HomeMy WebLinkAboutCAG-20-065 - Duvall - Subcontractor PnD Logging State of Washington
Department of Labor & Industries
Prevailing Wage Section - Telephone 360-902-5335
PO Box 44540, Olympia, WA 98504-4540
Affidavit of Wages Paid
Project Detail.- Project Dashboard
Document Received Intent Id: Affidavit Id: Status: Approved on
Date: 6/23/2023 1231916 1219932 6/23/2023
Company Details
Name PnD Logging Et Tree Service
Address PO Box 529
MAPLE VALLEY,WA,98038
WA UBI no. 601439180
Contractor Registration no. PNDLOLT867QQ
Industrial Insurance Account Id 83874700
OMWBE Certifications as of 5/9/2022 No active certifications existed when
Intent was submitted
Email Address pandlogging@comcast.net
Filed By Powell, Chris
Prime Contractor
Prime contractor name REED TRUCKING Et EXCAVATING INC
Prime contractor registration no. REEDTEI016JW
Prime contractor Phone Number 253-841-4837
Project Information
Awarding agency: RENTON, CITY OF
1055 S GRADY WAY RENTON, WA - 98055
Awarding agency contact: Flora Lee
Awarding agency contact phone number: 425-430-7303
Contract no. CAG-20-065
Project name Duvall Avenue NE
Project Description This project includes but is not limited to:
excavation; grading; removal of pavement;
• plaining pavement; paving with asphalt,
curb and gutter; drainage; illumination;
HAWK signal; sidewalk; walls; adjustments
to utility frames, grates, and covers;
property restoration; and other work.
Dollar amount of your contract: $ 11,600.00
Bid due date 6/22/2021
Contract award date 7/21/2021
Job site address/directions:
Hiring Contractor
Company Name REED TRUCKING Ft EXCAVATING INC
Contractor Registration No. REEDTEI016JW
WA UBI Number 601915034
Payment Details
Check Number:
Transaction Id: 109405102
Project Details
County where work was performed King
City where work was performed Renton
Prime contractor Intent form Id#for this 1170257
project
Intent filed date 5/9/2022
Job start date:MM-DD-YYYY 5/9/2022
Date work completed:MM-DD-YYYY 6/16/2023
Project Completion
Did your company hire any subcontractors? No
Did your company have employees perform Yes
work on this project?
Did you use apprentice employees on this No
project?
Company Owner Information
How many owner/operators performed 0
work on the project that own 30% or more
of the company?
No company owner added.
� y=
Affidavit Subcontractor(s)
No subcontractor is selected for this affidavit.
Journeylevel Wages
County Trade Occupation Wages . Fringes # #
Workers Hours
King Laborers Clean-up Laborer .52.39 0.00 4 32.00
King Laborers Faller It Bucker 53.35 0.00 2 16.00
Chain Saw
Apprentice Wages
Public Notes
El Show/Hide Existing Notes
No note exists
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: 5/9/2022 1231916 5/9/2022
Company Details
Company Name: PnD Logging Et Tree Service
Address: PO Box 529
MAPLE VALLEY, WA, 98038
Contractor Registration No. PNDLOLT867QQ
WA UBI Number 601439180
Phone Number 425-432-7636
Industrial Insurance Account ID 83874700
OMWBE Certifications as of 5/9/2022 No active certifications existed when
Intent was submitted
Email Address pandlogging@comcast.net
Filed By Chris Powell
Prime Contractor
Company Name REED TRUCKING Et EXCAVATING INC
Contractor Registration No. REEDTEI016JW
WA UBI Number 601915034
Phone Number 253-841-4837
Project Information
Awarding Agency RENTON, CITY OF
1055 S GRADY WAY RENTON, WA -
98055
Awarding Agency Contact Flora Lee
U �
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 &t EXCAVATING INC
Contractor Registration No. REEDTEI016JW
WA UBI Number 601915034
Payment Details
Check Number:
Transaction Id: 108671148
Intent Details
Expected project start date: (MM/DD/YYYY) 5/9/2022
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 $11,600.00
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?
No
A
Do you intend to use any apprentices?
(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 Laborers Clean-up Laborer $52.39 $0.00 4
King Laborers Faller Et Bucker Chain Saw $53.35 $0.00 2
Public Notes
o Show/Hide-Existing Notes
No note exists
State of Washington
Department of Labor & Industries
Prevailing Wage Section - Telephone 360-902-5335
PO Box 44540, Olympia, WA 98504-4540
Affidavit of Wages Paid
Project Detail - Project Dashboard
Document Received Intent Id: Affidavit Id: Status: Approved on
Date: 5/2/2022 1212066 1112368 5/2/2022
Company Details
Name PnD Logging Et Tree Service
Address PO Box 529
MAPLE VALLEY,WA,98038
WA UBI no. 601439180
Contractor Registration no. PNDLOLT867QQ
Industrial Insurance Account Id 83874700
OMWBE Certifications as of No active certifications existed when Intent
2/16/2022 was submitted
Email Address pandlogging®comcast.net
Filed By Powell, Chris
Prime Contractor
Prime contractor name REED TRUCKING Et EXCAVATING INC
Prime contractor registration REEDTEI016JW
no.
Prime contractor Phone 253-841-4837
Number
Project Information
Awarding agency: RENTON, CITY OF
1055 S GRADY WAY RENTON, WA - 98055
Awarding agency contact: Flora Lee
425-430-7303
Ti
Awarding agency contact
phone number:
Contract no. CAG-20-065
Project name Duvall Avenue NE
Project Description This project includes but is not limited to:
excavation; grading; removal of pavement;
plaining pavement; paving with asphalt, curb
and gutter; drainage; illumination; HAWK
signal; sidewalk; walls; adjustments to utility
frames, grates, and covers; property
restoration; and other work.
Dollar amount of your $ 9,250.00
contract:
Bid due date 6/22/2021
Contract award date 7/21/2021
Job site address/directions:
Hiring Contractor
Company Name REED TRUCKING &t EXCAVATING INC
Contractor Registration No. REEDTEI016JW
WA UBI Number 601915034
Payment Details
Check Number:
Transaction Id: 108658361
Project Details
County where work was King
performed
City where work was Renton
performed
Prime contractor Intent form 1170257
Id#for this project
Intent filed date 2/16/2022
Job start date:MM-DD-YYYY 2/18/2022
Date work completed:MM-DD- 2/18/2022
YYYY
Project Completion
Did your company hire any No
subcontractors?
s d
Did your company have Yes
employees perform work on
this project?
Did you use apprentice No
employees on this project?
Company Owner Information
How many owner/operators 0
performed work on the project
that own 30% or more of the
company?
No company owner added.
Affidavit Subcontractor(s)
No subcontractor is selected for this affidavit.
Journeylevel Wages
County Trade Occupation Wages Fringes # #
Workers Hours
King Laborers Clean-up 52.39 0.00 4 12.95
Laborer
King Laborers Faller a 53.35 0.00 2 7.00
Bucker Chain
Saw
Apprentice Wages
Public Notes
s Show/Hide Existing Notes
No note exists
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: 2/16/2022 1212066 2/16/2022
Company Details
Company Name: PnD Logging Et Tree Service
Address: PO Box 529
MAPLE VALLEY, WA, 98038
Contractor Registration No. PNDLOLT867QQ
WA UBI Number 601439180
Phone Number 425-432-7636
Industrial Insurance Account ID 83874700
OMWBE Certifications as of 2/16/2022 No active certifications existed when
Intent was submitted
Email Address pandlogging@comcast.net
Filed By Chris Powell
Prime Contractor
Company Name REED TRUCKING a EXCAVATING INC
Contractor Registration No. REEDTEI016JW
WA UBI Number 601915034
Phone Number 253-841-4837
Project Information
Awarding Agency RENTON, CITY OF
1055 S GRADY WAY RENTON, WA-
98055
Awarding Agency Contact Flora Lee
/1
1
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 &t EXCAVATING INC
Contractor Registration No. REEDTEI016JW
WA UBI Number 601915034
Payment Details
Check Number:
Transaction Id: 108528434
Intent Details
Expected project start date: (MM/DD/YYYY) 2/18/2022
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 $9,250.00
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?
Yes
V 4
Do you intend to use any apprentices?
