HomeMy WebLinkAboutCAG-20-065 - Duvall - Subcontractor totem Electric •
State of Washington
Department of Labor & Industries
Prevailing Wage Section - Telephone 360-902-5335
PO Box 44540, Olympia, WA 98504-4540
Statement of Intent to Pay Prevailing Wage
Project Detail - Project Dashboard
Document Received. Intent ID: Affidavit ID: Status: Approved On
Date: 8/24/2021 1171673 . 8/27/2021
Company Details
Company Name: TOTEM ELECTRIC OF TACOMA INC
Address: P0. BOX 1093
TACOMA, WA, 98401
Contractor Registration No. TOTEMET315BS
WA UBI Number 278043550
Phone Number 253-383-5022
Industrial Insurance Account ID 68441800
OMWBE Certifications as of 8/24/2021 No active certifications existed when
Intent was submitted
Email Address marks@totemelectric.com
Filed By Mark Stephens
Prime Contractor
Company Name REED TRUCKING Et EXCAVATING INC
Contractor Registration No. REEDTEI016JW
WA UBI Number 601915034
Phone Number 253-841-4837
Project Information
Awarding Agency RENTON, CITY OF
1055 S GRADY WAY RENTON, WA-
98055
Awarding Agency Contact Flora Lee
Awarding Agency Contact Phone Number 425-430-7303
Contract Number CAG-20-065
Project Name Duvall Avenue NE
Project Description This project includes but is not limited
to: excavation; grading; removal of
pavement; plaining pavement; paving
with asphalt, curb and gutter;
drainage; illumination; HAWK signal;
sidewalk; walls; adjustments to utility
frames, grates, and covers; property
restoration; and other work.
Contract Amount $5,218,171.95
Contract Type Description Bid-Build (Traditional)
Bid due date 6/22/2021
Award Date 7/21/2021
Project Site Address or Directions
Hiring Contractor
Company Name REED TRUCKING & EXCAVATING INC
Contractor Registration No. REEDTEI016JW
WA UBI Number 601915034
Payment Details
Check Number:
Transaction Id: 108240298
Intent Details
Expected project start date: (MM/DD/YYYY) 9/20/2021
In what county (or counties) will the work be King
performed?
In what city (or nearest city) will the work be Renton
performed?
What is the estimated contract amount? OR is $734,636.80
this a time and materials estimate?
Does your company intend to hire ANY Yes
subcontractors?
Will your company have employees perform Yes
work on this project?
-
Do you intend to use any apprentices? No
(Apprentices are considered employees.)
How many owner/operators performing work on 0
the project own 30% or more of the company?
Journey Level Wages
County Trade Occupation Wage Fringe #
Workers
King Power Equipment Operators Shovel, Excavator, Backhoe, $49.68 $23.37 2
Tractors Under 15 Metric Tons
IKing Laborers General Laborer $41.29 $13.39 2
King Electricians - Inside Journey Level $62.27 $26.36 3
Public Notes
E Show/Hide Existing Notes
No note exists
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_
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: Status: Approved on
Date: 12/18/2023 1171673 1/23/2024
Company Details
Name TOTEM ELECTRIC OF TACOMA INC
Address PO BOX 1093 •
TACOMA,WA,98401
WA UBI no. 278043550
Contractor Registration no. TOTEMET315BS
Industrial Insurance Account Id 68441800
OMWBE Certifications as of 8/24/2021 No active certifications existed when
Intent was submitted
Email Address tbarquist@reedtrucking.com
Filed By
Prime Contractor
Prime contractor name REED TRUCKING a 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
1 of 3 1/24/2024, 1:21 PM
Firefox https://secure.lni.wa.gov/wagelookup/AffidavitDetails.aspx
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: $ 225,013.25
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:
Project Details
County where work was performed King
City where work was performed Renton
Prime contractor Intent form Id# for this 1170257
project
Intent filed date 8/24/2021
Job start date:MM-DD-YYYY 1/13/2022
Date work completed:MM-DD-YYYY 7/19/2022
Project Completion
Did your company hire any Yes
subcontractors?
Did your company have employees Yes
perform 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?
2 of 3 1/24/2024, 1:21 PM
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No company owner added.
