) Missoula, MT- OT 0.00 0.00 0.00 0.00 6.00 0.00 0.00 6.00 $96.15 $576.90 / $8.74/hr $81.21 $159.22 $817.07 59802 $1,061.46 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $10'2 $0.00 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side 5. Power Equipment Workers' RG 0.00 0.00 0.00 0.00 2.75 0.00 0.00 2.75 $65.48 $180.07 Operators Compensation: Mechanics,All(leadmen- Matthew Wilson $3.96 $0.50 Per Hour Over 1014 Rodgers St OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $98.22 $0.00 $1,061.45 Mechanic) Missoula, MT- / $8.74/hr $81.21 $159.22 $817.07 59802 $1,061.46 (King) DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $160 9 $0.00 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side V 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 Gale Kirkendoll Payroll 5/19/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: ^w iall Avenue NE 5/1/2022 5/7/2022 "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.Camden Schmeck Power Equipment Operators Roto-mill,Roto-grinder $14.24 $6.74 $5.50 $1.25 $0.75 $0.00 • (Kin.) 2.Camden Schmeck ). "- wer Equipment Operators chanics,All(leadmen-$0.50 $14.24 $6.74 $5.50 $1.25 $0.75 $0.00 Per Hour Over Mechanic) (King) 3.david Shephard Power Equipment Operators Roto-mill,Roto-grinder $14.24 $6.74 $5.50 $1.25 $0.75 $0.00 (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side 4.Matthew Wilson Power Equipment Operators Roto-mill,Roto-grinder $8.74 J $6.74 $0.00 $1.25 $0.75 $0.00 (King) 5.Matthew Wilson Power Equipment Operators Mechanics,All(leadmen-$0.50 $8.74 $6.74 $0.00 $1.25 $0.75 $0.00 Per Hour Over Mechanic) ng) 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. 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 Gale Kirkendoll Payroll Gale Kirkendoll MB 5/20/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and :>t,;t Project Name County Project or Contract# r;it 'r Prime Contractor Industries % Duvall Avenue NE King CAG-20-065 Prevailing Wage Program �, 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 GROUND UP ROAD CONST INC (253)891-1413 Month Day Year Awarding Agency Address Address City State Zip+4 4/30/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1690 MILTON WA 98354 F Day and Date Deductions Work Classification Name t7 ~O o Sun Mon Tue Wed Thu Fri Sat Total Gross Amount and And - a� E 4/24 4/25 4/26 4/27 4/28 4/29 4/30 Total Rate Hourly E i= Hours of Pay Earned/Gross "Usual Withholding Net Wages at Payroll FICA Other Soc Sec#of Employee Address $ Hours Worked Each Day Benefits" Tax O 1. Power Equipment RG 0.00 0.00 6.25 0.00 0.00 0.00 0.00 6.25 $54.88 $343.00� Workers' Operators Compensation: Richard Contreras Brooms 715 118th St South $343.00/ $1.83 (King) Tacoma,WA- OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $82.32 $0.00 $343.00 $14.24/hr $26.24 $51.45 $263.48 98444 $109.7 * ** DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 6 $0.00 2. Truck Drivers RG 0.00 0.00 2.00 0.00 0.00 0.00 0.00 2.00 $50.31 Workers' $100.62 Other Trucks John Lorenz Compensation: (King) 4007 152nd ST CT $100.62/ NI $0.59 E OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $75.47 $0.00 $100.62 $14.24/hr $7.70 $15.09 $77.24 * _ _ ** Tacoma,WA- 98446 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $100.6 $0.00 3. Power Equipment RG 0.00 0.00 5.75 0.00 0.00 0.00 0.00 5.75 $58.60 $336.95 Workers' Operators Compensation: Bernard Michaelis Roto-mill,Roto-grinder 6630 92nd Lane $426.92/ $2.13 (King) Olympia,WA- OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $87.90 $0.00 $426.92 $14.24/hr $32.66 $64.04 $328.09 98513 $117.2 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0 1 $0.00 4. Power Equipment NI RG 0.00 0.00 1.50 0.00 0.00 0.00 0.00 1.50 $59.98 $89.97� Workers' Operators Compensation: Mechanics,All(leadmen- Bernard Michaelis $2.13 $0.50 Per Hour Over 6630 92nd Lane OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $89.97 $0.00 $426.92/ $14.24/hr $32.66 $64.04 $328.09 Mechanic) Olympia,WA- $426.92 (King) 98513 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $16 9 $0.00 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side 5. Power Equipment Workers' RG 0.00 0.00 5.00 0.00 0.00 0.00 0.00 5.00 $58.60 $293.00 Operators Taylor Sandberg Compensation: Roto-mill,Roto-grinder 15725 44th Ave CT $382 97/ $1.91 (King) E OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $87.90 $0.00 $382.97 $14.24/hr $29.29 $57.45 $294.32 Tacoma,WA- _ 98446 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $11 2 $0.00 - 6. Power Equipment RG 0.00 0.00 1.50 0.00 0.00 0.00 0.00 1.50 $59.98 $89.97� Workers' Operators Compensation: Mechanics,All(leadmen- Taylor Sandberg $1.91 $0.50 Per Hour Over 15725 44th Ave CT OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $89.97 $0.00 $382.97/ Mechanic) E $382.97 $14.24/hr $29.29 $57.45 $294.32 Tacoma,WA- (King) 98446 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 6 9 $0.00 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 Gale Kirkendoll Payroll 5/4/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons GROUND UP ROAD CONST INC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 4/24/2022 4/30/2022 "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.Richard Contreras Power Equipment Operators Brooms $14.24 $6.74 $5.50 $1.25 $0.75 $0.00 (King) 2.John Lorenz Truck Drivers Other Trucks $14.24 $6.74 $5.50 $1.25 $0.75 $0.00 (King) 3.Bernard Michaelis Power Equipment Operators Roto-mill,Roto-grinder $14.24 $6.74 $5.50 $1.25 $0.75 $0.00 (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side 4.Bernard Michaelis Power Equipment Operators Mechanics,All(leadmen-$0.50 $14.24 $6.74 $5.50 $1.25 $0.75 $0.00 Per Hour Over Mechanic) (King) 5.Taylor Sandberg Power Equipment Operators Roto-mill,Roto-grinder $14.24 $6.74 $5.50 $1.25 $0.75 $0.00 (King) 6.Taylor Sandberg Power Equipment Operators Mechanics,All(leadmen-$0.50 $14.24 $6.74 $5.50 $1.25 $0.75 $0.00 Per Hour Over Mechanic) (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. (5)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 Gale Kirkendoll Payroll Gale Kirkendoll F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side