(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 Laborers Faller Et Bucker Chain Saw $53.35 $0.00 5
King Laborers Clean-up Laborer $52.39 $0.00 2
Public Notes
o Show/Hide Existing Notes
No note exists
State of Washington
Department of Labor & Industries
Prevailing Wage Section - Telephone 360-902-5335
PO Box 44540, Olympia, WA 98504-4540
Affidavit of Wages Paid
Project Detail - Project Dashboard
Document Received Date: Intent Id: Affidavit Id: 1219932 Status: Approved on
6/23/2023 123.1916 6/23/2023
Company Details
Name PnD Logging Et Tree Service
Address PO Box 529
MAPLE VALLEY,WA,98038
WA UBI no. 601439180
Contractor Registration no. PNDLOLT867QQ
Industrial Insurance Account Id 83874700
OMWBE Certifications as of 5/9/2022 No active certifications existed when Intent was
submitted
Email Address pandlogging®comcast.net
Filed By Powell, Chris
Prime Contractor
Prime contractor name REED TRUCKING Et EXCAVATING INC
Prime contractor registration no. REEDTEI016JW
Prime contractor Phone Number 253-841-4837
Project Information
Awarding agency: RENTON, CITY OF
1055 S GRADY WAY RENTON, WA - 98055
Awarding agency contact: Flora Lee
Awarding agency contact phone number: 425-430-7303
Contract no. CAG-20-065
Project name Duvall Avenue NE
Project Description This project includes but is not limited to:
excavation; grading; removal of pavement;
plaining pavement; paving with asphalt, curb
and gutter; drainage; illumination; HAWK
restoration; and other work. �=
Dollar amount of your contract: $ 11,600.00
Bid due date .6/22/2021
Contract award date 7/21/2021
Job site address/directions:
Hiring Contractor
Company Name REED TRUCKING Et EXCAVATING INC
Contractor Registration No. REEDTEI016JW
WA UBI Number 601915034
Payment Details
Check Number:
Transaction Id: 109405102
Project Details
County where work was performed King
City where work was performed Renton
Prime contractor Intent form Id#for this 1170257
project
Intent filed date 5/9/2022
Job start date:MM-DD-YYYY 5/9/2022
Date work completed:MM-DD-YYYY 6/16/2023
Project Completion
Did your company hire any subcontractors? No
Did your company have employees perform Yes
work on this project?
Did you use apprentice employees on this No
project?
Company Owner Information
How many owner/operators performed work on 0
the project that own 30% or more of the
company?
No company owner added.
Affidavit Subcontractor(s)
No subcontractor is selected for this affidavit.
Journeylevel Wages
County Trade Occupation Wages Fringes # #
Workers Hours
w��5 uuv.....I.i �.w u�� ur �uvv�..� .ic..ii u.vv z JAL•vv
~ King Laborers Faller Et Bucker Chain 53.35 0.00 2 16.00
Saw
Apprentice Wages
Public Notes
o Show/Hide Existing Notes
No note exists
12/14/2' ;3:11 PM about:blank
State of Washington
Department of Labor & Industries
Prevailing Wage Section - Telephone 360-902-5335
PO Box 44540, Olympia, WA 98504-4540
Affidavit of Wages Paid
Project Detail - Project Dashboard
Document Received Date: Intent Id: Affidavit Id: 1219932 Status: Approved on 6/23/2023
6/23/2023 1231916
Company Details
Name PnD Logging Et Tree Service
Address PO Box 529
MAPLE VALLEY,WA,98038
WA UBI no. 601439180
Contractor Registration no. PNDLOLT867QQ
Industrial Insurance Account Id 83874700
OMWBE Certifications as of 5/9/2022 No active certifications existed when Intent was
submitted
Email Address pandlogging@comcast.net
Filed By Powell, Chris
Prime Contractor
Prime contractor name REED TRUCKING a EXCAVATING INC
about:blank 1/4
12/14/23,3:11 PM about:blank
Prime contractor registration no. REEDTEI016JW
Prime contractor Phone Number 253-841-4837
Project Information
Awarding agency: RENTON, CITY OF
1055 S GRADY WAY RENTON, WA - 98055
Awarding agency contact: Flora Lee
- Awarding agency contact phone number: 425-430-7303
Contract no. CAG-20-065
Project name Duvall Avenue NE
Project Description This project includes but is not limited to: excavation;
grading; removal of pavement; plaining pavement; paving
with asphalt, curb and gutter; drainage; illumination;
HAWK signal; sidewalk; walls; adjustments to utility
frames, grates, and covers; property restoration; and
other work.
' Dollar amount of your contract: $ 11,600.00
Bid due date 6/22/2021
Contract award date 7/21/2021
Job site address/directions:
Hiring Contractor
Company Name REED TRUCKING Ft EXCAVATING INC
Contractor Registration No. REEDTEI016JW
WA UBI Number 601915034
Payment Details
Check Number:
Transaction Id: 109405102
Project Details
County where work was performed King
aboutk'slank 2/4
--12/14i2:i;3:11 PM about:blank
City where work was performed Renton
Prime contractor Intent form Id# for this project 1170257
Intent filed date 5/9/2022
Job start date:MM-DD-YYYY 5/9/2022
Date work completed:MM-DD-YYYY 6/16/2023
Project Completion
Did your company hire any subcontractors? No
Did your company have employees perform work on this Yes
project?
Did you use apprentice employees on this project? No
Company Owner Information
How many owner/operators performed work on the 0
project that own 30% or more of the company?
No company owner added.
Affidavit Subcontractor(s)
No subcontractor is selected for this affidavit.
Journeylevel Wages
County Trade Occupation Wages Fringes Workers # Hours
King Laborers Clean-up Laborer 52.39 0.00 4 32.00
King Laborers Faller a Bucker Chain Saw 53.35 0.00 2 16.00
Apprentice Wages
Public Notes
o Show/Hide Existing Notes
about:blank 3/4
12/14/23,3:32 PM about:blank
State of Washington
Department of Labor & Industries
Prevailing Wage Section - Telephone 360-902-5335
PO Box 44540, Olympia, WA 98504-4540
Affidavit of Wages Paid
Project Detail - Project Dashboard
Document Received Date: Intent Id: Affidavit Id: 1112368 Status: Approved on 5/2/2022
5/2/2022 1212066
Company Details
Name PnD Logging Et Tree Service
Address PO Box 529
MAPLE VALLEY,WA,98038
WA UBI no. 601439180
Contractor Registration no. PNDLOLT867QQ
Industrial Insurance Account Id 83874700
OMWBE Certifications as of 2/16/2022 No active certifications existed when Intent was
submitted
Email Address pandlogging@comcast.net
Filed By Powell, Chris
Prime Contractor
Prime contractor name REED TRUCKING &t EXCAVATING INC
about:blank 1/4
12/14/23,3:32 PM about:blank
Prime contractor registration no. REEDTEI016JW
Prime contractor Phone Number 253-841-4837
Project Information
Awarding agency: RENTON, CITY OF
1055 S GRADY WAY RENTON, WA - 98055
Awarding agency contact: Flora Lee
Awarding agency contact phone number: 425-430-7303
Contract no. CAG-20-065
Project name Duvall Avenue NE
Project Description This project includes but is not limited to: excavation;
grading; removal of pavement; plaining pavement; paving
with asphalt, curb and gutter; drainage; illumination;
HAWK signal; sidewalk; walls; adjustments to utility
frames, grates, and covers; property restoration; and
other work.
Dollar amount of your contract: $ 9,250.00
Bid due date 6/22/2021
Contract award date 7/21/2021
Job site address/directions:
Hiring Contractor
Company Name REED TRUCKING Et EXCAVATING INC
Contractor Registration No. REEDTEI016JW
WA UBI Number 601915034
Payment Details
Check Number:
Transaction Id: 108658361
Project Details
County where work was performed King
about:blank 2/4
12/14/23,3:32 PM about:blank
City where work was performed Renton
Prime contractor Intent form Id# for this project 1170257
Intent filed date 2/16/2022
Job start date:MM-DD-YYYY 2/18/2022
Date work completed:MM-DD-YYYY 2/18/2022
Project Completion
Did your company hire any subcontractors? No
Did your company have employees perform work on this Yes
project?
Did you use apprentice employees on this project? No
Company Owner Information
How many owner/operators performed work on the 0
project that own 30% or more of the company?
No company owner added.
Affidavit Subcontractor(s)
No subcontractor is selected for this affidavit.
Journeylevel Wages
County Trade • Occupation Wages Fringes Workers # Hours
King Laborers Clean-up Laborer 52.39 0.00 4 12.95
King Laborers Faller a Bucker Chain Saw 53.35 0.00 2 7.00
Apprentice Wages
•
Public Notes
o Show/Hide Existing Notes
about:blank 3/4
Certified Payroll Report
Department of Labor and t,•STATA Project Name County Project or Contract#
?:i= Prime Contractor ❑
Industries %:_._.!_ _ __=4
:_x Duvall Avenue NE King CAG-20-065
Prevailing Wage Program �{m:• ••:••z
,,:,,,,. ••:i;•;. Subcontractor El
PO Box 44540 d'�.,_� �;� Project Address
Olympia WA 98504-4540 y` '�"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 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
2/5/2023 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
Work Classification Name c9 O~ o Mon Tue Wed Thu Fri Sat Sun Total
m Gross Amount
and And a) E 1/30 1/31 2/1 2/2 2/3 2/4 2/5 Total Rate Earned/Gross es
Hourly Net Wages
E a Hours of Pay Payroll "Usual FICA Withholding Other g
Soc Sec#of Employee Address CD Ct 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 CHRIS R POWELL President
2/9/2023
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
^••vall Avenue NE 1/30/2023 2/5/2023
"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.