Affidavit Subcontractor(s)
Company Name UBI License#
GARY MERLINO CONST CO INC 600584952 GARYMCC150MW
INTEGRITY NETWORKS INC 602512350 INTEGNI932LH
Miles Sand Et Gravel Company 171004760
Journeylevel Wages
County Trade Occupation Wages Fringes # #
Workers Hours
King Power Equipment Shovel, Excavator, 52.12 24.47 5 688.50
Operators Backhoe, Tractors
Under 15 Metric
Tons
King Laborers General Laborer 42.86 14.00 3 260.50
King Electricians - Journey Level 70.74 27.34 8 728.00
Inside
Apprentice Wages
Public Notes
o Show/Hide Existing Notes
-- On 1 /23/2024:--
Reed Trucking is filing on behalf of Totem Electric due to ceased operations and
bankruptcy. UBI 278-043-550, Cont Reg TOTEMET315BS, PO BOX 1093 Tacoma, WA
98401
3 of 3 1/24/2024, 1:21 PM
a
•
•
Certified Payroll Report
'IDhdustriesnt of Labor and �a �sTAre �� Prime Contractor ❑ Project Name County Project or Contract#
c!„iit`, .i!ht„ Duvall Avenue NE King CAG-20-065
'Prevailing Wage Program °III i,-- IIIIjr Subcontractor N
PO Box 44540 �y ,sas''° Project Address .
Olympia WA 98504-4540 Final Week of
(360) 902-5335 Payroll N
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TOTEM ELECTRIC OF TACOMA INC (253)383-5022
Month Day Year Awarding Agency Address Address City State Zip+4
7/23/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1093 TACOMA WA 98401
7 - Day and Date Deductions
' H
Work Classification Name & 0 o Sun Mon Tue Wed Thu Fri Sat Gross Amount Total
• and And , a) E 7/17 7/18 7/19 7/20 7/21 7/22 7/23 Total Rate
Earned/Gross Hourly
m E Hours of Pay "Usual Withholding Net Wages
w. a) Payroll FICA Other
Soc Sec#of Employee Address O o Hours Worked Each Day Benefits" Tax
0
1. Electricians-Inside • RG 0.00 8.00 8.00 0.00 0.00 0.00 0.00 16.00 $70.74 $1,131.8 Workers'
Journey Level _ 4 Compensation:
(King) Schaun Brodie $106.1 $1,131.84 $6.30, Paid
19309 SE 344th OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1 $0.00 / $27.34/hr $108.24 $121.95 Family Medical $1,087.20
` *"`""" Leave:$6.22,
Auburn,WA-98092 $1,414.80
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1 81.4 $0.00 vacation:$84.89
2. Power Equipment Workers'
RG 0.00 8.00 8.00 0.00 0.00 0.00 0.00 16.00 $52.12 $833.92
Operators Compensation:
Shovel,Excavator,Backhoe, $8.61, Paid
Tractors Under 15 Metric Tons Chad Crandall OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $78.18 $0.00 Family Medical
;g) 519 Maxwell St $833.92/ $24.47/hr $95.69 $61.24 Leave:$5.50, $1,047.62
,' Davenport,WA- $1,250.88 Union Dues:
^� ***_*._«z= 99122-9432
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $14'2 $7.2002$0.00 $ ,nw fca:
3. Laborers Workers'
RG 0.00 8.00 8.00 0.00 0.00 0.00 0.00 16.00 $42.86 $685.76
General Laborer Compensation:
(King) $5.74,Paid
Brian Grohs OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $64.29 $0.00 4 J Family Medical
.le._.>_.ie.* 2612 375th PI. _ $685.76/ Leave:$3.01,
Federal Way,WA- $685.76 $14.00/hr $52.46 $94.39 Union Dues: $484.72
98003 $28.64,vacation:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $85.72 $0.00 $16.80
4. Electricians-Inside Nicholls Jonas RG 0.00 8.00 8.00 0.00 0.00 0.00 0.00 16.00 $70.74 $1,131.8 Workers'
3489 Division St 4 $1,131.84 $27.34/hr $86.59 $109.93 Compensation: $857.40
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Journey Level Enumclaw,WA- $106.1 I $5.04,Paid
(King) 98022 OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1 $0.00 $1,131.84 Family Medical
Leave:$4.97,
********* $141.4 vacation:$67.91
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 8 $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 Jamie Gordon Payroll
7/26/2022
•
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TOTEM ELECTRIC OF TACOMA INC
• employed by:
Project Name: For the week starting: For the week ending:
^.wall Avenue NE 7/17/2022 7/23/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F)Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
401(k):$2.50/hr,
1.Schaun Brodie nebf:$2.12/hr,neca:
Electricians-Inside $0.71/hr,sap:
Journey Level $27.34 $10.63 $10.35 $0.00 $0.00 $0.87 $0.05/hr,Imcc/nlmcc:
$0.11/hr
(King)
national training fund:
2.Chad Crandall $0.05/hr
"-wer Equipment Operators
ovel,Excavator, Backhoe, $24.47 $16.40 $7.32 $0.00 $0.00 $0.70
ractors Under 15 Metric Tons
(King)
wcisap:$0.06/hr,
3.Brian Grohs nelecet:$0.14/hr
Laborers
General Laborer $14.00 J $5.30 $7.55 $0.00 $0.00 $0.95
(King)
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
401(k):$2.50/hr,
nebf:$2.12/hr,neca:
4.Nicholas Jonas
Electricians-Inside $0.71/hr,sap:
Journey Level $27.34 $10.63 $10.35 $0.00 $0.00 $0.87 $0.05/hr,Imcc/nlmcc:
$0.11/hr
(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.