,rs)Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and
r fling 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
CHRIS R POWELL President CHRIS R POWELL
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 ���5 "T£�� Prime Contractor ❑ Project Name County Project or Contract#
Industries (TjJ'
Duvall Avenue NE King CAG-20-065
Prevailin Wa a Pro ram 9 9 9 Subcontractor ►z�PO Box 44540Project Address
Olympia WA 98504-4540 'bBy Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
1/29/2023 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
p
Work Classification Name c9 ~• O o Mon Tue Wed Thu Fri Sat Sun Total
a� Gross Amount
and And a� E 1/23 1/24 1/25 1/26 1/27 1/28 1/29 Total Rate Earned/Gross Hourly Net Wages
• r Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address 0 > z 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 CHRIS R POWELL President
2/2/2023
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
Duvall Avenue NE 1/23/2023 1/29/2023
"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.
.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
CHRIS R POWELL President CHRIS R POWELL
MB 2/2/23
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and STATE Project Name County Project or Contract#
Industries a ;: Q4 Prime Contractor ❑
' Duvall Avenue NE King CAG-20-065
Prevailing Wage Program -'"' Subcontractor ►'�
�r� .€:�
PO Box 44540 �' va Project Address
Olympia WA 98504-4540 y� `�e�'IC)
Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
1/22/2023 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
p
Work Classification Name Mon Tue Wed Thu Fri Sat Sun Total
cC O0 o a) Gross Amount
and And E 1/16 1/17 1/18 1/19 1/20 1/21 1/22 Total Rate Hourly
"
Earned/Gross Net Wages
E Hours of Pay Usual FICA Withholding Other
Soc Sec#of Employee Address a) wO Jo
Q 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 CHRIS R POWELL President
1/26/2023
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
n'.vall Avenue NE 1/16/2023 1/22/2023
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
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
CHRIS R POWELL President CHRIS R POWELL
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 EST^re Project Name County Project or Contract#
��... Prime Contractor ❑
Industries 4 :: s.
�:::: - Duvall Avenue NE King CAG-20-065
Prevailing Wage Program Subcontractor _�
PO Box 44540y�, aoy" Project Address
Olympia WA 98504-4540 ` `BeV Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
1/15/2023 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
i= _
Work Classification Name 6 O~ a Mon Tue Wed Thu Fri Sat Sun Gross Amount Total
and And E F 1/9 1/10 1/11 1/12 1/13 1/14 1/15 Total Rate Earned/Gross Hourly Net Wages
Hours of Pay "Usual FICA Withholding Other
Soc Sec#of Employee Address o o Hours Worked Each Day Payroll Benefits" Tax
0
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date CHRIS R POWELL President
1/19/2023
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
vall Avenue NE 1/9/2023 1/15/2023
"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.
' '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
CHRIS R POWELL President CHRIS R POWELL
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 ;TATA, Project Name County Project or Contract#
Industries ,�t.i'""• °". Prime Contractor ❑
:i" jia y Duvall Avenue NE King CAG-20-065
Prevailing Wage Program f,ji;;, :i;Ei!�= Subcontractor El
PO Box 44540 '''.yi+' , 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 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
1/8/2023 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
i=
Work Classification Name O~ o Mon Tue Wed Thu Fri Sat Sun Gross Amount Total
and And N E 1/2 1/3 1/4 1/5 1/6 1/7 1/8 Total Rate Earned/Gross Hourly Net Wages
E Hours of Pay "Usual FICA Withholding Other
Soc Sec#of Employee Address 0 f , Payroll Benefits" Tax
ct
O o' Hours Worked Each Day
0
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date CHRIS R POWELL President
1/13/2023
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
tall Avenue NE 1/2/2023 1/8/2023
"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.
!c',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
CHRIS R POWELL President CHRIS R POWELL
MB 1/17/23
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�,f; Project Name County Project or Contract#
.c?..�� .", Prime Contractor ❑
Industries "':' "r Duvall Avenue NE King CAG-20-065
Prevailing Wage Program a'=.>;• eieiii Subcontractor N
PO Box 44540 .3.Y,
J tIN Project Address
1
Olympia WA 98504-4540 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 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
1/1/2023 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
Work Classification Name p o Mon Tue Wed Thu Fri Sat Sun Total
ce CZ 12/2 12/2 12/2 12/2 12/3 12/3 Gross Amount
and And E 6 7 8 9 0 1 1/1 Total Rate Hourly
Earned/Gross Net Wages
r a, Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address , > a 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 CHRIS R POWELL President
1/5/2023
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
n''vall Avenue NE 12/26/2022 1/1/2023
"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
r r
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
)-g>„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
CHRIS R POWELL President CHRIS R POWELL
MB- 1/10/23
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,S,.A F.�,� Project Name County Project or Contract#
.=.i� t... Prime Contractor ❑
Industries ii, :�.y
tg@;1r Duvall Avenue NE King CAG-20-065
Prevailing Wage Program {ii , -a=uuiz Subcontractor ►z�
PO Box 44540 'fit• v Project Address
Olympia WA 98504-4540 y� '""y Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
12/25/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
~ Mon Tue Wed Thu Fri Sat Sun
Work Classification Name c9 p Total
ct 2 w 12/1 12/2 12/2 12/2 12/2 12/2 12/2 Gross Amount
and And Total Rate Hourly
9 0 1 2 3 4 5 Earned/Gross WithholdingNet Wages
c E Hours of Pay "Usual FICA Other
Soc Sec#of Employee Address m cp Payroll Benefits" Tax
O oo 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 CHRIS R POWELL President
12/29/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
Duvall Avenue NE 12/19/2022 12/25/2022
"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
A. l�
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
f'-,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
CHRIS R POWELL President CHRIS R POWELL
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 ac,sTA �� Prime Contractor ❑ Project Name County Project or Contract#
Industries c:'•.`•' ,, Duvall Avenue NE King CAG-20-065
Prevailing Wage Program Subcontractor El
PO Box 44540 �"�' ov" Project Address
Olympia WA 98504-4540 y� te8�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 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
12/18/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
o Mon Tue Wed Thu Fri Sat Sun
Work Classification Name c7 Total
cc o a> 12/1 12/1 12/1 12/1 12/1 12/1 12/1 Gross Amount
£ Total Rate Hourly
and And Earned/Gross Net Wages
co E 2 3 4 5 6 7 8 Hours of Pay "Usual FICA Withholding Other
Soc Sec#of Employee Address c a) - Payroll Benefits" Tax
CC 0 8 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 CHRIS R POWELL President
12/29/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
^'.vall Avenue NE 12/12/2022 12/18/2022
"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.
ig 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
CHRIS R POWELL President CHRIS R POWELL
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 �a� STATA:�n Project Name County Project or Contract#
Prime Contractor ❑
Industries o`, ;,` Duvall Avenue NE King CAG-20-065
Prevailing Wage Program <"" x Subcontractor El
PO Box 44540 4)y'a; �,oy"� Project Address
Olympia WA 98504-4540 ` 1$By Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
12/11/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
~ Sat Sun
Work Classification Name t9 ~O o Mon Tue Wed Thu Fri Total
a� 12/1 12/1 Gross Amount
and And a) E 12/5 12/6 12/7 12/8 12/9 1 Total Rate Earned/Gross Hourly Net Wages
E Hours of Pay "Usual FICA Withholding Other
Soc Sec#of Employee Address o f 3 Payroll Benefits" Tax
r2 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 CHRIS R POWELL President
12/15/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
nuvall Avenue NE 12/5/2022 12/11/2022
"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
� _l
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
! `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
CHRIS R POWELL President CHRIS R POWELL
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 ,TAPE Project Name County Project or Contract#
industries ,. ipi' q `t y_ Prime Contractor ❑
-i•` ,;.;.?; Duvall Avenue NE King CAG-20-065
Prevailing Wage Program w�li,' ' I,, Subcontractor
PO Box 44540 '',;`•, °,� Project Address
Olympia WA 98504-4540 y� '�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 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
12/4/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
o Mon Tue Wed
Work Classification Name C9 o Thu Fri Sat Sun Total
a> 11/2 11/2 11/3 Gross Amount
and And E I= 8 9 0 12/1 12/2 12/3 12/4 Total Rate
Hours of Pay Earned/Gross Hourly
"Usual FICA Withholding Other Net Wages
Soc Sec#of Employee Address aai a) - Payroll Benefits" Tax
I:K 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 CHRIS R POWELL President
12/6/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
nuvall Avenue NE 11/28/2022 12/4/2022
"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.