/-`.;4ny 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
Jamie Gordon Payroll Jamie Gordon
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 tiTnrf. Project Name County Project or Contract#
`'F i
me Contractor ❑
Industries ❑., ,it
. '; Pr
i Duvall Avenue NE King CAG-20-065
Prevailing Wage Program 1?,.Hilt, ;:��11 Subcontractor NI
PO Box 44540 4,till , y' Project Address
Olympia WA 98504-4540 """ Final Week of
(360) 902-5335 Payroll D
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TOTEM ELECTRIC OF TACOMA INC (253)383-5022
Month Day Year Awarding Agency Address Address City State Zip+4
7/16/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1093 TACOMA WA 98401
Day and Date Deductions
E=
Work Classification Name & ~ o Sun Mon Tue Wed Thu Fri Sat Total
Gross Amount
and And E 7/10 7/11 7/12 7/13 7/14 7/15 7/16 Total Rate Earned/Gross Hourly Net Wages
`.. f a Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address 11 O o Hours Worked Each Day Benefits" Tax
a
1. Power Equipment Workers'
RG 0.00 10.00 4.00 0.00 0.00 0.00 0.00 14.00 $52.12 $729.68
Operators Compensation:
Shovel, Excavator,Backhoe, $17.25,Paid
Tractors Under 15 Metric Tons Robert Arnold OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $78.18 $0.00 Family Medical
(King) 5501 136th St.E. $729.68/ $24.47/hr $207.34 $354.48 Leave:$11.91, $2,050.66
Puyallup,WA- $2,710.24 Union Dues:
98373
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $14 2 $14.40$0.00 $ ,nw fca:
$14.40
2. Electricians-Inside Workers'
RG 0.00 8.00 0.00 0.00 0.00 0.00 0.00 8.00 $70.74 $565.92
Journey Level Compensation:
g) Blake Ellis $12.59,Paid
38303 238th Ave OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $106.1 $0 00 $565.92! Family Medical
1Enumclaw,WA- $2,829.60 $27.34/hr $216.46 $444.48 Leave:$12.43, $1,573.86
401(k):$400.00,
98022 $141.4 vacation:$169.78
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 8 $0.00
3. Laborers Workers'
RG 0.00 8.00 2.00 4.00 0.00 0.00 0.00 14.00 $42.86 $600.04
General Laborer Compensation:
(King) Chad Turner $17.25,Paid
407 Valley Ave NE OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $64.29 $0.00 Family Medical
Apt T-305 $600.04! $14.00/hr $170.50 $396.27 Leave:$9.79, $1,498.59
Puyallup,WA- $2,228.72 Union Dues:
98372 $85.92,vacation:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $85.72 $0.00 $50.40
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 Jamie Gordon Payroll
7/22/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TOTEM ELECTRIC OF TACOMA INC
employed by:
Project Name: For the week starting: For the week ending:
§vall Avenue NE 7/10/2022 7/16/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
national training:
1.Robert Arnold $0.05/hr
Power Equipment Operators
Shovel,Excavator,Backhoe, $24.47 $16.40 $7.32 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
401(k):$2.50/hr,
Blake Ellis
nebf:$2.12/hr,neca:
‘ectricians-Inside $0.71/hr,sap:
Journey Level $27.34� $10.63 $10.35 $0.00 $0.00 $0.87 $0.05/hr,Imcc/nlmcc:
$0.11/hr
(King)
drug testing:
3.Chad Turner $0.06/hr,nwlecet:
Laborers
$0.14/hr
General Laborer $14.00 $5.30 $7.55 $0.00 $0.00 $0.95
(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
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
Jamie Gordon Payroll Jamie Gordon
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 ��,,,,,�,, Project Name County Project or Contract#
;pti'4 °-- Prime Contractor ❑
Industries 4 ail �• 4 Duvall Avenue NE King CAG-20-065
un,- , ,�iii r
Prevailing Wage Program a�illli' ,111.1< Subcontractor Lk7
PO Box 44540 "pl•' 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 TOTEM ELECTRIC OF TACOMA INC (253)383-5022
Month Day Year Awarding Agency Address Address City State Zip+4
7/9/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1093 TACOMA WA 98401
Day and Date Deductions
p
Work Classification Name C7 ~O o Sun Mon Tue Wed Thu Fri Sat Total