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
CHRIS R POWELL President CHRIS R POWELL
MB 11/21/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and ���isrnrso� Project Name County Project or Contract#
Industries 4,,,, ,_., Prime Contractor ❑
o,:;; - ,w,,;; Duvall Avenue NE King CAG-20-065
Prevailing Wage Program < =.i i =:: Subcontractor ❑x
wo IF" -iti. Project Address
PO Box 44540 ;f'r; 04Q j
Olympia WA 98504-4540 `teas Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
11/27/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
Work Classification Name c i= o Mon Tue Wed Thu Fri Sat Sun Total
o
cc at 11/2 11/2 11/2 11/2 11/2 11/2 11/2 Gross Amount
w E Total Rate Hourly
Earned/Gross Net Wages
and And = E F 1 2 3 4 5 6 7 Hours of Pay Payroll Usual FICA Withholding Other g
Soc Sec#of Employee Address a°'i CD - y Benefits" Tax
o 0 8 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 CHRIS R POWELL President
12/6/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
Duvall Avenue NE 11/21/2022 11/27/2022
"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.
(51Any 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
CHRIS R POWELL President CHRIS R POWELL
MB 11/21/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and ^AFT^;'i_,� Prime Contractor ❑ Project Name County Project or Contract#
Industries ...:, L4
-Air4' ".. % , Duvall Avenue NE King CAG-20-065
Prevailing Wage Program r iit;' r'4i�< SubcontractorEl
PO Box 44540 1 - v� Project Address
Olympia WA 98504-4540 y� '"B"�° Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
11/20/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
o Mon Tue Wed Thu Fri Sat Sun
Work Classification Name c9 Total
cC o a) 11/1 11/1 11/1 11/1 11/1 11/1 11/2 Gross Amount
a, E Total Rate Hourly
and And `m E i 4 5 6 7 8 9 0 Hours of Pay Earned/Gross 'Usual FICA Withholding Other Net Wages
Soc Sec#of Employee Address m Z Payroll Benefits" Tax
o 0 0 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 CHRIS R POWELL President
12/6/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
Duvall Avenue NE 11/14/2022 11/20/2022
"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
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
CHRIS R POWELL President CHRIS R POWELL
MB 11/21/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and t,,,TAT,‘ Project Name County Project or Contract#
,? ii <i ., Prime Contractor ❑
Industries 111 lii.t
:�;;y Duvall Avenue NE King CAG-20-065
Prevailing Wage Program 49iiii.- ,ollix
Subcontractorvilif ffyl i IM
PO Box 44540
Project Address
y` "�y r
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 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
11/13/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
Work Classification Name c9 o Mon Tue Wed Thu Fri Sat Sun Total
cr o m 11/1 11/1 11/1 11/1 Gross Amount
and And 11/7 11/8 11/9 0 1 2 3 Total Rate Earned/Gross Hourly Net Wages
f a) Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address cr > 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 CHRIS R POWELL President
11/22/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
^..vall Avenue NE 11/7/2022 11/13/2022
"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
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.
1,5N Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and
,ping Council.
Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties.
Printed name of party signing this report Title Signature
CHRIS R POWELL President CHRIS R POWELL
•
MB 12/1/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
•r
Certified Payroll Report
Department of Labor and ���srnTso� Project Name County Project or Contract#
Industries a.:,:, ,,,,� Prime Contractor ❑
on 1 ii s Duvall Avenue NE King CAG-20-065
PrevailingWage Program ��i•. t:•i ,
9 9 =,,=. l;;,g Subcontractor
PO Box 44540 ':=I ` O4) Project Address
Olympia WA 98504-4540 y` 1889 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 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City NState Zip+4
11/6/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
IN
r Day and Date Deductions
Work Classification Name c I- o Mon Tue Wed Thu Fri Sat Sun Total
ix O N 10/3 Gross Amount
and And E E 1 11/1 11/2 11/3 11/4 11/5 11/6 Total Rate Earned/Gross Hourly Net Wages
f F.
Hours of Pay Payroll "Usual FICA Withholding
Other
Soc Sec#of Employee Address c a) z 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 CHRIS P POWELL President
11/8/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
^^all Avenue NE 10/31/2022 11/6/2022
"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.
/=` Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and
ping Council.
Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties.
Printed name of party signing this report Title Signature
CHRIS P POWELL President CHRIS P POWELL
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 ,Tnrx Project Name County Project or Contract#
,st`E";r..tt4l,°4 Prime Contractor ❑
Industries ;�ii t�tf
Prevailing Wage Program 48,3. 1:t Duvall Avenue NE King CAG-20-065
w 13i i Subcontractor
PO Box 44540 'r�'t';t ,, Project Address
Olympia WA 98504-4540 y�it
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 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
10/30/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date iDeductions
o Mon Tue Wed Thu Fri Sat Sun
Work Classification Name t7 Total
o a) 10/2 10/2 10/2 10/2 10/2 10/2 10/3 Gross Amount
a, E Total Rate Hourly
and And E 4 5 6 7 8 9 0 Hours of PayEarned/Gross °Usual Withholding Net Wages
rn f a, Payroll Benefits" FICA Tax Other
Soc Sec#of Employee Address a, >
IY 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 CHRIS P POWELL President
11/8/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
Duvall Avenue NE 10/24/2022 10/30/2022
"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.
;t'.",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
CHRIS P POWELL President CHRIS P POWELL
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 TA1'F Project Name County Project or Contract#
,�t'i=••isr°'. Prime Contractor ❑
Industries �i. !«:y.
�: - ,;::u;g Duvall Avenue NE King CAG-20-065
Prevailing Wage Program 4Flil filIi!= Subcontractor
,,:!3h. { '`I,
PO Box 44540 "`_ ,csv" Project Address
Olympia WA 98504-4540 y4 '""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 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
10/23/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
Work Classification Name o Mon Tue Wed Thu Fri Sat Sun Total
I .. a) 10/1 10/1 10/1 10/2 10/2 10/2 10/2 Gross Amount
a, E Total Rate Hourly
and And j E 7 8 9 0 1 2 3 Hours of Pay Earned/Gross °Usual FICA Withholding Other Net Wages
Soc Sec#of Employee Address Pr a) Payroll Benefits" Tax
CK 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 CHRIS R POWELL President
10/25/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
n'.vall Avenue NE 10/17/2022 10/23/2022
"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.
'"Iny 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
CHRIS R POWELL President CHRIS R POWELL
MB 11/21/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and 5TAT{ Project Name County Project or Contract#
,`'."4+ 's!" Prime Contractor ❑
Industries ;;.- =;7 Duvall Avenue NE King CAG-20-065
Prevailing Wage Program Wfli�,� �'i�z Subcontractor NI
PO Box 44540 ''�' ' o 3 Project Address
Olympia WA 98504-4540 y� 'be"° Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
10/16/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
Work Classification Name (— p o Mon Tue Wed Thu Fri Sat Sun Total
i o w 10/1 10/1 10/1 10/1 10/1 10/1 10/1 Gross Amount
and And `m E i= 0 1 2 3 4 5 6 Total Rate Earned/Gross Hourly Net Wages
a Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address 0 > - Benefits" Tax
rI 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 CHRIS R POWELL President
12/6/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
^-vall Avenue NE 10/10/2022 10/16/2022
"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.
f`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
CHRIS R POWELL President CHRIS R POWELL
MB 11/21/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and srnrF Project Name County Project or Contract#
< :: °,• Prime Contractor ❑
Industries ¢
o ;;' ii: Duvall Avenue NE King CAG-20-065
PrevailingWage Program <°°°
9 9 Subcontractor
PO Box 44540 tPyy.,�1'9 aoy�x 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 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
10/9/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
1---
Work Classification Name c9 ~O o Mon Tue Wed Thu Fri Sat Sun Total
cC a) Gross Amount
and And a� E 10/3 10/4 10/5 10/6 10/7 10/8 10/9 Total Rate Earned/Gross Hourly Net Wages
r Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address aa) -0 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 CHRIS R POWELL President
10/13/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
Duvall Avenue NE 10/3/2022 10/9/2022
"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.
-`(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
CHRIS R POWELL President CHRIS R POWELL
1 .
;MB,10711/22
F700-065-000 certified payroll report 05-09 Employee Benefits.Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and srera Project Name County Project or Contract#
4 °A Prime Contractor ❑
Industries 4:::i° £
o:::: Duvall Avenue NE King CAG-20-065
Prevailing Wage Program y° Subcontractor
PO Box 44540 c:47' ao Project Address
Olympia WA 98504-4540 ` "8D Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
10/2/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
• Day and Date Deductions
Work Classification Name C9 ~O o Mon Tue Wed Thu Fri Sat Sun Total
a) Gross Amount
and And '05E 9/26 9/27 9/28 9/29 9/30 10/1 10/2 Total Rate Earned/Gross Hourly Net Wages
.E Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address 12 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 CHRIS R POWELL President
10/6/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
mall Avenue NE 9/26/2022 10/2/2022
"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
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
CHRIS R POWELL President CHRIS R POWELL
MB. 10/6/2Z
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 Project Name County Project or Contract#
�,!,,g° '�f Prime Contractor ❑
Industries 4iT _ _= y
o::=� _,r Duvall Avenue NE King CAG-20-065
Prevailing Wage Program k =:ii9•',x, Subcontractor XI
rya;;;;. {tl..
PO Box 44540 °' '', , oy� Project Address
Olympia WA 98504-4540 � 'e"°a Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
9/25/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
p
Work Classification Name C7 ~O o Mon Tue Wed Thu Fri Sat Sun Total
m Gross Amount
and And E 9/19 9/20 9/21 9/22 9/23 9/24 9/25 Total Rate Earned/Gross Hourly Net Wages
:— i= Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address c > - y Benefits" Tax
o' 0 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 CHRIS R POWELL President
9/29/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
Duvall Avenue NE 9/19/2022 9/25/2022
"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.
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
CHRIS R POWELL President CHRIS R POWELL
MB 10/4/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and ��F.sr�rE.o� Project Name County Project or Contract#
Industries ;;•• Prime Contractor ❑
c:iii Duvall Avenue NE King CAG-20-065
Prevailing Wage Program ;_;_ ,:'iii$ Subcontractor x❑
PO Box 44540 ° I 04�pe
Project Address
Olympia WA 98504-4540 '`18&fl a. Final Week of
(360) 902-5335 Payroll El
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address , City State Zip+4
9/18/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
�. - -
Day and Date Deductions
Work Classification Name cF ~o o Mon Tue Wed Thu Fri Sat Sun Total
m Gross Amount
and And ` N E 9/12 9/13 9/14 9/15 9/16 9/17 9/18 Total Rate Earned/Gross Hourly Net Wages
E Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address > - y Benefits" Tax
CY O o Hours Worked Each Day
a
No Employees performed work on this project during this reporting period.
a
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 CHRIS R POWELL president
9/21/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
n.wall Avenue NE 9/12/2022 9/18/2022
"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
Aning 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
CHRIS R POWELL president CHRIS R POWELL
MB 9/28/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and �*; ,�nrf Project Name County Project or Contract#
Industries _"_"6, Prime Contractor ❑
�•oeo ===•r„` Duvall Avenue NE King CAG-20-065
Prevailing Wage Program I<;;,;,,;i:I=;'=l Subcontractor 0
PO Box 44540 °'4( 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 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
9/11/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
Work Classification Name c9 8 o Mon Tue Wed Thu Fri Sat Sun Total
Gross Amount
and And - a.) E 9/5 9/6 9/7 9/8 9/9 9/10 9/11 Total Rate Hourly
E t= Hours of Pay Earned/Gross "Usual Withholding Net Wages
w — Payroll FICA Other
Soc Sec#of Employee Address CD
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 CHRIS R POWELL President
9/15/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
niivall Avenue NE 9/5/2022 9/11/2022
"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.
r 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
CHRIS R POWELL President CHRIS R POWELL
MB 9/28/22
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:sTAT low Project Name County Project or Contract#
Industries 4 ,, Prime Contractor ❑
o. . _;; Duvall Avenue NE King CAG-20-065
Prevailing Wage Program _b. i4 Subcontractor x❑
PO Box 44540 °`'q; the Project�, goy 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 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
9/4/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
H
Work Classification Name c� ~o o Mon Tue Wed Thu Fri Sat Sun Total
Gross Amount
and And E 8/29 8/30 8/31 9/1 9/2 9/3 9/4 Total Rate Earned/Gross Hourly Net Wages
f i Hours of Pay Payroll "Usual FICA Withholding Other g
Soc Sec#of Employee Address rY 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 CHRIS R POWELL President
9/8/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
Duvall Avenue NE 8/29/2022 9/4/2022
"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.
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
CHRIS R POWELL President CHRIS R POWELL
M B 9/28/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and s��rF• Project Name County Project or Contract#
��•__ °, Prime Contractor ❑
Industries �..=.1i" _.
o:-ei - „I: Duvall Avenue NE King CAG 20 065
Prevailing Wage Program i,= iiji'ix
�I;jjh Subcontractor �
PO Box 44540 4,==ii !ly Project Address
Olympia WA 98504-4540 y` 'ow`�, Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
8/28/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date I Deductions
F=-
Work Classification Name E. ~O o Mon Tue Wed Thu Fri Sat Sun Total
m Gross Amount
and And E 8/22 8/23 8/24 8/25 8/26 8/27 8/28 Total Rate Earned/Gross Hourly Net Wages
.E Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address c .05> - y Benefits" Tax
(1 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 CHRIS R POWELL President
9/1/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
Duvall Avenue NE 8/22/2022 8/28/2022
"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.
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
CHRIS R POWELL President CHRIS R POWELL
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 s,�rA• Project Name County Project or Contract#
.s�'.::�• °F Prime Contractor ❑
Industries a.ili 4
�::;, - �..`�:_;� Duvall Avenue NE King CAG-20-065
Prevailing Wage Program s=. •'_'_= Subcontractor X7
.=;ill• si'` Project Address
PO Box 44540 '••'`�` y° 1
Olympia WA 98504-4540 �y� 'g�°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 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
8/21/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
P
Work Classification Name c7 ~O G. Mon Tue Wed Thu Fri Sat Sun Total
a) Gross Amount
and And m E 8/15 8/16 8/17 8/18 8/19 8/20 8/21 Total Rate Earned(Gross Hourly Net Wages
E Hours of Pay Payroll "Usual FICA Withholdingci, Other
Soc Sec#of Employee Address > - Benefits" Tax
f 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 CHRIS R POWELL president
8/25/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
n'i'iall Avenue NE 8/15/2022 8/21/2022
"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.
",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
CHRIS R POWELL president CHRIS R POWELL
•
MB 9/6/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
s
Certified Payroll Report
Department of Labor and ,,e ere Project Name County Project or Contract#
4 Industries i
Prime Contractor
o.,. Duvall Avenue NE King CAG 20 065
Prevailing Wage Program '.: Subcontractor IXJ
PO Box 44540 ,� Project Address
Olympia WA 98504-4540 4IMB '. Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
8/14/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
H
Work Classification Name c7 8 -- Mon Tue Wed Thu Fri Sat Sun Total
Cr O N Gross Amount
and And a) E 8/8 8/9 8/10 8/11 8/12 8/13 8/14 Total Rate Earned/Gross Hourly Net Wages
as E H Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address c f y Benefits" Tax
Et 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 Sid(
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 Chris Powell President
8/17/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
'' vall Avenue NE 8/8/2022 8/14/2022
"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 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
Chris Powell President Chris Powell
MB 8/17/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and rnrf: Project Name County Project or Contract#
'''. l'.� °
'"`F Prime Contractor ❑
Industries iii f. •Duvall Avenue NE King CAG-20-065
Prevailing Wage Program iimi j i., ,+_i Subcontractor LRJ
PO Box 44540 , ,y 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 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
8/7/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
Work Classification Name (- ~O o Mon Tue Wed Thu Fri Sat Sun Total
a) Gross Amount
and And a) E 8/1 8/2 8/3 8/4 8/5 8/6 8/7 Total Rate Earned/Gross Hourly Payroll Net Wages
Hours of Pay "Usual FICA Withholding Other
Soc Sec#of Employee Address ax
O 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 chris Powell president
8/17/2022 -
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
—wall Avenue NE 8/1/2022 8/7/2022
"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
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.
'cl 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
chris Powell president chris Powell
MB 8/17/22
•
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�. Project Name County Project or Contract#
��'ii it,°F Prime Contractor ❑
IndustriesL. :41 �.
ip:- „.94., Duvall Avenue NE King GAG-20-065
Prevailing Wage Program <.Ijjji; ,��l i ) Subcontractor
PO Box 44540 '',',',.. ^`Y Project Address
Olympia WA 98504-4540 8nd ' Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
7/31/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
t=
Work Classification Name 0 ~O o Mon Tue Wed Thu Fri Sat Sun Total
u, Gross Amount
and And E 7/25 7/26 7/27 7/28 7/29 7/30 7/31 Total Rate Earned/Gross Hourly Net Wages
E i= Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Addressii) y 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 Chris Powell President
8/17/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
^ wall Avenue NE 7/25/2022 7/31/2022
"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.
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
Chris Powell President Chris Powell
MB 8/17/22
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;,�s�ArF",� Project Name County Project or Contract#
Prime Contractor ❑
Industries °c.:t! � f. Duvall Avenue NE King CAG-20-065
Prevailing Wage Program yi;ii#1. ,iiil Subcontractor LRJ
PO Box 44540 °'�::: 5.v Project Address
Olympia WA 98504-4540 y� '"�"aFinal Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
7/24/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
Work Classification Name E79 ~O o Mon Tue Wed Thu Fri Sat Sun Total
Gross Amount
and And E 7/18 7/19 7/20 7/21 7/22 7/23 7/24 Total Rate Earned/Gross Hourly Net Wages
E i Hours of Pay "Usual Withholdingg
w a, Payroll FICA Other
Soc Sec#of Employee Address O o Hours Worked Each Day Benefits" Tax
0
1. Laborers RG 3.00 0.00 0.00 0.00 0.00 0.00 0.00 3.00 $52.39 $157.17
Clean-up Laborer Mike Curtiss
(King) 804 Grinnell AVE $157.17/
SW OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.03 $0.00 $157.17 $0.00/hr $12.02 $2.90 $142.25
_ _ «• Orting,WA-98360-
9426 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1006.7 $0.00
2. Laborers RG 3.00 0.00 0.00 0.00 0.00 0.00 0.00 3.00 $52.39 $157.17
Clean-up Laborer Stanley Petrick
(King) 22831 NE 74th St OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $78.59 $0.00 $157.17/ $0.00/hr $12.02 $2.90 $142.25
Redmond,WA- $157.17
98053 $104.7
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 8 $0.00
3. Laborers RG 3.00 0.00 0.00 0.00 0.00 0.00 0.00 3.00 $53.35 $160.05
Faller&Bucker Chain Saw Chris Powell Jr
(King) 20429 SE 222nd St OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.03 $0.00 $160.05/ $0.00/hr $12.24 $2.90 $144.91
Maple Valley,WA- $160.05
98038 - $106.7
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0 $0.00
4. Laborers `/ J
RG 3.00 0.00 0.00 0.00 0.00 0.00 0.00 3.00 $53.35 $160.05 J
Faller&Bucker Chain Saw Jacen Renfrow
(King) 24909 SE 232nd St OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.03 $0.00 $160.05/ $0.00/hr $12.24 $2.90 $144.91
Maple Valley,WA- $160.05
98038 $106.7
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0 $0.00
5. Laborers Nic Scroggins RG 3.00 0.00 0.00 0.00 0.00 0.00 0.00 3.00 $52.39 $157.17
6115 36th St SE $157.17/ $0.00/hr $12.02 $2.90 $142.25
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Clean-up Laborer Auburn,WA-98092 $157.17
(King) OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $78.59 $0.00
********* DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $184.7 $0.00
6. Laborers RG 3.00 0.00 0.00 0.00 0.00 0.00 0.00 3.00 $52.39 $157.17
Clean-up Laborer Dylan Sergi
(King) 12619 214th Ave Ct $157.17/
E OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $78.59 $0.00 $157.17 $0.00/hr $12.02 $2.90 $142.25
* ***** Bonney Lake,WA-
98391 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $18 04.7 $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 CHRIS R POWELL President
7/28/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
^_wall Avenue NE 7/18/2022 7/24/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
1.Mike Curtiss
Laborers
Clean-up Laborer $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
(King)
2.Stanley Petrick
'--5orers
;:an-up Laborer $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
(King)
3.Chris Powell Jr
Laborers
Faller&Bucker Chain Saw $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
(King)
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
4.Jacen Renfrow
Laborers
Faller&Bucker Chain Saw $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
(King)
5.Nic Scroggins
Laborers
Clean-up Laborer $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
(King)
' Dylan Sergi
Laborers
Clean-up Laborer $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
(King)
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
F
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
• contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
'c 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
CHRIS R POWELL President CHRIS R POWELL
, .\
MB 8/2/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and �, ?+rE Project Name County Project or Contract#
i'i.• ; :°F Prime Contractor El
Industries ' "' `f• . Duvall Avenue NE King CAG-20-065
Prevailing Wage Program �.jiili r'`I(�; Subcontractor
PO Box 44540 °,� Key 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 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
7/17/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
p
Work Classification Name c7 ~O o Mon Tue Wed Thu Fri Sat Sun Total
Gross Amount
a� E 7/11 7/12 7/13 7/14 7/15 7/16 7/17 Total Rate Hourly
and And
E i- Hours of Pay Earned/Gross "Usual Withholding Net Wages
f 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 chris powell president
8/17/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
ivall Avenue NE 7/11/2022 7/17/2022
"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
chris powell president chris powell
MB 8/17/22
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'^,i�F Prime Contractor ❑ Project Name County Project or Contract#
Industries =3 4.
Er- , i„ Duvall Avenue NE King CAG-20-065
Prevailing Wage Program Id, "= Subcontractor
PO Box 44540 "'/:;' , )y` Project Address
Olympia WA 98504-4540 H ""d Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON, CITY OF (425)430-7303 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
7/10/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
H=
Work Classification Name C7 b o Mon Tue Wed Thu Fri Sat Sun Total
11 O a) Gross Amount
and And E 7/4 7/5 7/6 7/7 7/8 7/9 7/10 Total Rate Earned/Gross Hourly Net Wages
E Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address 0 y Benefits" Tax
l 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 Chris Powell President
8/17/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
vall Avenue NE 7/4/2022 7/10/2022
"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.
irl 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
Chris Powell President Chris Powell
•
MB 8/17/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
r
Certified Payroll Report
Department of Labor and ;, �rF:, 1 Project Name County Project or Contract#
,$..: ,! :�:F Prime Contractor ❑
Industries Duvall Avenue NE King CAG-20-065
Prevailing Wage Program VP!, e'IV Subcontractor ❑x
PO Box 44540 4,;;I. y Project Address
Olympia WA 98504-4540 ti� '"""' Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
7/3/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
I--
Work Classification Name C7 ~O o Mon Tue Wed Thu Fri Sat Sun Total
a) Gross Amount
and And m E 6/27 6/28 6/29 6/30 7/1 7/2 7/3 Total Rate Earned/Gross Hourly Net Wages
f a Hours of Pay Payroll "Usual FICA Withholding
holding Other
Soc Sec#of Employee Address ay' o - Benefits" Tax
O M 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 Chris Powell President
8/17/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
^.ivall Avenue NE 6/27/2022 7/3/2022
"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
a,.
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally -
permissible, have been made by any person either directly or indirectly from the full wages earned.
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
Chris Powell President Chris Powell
MB 8/17/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and �,s �rf. Project Name County Project or Contract#
,.:i t ::`'F Prime Contractor ❑
Industries _� _. f.
ems•' - :yr Duvall Avenue NE King CAG-20-065
WageProgram ,Ilj}'l, I . Subcontractor IX
Prevailing � ,� ,_
`''a' �,` Project Address
PO Box 44540 °�ti'� w`,y
Olympia WA 98504-4540 ` '��" 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 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
6/26/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
p
Work Classification Name C9 ~O 9- Mon Tue Wed Thu Fri Sat Sun Total
a) Gross Amount
and And a� E 6/20 6/21 6/22 6/23 6/24 6/25 6/26 Total Rate Earned/Gross Hourly Net Wages
E Hours of Pay "Usual FICA Withholding Other
Soc Sec#of Employee Address C) o o Hours Worked Each Day Payroll Benefits" Tax
0
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Chris Powell President
8/17/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
"wall Avenue NE 6/20/2022 6/26/2022
"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
Certified Payroll Report
Department of Labor and ` 14rf: Project Name County Project or Contract#
,, '. .i,i °F Prime Contractor ❑
Industries 'i'• 4. Duvall Avenue NE King CAG-20-065
Prevailing Wage Program AIlii€t 410 Subcontractor ❑x
PO Box 44540 4..q: ,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 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
6/19/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
p
Work Classification Name (7 ~▪ O o Mon Tue Wed Thu Fri Sat Sun Total
a) Gross Amount
and And ai E 6/13 6/14 6/15 6/16 6/17 6/18 6/19 Total Rate Earned/Gross Hourly Net Wages
E Hours of Pay "Usual FICA Withholding Other
Soc Sec#of Employee Address m - Payroll 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 Chris Powell President
8/17/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
ivall Avenue NE 6/13/2022 6/19/2022
"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.
( 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
Chris Powell President Chris Powell
MB 8/17/22
•
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�rk•o� Project Name County Project or Contract#
.... Prime Contractor ❑
Industries �:i! f
o:: ::: Duvall Avenue NE King CAG 20 065
Prevailing Wage Program 1'.. Subcontractor
PO Box 44540 �,�� ,�` Fyn Project Address
Olympia WA 98504-4540 y� �e"w Final Week of
(360) 902-5335 Payroll
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
6/12/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
p
Work Classification Name C7 ~ Mon Tue Wed Thu Fri Sat Sun Total
cc O a, Gross Amount
and And . E 6/6 6/7 6/8 6/9 6/10 6/11 6/12 Total Rate Earned/Gross Hourly Net Wages
m E H Hours of Pay "Usual FICA Withholding Other
Soc Sec#of Employee Address m > Payroll Benefits" Tax
ce 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 Chris Powell President
8/16/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
ivall Avenue NE 6/6/2022 6/12/2022
"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
( :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
Chris Powell President Chris Powell
MB 8/17/22
•
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and CAPE Project Name County Project or Contract#
4z; it+it°F Prime Contractor ElIndustries l! ;!L*
=;»:- .,:1,r,,, Duvall Avenue NE King CAG-20-065
Prevailing Wage Program ;y lifllz' oily Subcontractor IZ
PO Box 44540 ,,.. '•',�, 1 ,• 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 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
6/5/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
P
Work Classification Name C7 ~O o Mon Tue Wed Thu Fri Sat Sun Total
Gross Amount
and And 5/30 5/31 6/1 6/2 6/3 6/4 6/5 Total Rate Hourly
Hours of Pay Earned/Gross "Usual Withholding Net Wages
�, Payroll FICA Other
Soc Sec#of Employee Address Cn
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 CHRIS R POWELL President
6/6/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
^ ivall Avenue NE 5/30/2022 6/5/2022
"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.
ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and
r 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
CHRIS R POWELL President CHRIS R POWELL
l J
M B.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 t,sTArF Project Name County Project or Contract#
4.?.!, ,iii', Prime Contractor ❑
Industries 4.
�::_i: - .;r!==;'„ Duvall Avenue NE King CAG-20-065
Prevailing Wage Program Nil. ,;rlj'; Subcontractor IXJ
PO Box 44540 °:z.' �', 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 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
5/29/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
IL-
Work Classification Name (. ~O -- Mon Tue Wed Thu Fri Sat Sun Total
ix au Gross Amount
and And E 5/23 5/24 5/25 5/26 5/27 5/28 5/29 Total Rate Earned/Gross Hourly Net Wages
m E i Hours of Pay Net FICA Withholding• Other
Soc Sec#of Employee Address c > - 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 Chris Powell President
6/6/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
^wall Avenue NE 5/23/2022 5/29/2022
"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.
r`, 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
Chris Powell President Chris Powell •
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 Project Name County Project or Contract#
t • °, Prime Contractor ❑
Industries f.
3:i==.: •r Duvall Avenue NE King CAG-20-065
Prevailing Wage Program _':;:; : ' Subcontractor
PO Box 44540 ""� �y Project Address
Olympia WA 98504-4540 �y� '"Kd Final Week of
(360) 902-5335 Payroll Z
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
5/22/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
_ _
Work Classification Name c9 ~O o Mon Tue Wed Thu Fri Sat Sun AmountTotal
Gross
and And — E 5/16 5/17 5/18 5/19 5/20 5/21 5/22 Total Rate
mHourly
E Hours of Pay Earned/Gross "Usual Withholding Net Wages
r a) Payroll FICA Other
Soc Sec#of Employee Address cr
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 Chris Powell President
5/25/2022
The party signing this report pays or (Name of contractor or subcontractor) •
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
^ vall Avenue NE 5/16/2022 5/22/2022
i
"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
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
Chris Powell President Chris Powell
MB 5/24/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and ,,rf Project Name County Project or Contract#
a'f' •, °F Prime Contractor CIt, ,
Industries iit
��i:;;. - :,'::,;;. Duvall Avenue NE King CAG-20-065
Prevailing Wage Program iiiiii. ;:ilil , Subcontractor X
PO Box 44540 , 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 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
5/15/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
p
Work Classification Name C5 ~O o Mon Tue Wed Thu Fri Sat Sun Total
a) Gross Amount
and And a� E 5/9 5/10 5/11 5/12 5/13 5/14 5/15 Total Rate Earned/Gross Hourly Net Wages
E Hours of Pay "Usual FICA Withholding Other
m Payroll Benefits" Tax
Soc Sec#of Employee Address O o Hours Worked Each Day
0
1. Laborers RG 5.00 0.00 0.00 0.00 0.00 0.00 0.00 5.00 $52.39 $261.95
Clean-up Laborer Mike Curtiss
(King) 804 Grinnell AVE $261.95/
SW OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.03 $0.00 $261.95 $0.00/hr $20.04 $4.83 $237.08
Orting,WA-98360-
9426 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $106 7 $0.00.0
2. Laborers RG 5.00 0.00 0.00 0.00 0.00 0.00 0.00 5.00 $52.39 $261.95
Clean-up Laborer Stanley Petrick ./
(King) 22831 NE 74th St OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $78.59 $0.00 $261.95/ $0.00/hr $20.04 $4.83 $237.08
Redmond,WA- $261.95
* ** 98053 I $104.7
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 8 $0.00
s. Laborers RG 5.00 0.00 0.00 0.00 0.00 0.00 0.00 5.00 $53.35 $266.75
Faller&Bucker Chain Saw Chris Powell Jr
(King) 20429 SE 222nd St OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.03 $0.00 $266.75/ $0.00/hr $20.40 $4.83 $241.52
Maple Valley,WA- $266.75
98038 $106.7
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0 $0.00
4. Laborers RG 5.00 0.00 0.00 0.00 0.00 0.00 0.00 5.00 $53.35 $266.75
Faller&Bucker Chain Saw Jacen Renfrow
(King) 24909 SE 232nd St OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.03 $0.00 $266.75/ $0.00/hr $20.40 $4.83 $241.52
* ** Maple Valley,WA- $266.75
98038 $106.7
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0 $0.00
5. Laborers Nic Scroggins RG 5.00 0.00 0.00 0.00 0.00 0.00 0.00 5.00 $52.39 $261.95
6115 36th St SE $261.95/ $0.00/hr $20.04 $4.83 $237.08
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Clean-up Laborer Auburn,WA-98092 $261.95
(King) OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $78.59 $0.00
****** DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1$4'7 $0.00
6. Laborers RG 5.00 0.00 0.00 0.00 0.00 0.00 0.00 5.00 $52.39 $261.95
Clean-up Laborer Dylan Sergi
(King) 12619 214th Ave Ct $261.95/
E OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $78.59 $0.00 $261.95 $0.00/hr $20.04 $4.83 $237.08
_ _ ** Bonney Lake,WA-
98391 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $104.78 $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 Chris Powell President
6/1/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
^ -rail Avenue NE 5/9/2022 5/15/2022
"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
1.Mike Curtiss
Laborers
Clean-up Laborer $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
(King)
2.Stanley Petrick
'--`borers
,an-up Laborer $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
(King)
3.Chris Powell Jr
Laborers
Faller&Bucker Chain Saw $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
(King)
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
4.Jacen Renfrow
Laborers
Faller&Bucker Chain Saw $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
(King)
5.Nic Scroggins
Laborers
Clean-up Laborer $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
(King)
Dylan Sergi
Laborers
Clean-up Laborer $0.00 $0.00 $0.00 $0.00 $0.00 $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.
,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
Chris Powell President Chris Powell
Amended Reason
I missed a step in completing the gross and net wages ,
MB 6/14/22
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,',lt%P Project Name County Project or Contract#
�a
Industries 4 :::. ,y Prime Contractor ❑
;;=i: r111 r Duvall Avenue NE King CAG-20-065
Prevailing Wage Program 1'iij,; ,41111^ Subcontractor
PO Box 44540 d., •,� �y Project Address
Olympia WA 98504-4540 y� '"d°a Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
5/8/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
p
Work Classification Name C7 ~ o Mon Tue Wed Thu Fri Sat Sun Total
cC O a) Gross Amount
and And m E 5/2 5/3 5/4 5/5 5/6 5/7 5/8 Total Rate Earned!Gross Hourly Net Wages
Hours of Pay Payroll 'Usual FICA Wit holding Other
Soc Sec#of Employee Address al > Benefits" Tax
CC 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 CHRIS R POWELL president
5/17/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
wall Avenue NE 5/2/2022 5/8/2022
"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 made either directly or
indirectly to or on behalf of the_above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
f=>,Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and
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
CHRIS R POWELL president CHRIS R POWELL
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 �,S7Arf'� Project Name County Project or Contract#
?..ii• ;•� Prime Contractor ❑
Industries ;;=i f.
Prevailing Wage Program t ``i= Duvall Avenue NE King CAG-20-065
PO Box 44540 ...4 ••ac Subcontractor Z Project Address
Olympia WA 98504-4540 y� '""a� Final Week of
(360)902-5335 Payroll Z
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
4/9/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
H
Work Classification Name a ~O o Sun Mon Tue Wed Thu Fri Sat Total
a) Gross mount
E E 4/3 4/4 4/5 4/6 4/7 4/8 4/9 Total Rate A Hourly
and And Earned/Gross Net Wages
H Hours of Pay "Usual FICA Withholding Other
Soc Sec#of Employee Address cc o o Hours Worked Each Day Payroll Benefits" Tax
0
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Chris Powell President
4/14/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
^.-tall Avenue NE 4/3/2022 4/9/2022
"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.
—c-4ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and
Wing 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
Chris Powell President Chris Powell
MB 4/18/22
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�rt:G Project Name County Project or Contract#
A?..�_ •t:.� Prime Contractor ❑
Industries r Duvall Avenue NE King CAG-20-065
:" ',.._ "
Prevailing Wage Program <, .;,.
w.,= . ••;;,•� Subcontractor LRJ
PO Box 44540 `•4r Project Address
Olympia WA 98504-4540 y� '"�°''''Cs
Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
4/2/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
H
Work Classification Name c7 ~O o Sun Mon Tue Wed Thu Fri Sat Total
and And Gross Amount
a� E 3/27.3/28 3/29 3/30 3/31 4/1 4/2 Total Rate Hourly
m E i Hours of Pay Earned/Gross °Usual Withholding Net Wages
r m Payroll FICA Other
Soc Sec#of Employee Address cc 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 Chris Powell President
4/14/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
^"vall Avenue NE 3/27/2022 4/2/2022
"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
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;,r, 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
Chris Powell President Chris Powell
MB 4/18/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
•
Certified Payroll Report
Department of Labor and •sa4a "r`_o, Prime Contractor ❑ Project Name County Project or Contract#
Industries ::si: li f.
'.
s r Duvall Avenue NE King CAG-20-065
Prevailing Wage Program =iiht i: i= Subcontractor
PO Box 44540 VIM' • Project Address
"' .: • y i `
Olympia WA 98504-4540 yy •
'xaa 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 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
3/26/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
H
Work Classification Name 6 ~O o Sun Mon Tue Wed Thu Fri Sat Total
Gross Amount
7 a> E 3/20 3/21 3/22 3/23 3/24 3/25 3/26 Total Rate Hourly
and And
m E i= Hours of Pa Earned/Gross "Usual Withholding Net Wages
- "-E a, y Payroll FICA Tax Other
Soc Sec#of Employee Address iY O 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 Chris Powell President
4/14/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
iiuvall Avenue NE 3/20/2022 3/26/2022
"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.
irs 1ny 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
Chris Powell President Chris Powell
•
MB 4/18/22
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`:s7nrf�F Project Name County Project or Contract#
Prime Contractor ❑
Industries :E E Duvall Avenue NE King CAG 20 065
Prevailing Wage Program k;;;;, ;: � Subcontractor
PO Box 44540 ",��°: • , 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 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
3/19/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
Work Classification Name & ~O o Sun Mon Tue Wed Thu Fri Sat Total
re and And Gross Amount
a� E 3/13 3/14 3/15 3/16 3/17 3/18 3/19 Total Rate Hourly
03 E i= Hours of Pay Earned/Gross "Usual Withholding Net Wages
f a) Payroll FICA Other
Soc Sec#of Employee Address CD 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 Chris Powell President
4/14/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
'veil Avenue NE 3/13/2022 3/19/2022
"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.
! >„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
Chris Powell President Chris Powell
MB 4/18/22
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,5T+/E. Project Name County Project or Contract#
A.::! Prime Contractor
Industries 4i 4.
���!' i!!.�, Duvall Avenue NE King CAG-20-065
Prevailing Wage Program
-R!N!• . -?!!' Subcontractor !
PO Box 44540 f,0,- goy" 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 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
3/12/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
p
Work Classification Name C7 ~O 9 Sun Mon Tue Wed Thu Fri Sat Total
Gross Amount
and And E 3/6 3/7 3/8 3/9 3/10 3/11 3/12 Total Rate Earned/Gross Hourly Net Wages
`m E Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address - O> 8 Hours Worked Each Day Benefits" Tax
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 CHRIS POWELL President
3/18/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
Duvall Avenue NE 3/6/2022 3/12/2022
"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.
,(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
CHRIS POWELL President CHRIS POWELL
M B 3/18/22
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 Project Name County Project or Contract#
.,?:1. q.:°- Prime Contractor
Industries 4.: s.
Prevailing Wage Program I" . \'llk i',= Duvall Avenue NE King CAG-20-065
PO Box 44540 - , Ly Subcontractor ! Project Address
Olympia WA 98504-4540 y1 "�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 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
3/5/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
ip ,
Work Classification Name c� p ° Sun Mon Tue Wed Thu Fri Sat Total
m Gross Amount
a, E 2/27 2/28 3/1 3/2 3/3 3/4 3/5 Total Rate Hourly
and And
E i= _ Hours of Pay Earned/Gross "Usual Withholding Net Wages
Soc Sec#of Employee Address v > a Payroll Benefits" FICA Tax Other
cc O 8 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 CHRIS POWELL President
3/18/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
Duvall Avenue NE 2/27/2022 3/5/2022
"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.
(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
CHRIS POWELL President CHRIS POWELL
MB 3/18/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and ,ttn'I k , Project Name County Project or Contract#
Industries
�i `.;,'- Prime Contractor
,, .,
•f' ::�l �; Duvall Avenue NE King CAG-20-065
Prevailing Wage Program .a ,r
, Subcontractor !
PO Box 44540 1;fir , 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 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
2/26/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
Work Classification Name C9 ~O •o Sun Mon Tue Wed Thu Fri Sat Total
Gross Amount
and And — EE 2/20 2/21 2/22 2/23 2/24 2/25 2/26 Total Rate Hourly
F= Hours of PayEarned/Gross "Usual WithholdingNet Wages
a) Payroll FICA Other
Soc Sec#of Employee Address tr O> 8 Hours Worked Each Day Benefits" Tax
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 CHRIS POWELL President
3/18/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
Duvall Avenue NE 2/20/2022 2/26/2022
"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.
(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
CHRIS POWELL President CHRIS POWELL
M B 3/18/22
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� 57AT`;r` Project Name County Project or Contract#
Industries Prime Contractor ❑
_:• t.;itt r, Duvall Avenue NE King CAG-20-065
Prevailing Wage Program I s y, ,11lli^`( 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 PnD Logging&Tree Service (425)432-7636
Month Day Year Awarding Agency Address Address City State Zip+4
2/19/2022 1055 S GRADY WAY RENTON,WA-98055 PO Box 529 MAPLE VALLEY WA 98038
Day and Date Deductions
H
Work Classification Name c9 ~O - Sun Mon Tue Wed Thu Fri Sat Total
Gross
Amount
and And a� E 2/13 2/14 2/15 2/16 2/17 2/18 2/19 Total RateHourly
f0 E i= Hours of PayEarned/Gross "Usual WithholdingNet Wages
r a) Payroll FICA Other
Soc Sec#of Employee Address o o Hours Worked Each Day Benefits" Tax
0 J J
1. Laborers 7335 $186
3.50
$53
0.00
3.50
0.00
0.00
0.00
0.00
. .
Faller&Bucker Chain Saw Mike Curtiss RG 0.00J
(King) 804 Grinnell AVE $186.73/
SW OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.03 $0.00 $186.73 $0.00/hr $0.00 $0.00 $186.73
* _ _ ** Orting,WA-98360-
9426 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $106.7 $0.
2. Laborers RG 0.00 0.00 0.00 0.00 0.00 3.50 0.00 3.50 $52.39 $183.37
Clean-up Laborer Bernardo Garita-
(King) J
(King) Ramirez $183.37/
1418 Kirkland Ave OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $78.59 $0.00 $183.37 $0.00/hr $0.00 $0.00 $183.37
NE
Renton,WA-98056 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1J7 $0.
3. Laborers RG 0.00 0.00 0.00 0.00 0.00 2.45 0.00 2.45 $52.39 $128.36
Clean-up Laborer Cody Giustetti J
(King) 181 Upland Road $128.36/
Cle Elum,WA- OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.03 $0.00 $128.36 $0.00/hr $0.00 $0.00 $128.36
* ** 98922 $106.7
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 „, $O.O/p
4. Laborers 2. v J
RG 0.00 0.00 0.00 0.00 0.00 3.50 0.00 3.50 $52.39 $183.37
Clean-up Laborer Stanley Petrick
(King) 22831 NE 74th St OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $78.59 $0.00 $183.37/ $0.00/hr $0.00 $0.00 $183.37
********* Redmond,WA- $183.37
98053 $104.7
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0/ $0°
5. Laborers Jacen Renfrow J RG 0.00 0.00 0.00 0.00 0.00 3.50 0.00 3.50 $53.35 $186.73
24909 SE 232nd St $186.73/ $0.00/hr $0.00 $0.00 $186.73
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Faller&Bucker Chain Saw Maple Valley,WA- $186.73
(King) 98038 OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $80.03 $0.00
*** ** DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $106;7 $01)
6. Laborers RG 0.00 0.00 0.00 0.00 0.00 3.50 0.00 3.50 $52.39 $183.37
Clean-up Laborer Dylan Sergi \/
(King) 12619 214th Ave Ct $183.371
E OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $78.59 $0.00 $0.00/hr $0.00 $0.00 $183.37
** Bonney Lake,WA- $183.37
98391 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1$4.7 $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 Chris Powell President
2/23/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons PnD Logging&Tree Service
employed by:
Project Name: For the week starting: For the week ending:
r'.eall Avenue NE 2/13/2022 2/19/2022
"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
1.Mike Curtiss
Laborers
Faller&Bucker Chain Saw $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
(King)
2.Bernardo Garita-Ramirez
'-,borers
)an-up Laborer $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
(King)
3.Cody Giustetti
Laborers
Clean-up Laborer $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
(King) -
•
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
4.Stanley Petrick
Laborers
Clean-up Laborer $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
(King)
5.Jacen Renfrow
Laborers
Faller&Bucker Chain Saw $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
(King)
Dylan Sergi
Laborers
Clean-up Laborer $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
(King)
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
s
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 filliErly apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and
W9Trig 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
Chris Powell President Chris Powell
MB 3/1/22
•
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification'on Reverse Side