Gross Amount
E 7/3 7/4 7/5 7/6 7/7 7/8 7/9 Total Rate Hourly
and And
`m E Hours of Pay Earned/Gross "Usual Withholding Net Wages
f ai Payroll FICA Other
Soc Sec#of Employee Address CD O o Hours Worked Each Day Benefits" Tax
0
1. Power Equipment RG 0.00 0.00 0.00 10.00 10.00 10.00 0.00 30.00 $52.12 $1,563.6 Workers'
Operators 0 Compensation:
Shovel, Excavator,Backhoe, $15.44, Paid
Tractors Under 15 Metric Tons Robert Arnold OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $78.18 $0.00 $1,563.60
136th St Family Medical
(King) 5501 .E. / $24.47/hr $199.36 $331.55 $1,983.18
WA Leave: $11.45,
Puyallup, $2,606.00 Union Dues:
98373
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1�4.2 $0.00 $52.12,nw fca:
$12.90
2. Electricians-Inside RG 0.00 0.00 10.00 10.00 8.00 10.00 0.00 38.00 $70.74 $2,688.1 Workers'
Journey Level 2 Compensation:
9) Schaun Brodie $106.1 $3,112.56 $13.84,Paid
19309 SE 344th OT 0.00 0.00 0.00 0.00 0.00 0.00 4.00 4.00 1 $424.44 / $27.34/hr $254.34 $489.68 Family Medical $2,352.82
Auburn,WA-98092 $3,324.78 Leave:$14.61,
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1$1.4 $0.00 vacation:$199.49
3. Power Equipment RG 0.00 0.00 10.00 10.00 8.00 10.00 0.00 38.00 $52.12 $1,980 5 Workers'
Operators 6 Compensation:
Shovel, Excavator,Backhoe, 9 $15.81,Paid
Tractors Under 15 Metric Tons Chad Crandall OT 0.00 0.00 0.00 0.00 0.00 0.00 4.00 4.00 $78.18 $312.72 $2 23 28 Family Medical
(King) 519 Maxwell St / $24.47/hr $187.40 $312.53 $1,860.957
Davenport,WA- Union Dues:
99122-9432 $2,449.64
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1�4.2 $13.20$0.00 $48.99,nw fca:
4. Electricians-Inside Blake Ellis RG 0.00 0.00 0.00 0.00 9.00 8.00 0.00 17.00 $70.74 $1,202.5 Workers'
38303 238th Ave 8 $1,202.58 $27.34/hr $211.05 $451.50 Compensation: $1,609.22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Journey Level Enumclaw,WA- $106.1 / $9.44,Paid
(King) 98022 OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1 $0.00 $2,758.86 Family Medical
Leave:$12.12,
***_**_**** 401(k):$300.00,
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1 81.4 $0.00 vacation:$165.53
5. Laborers RG 0.00 0.00 10.00 10.00 8.00 10.00 0.00 38.00 $42.86 $1,628.6 Workers'
General Laborer 8 Compensation:
(King) $18.32,Paid
Brian Grohs OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $64.29 $0.00 $1,628.68 Family Medical
» »_»»_» »» 2612 375th Pl. Leave:$10.92,
Federal Way,WA- / $14.00Jhr $190.18 $373.32 Union Dues: $1,748.30
98003 $2,485.88
$91.29,vacation:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $85.72 $0.00 $53.55
a Electricians-Inside 401(k):$3.00,
RG 0.00 0.00 4.00 0.00 0.00 0.00 0.00 4.00 $77.17 $308.68 rney Level credit union:
rsnl $276.58,Union
g) OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1 5'7 $0.00 Dues:$55.56,
'** ** Wade Sanders vacation:
12502 118th St Ct E $308.68/ $120.39,
Puyallup,WA- $2 778 12 $27.60/hr $212.53 $527.40 Workers' $1,561.64
98374 $154.3 Compensation:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 $8.82,Paid
Family Medical
Leave:$12.20
7. Laborers RG 0.00 0.00 10.00 10.00 10.00 10.00 0.00 40.00 $42.86 $1,714.4 Workers'
General Laborer 0 Compensation:
(King) Chad Turner $19.03,Paid
407 Valley Ave NE OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $64.29 $0.00 $1,714.40 Family Medical
"*'*;*** Apt T-305 / $14.00/hr $196.72 $478.56 Leave:$11.30, $1,715.47
Puyallup,WA- $2,571.60 Union Dues:
98372 $94.87,vacation:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $85.72 $0.00 $55.65
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 Jamie Gordon Payroll
7/20/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TOTEM ELECTRIC OF TACOMA INC
employed by:
Project Name: For the week starting: For the week ending:
fl vall Avenue NE 7/3/2022 7/9/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
national training fund:
1.Robert Arnold - $0.05/hr
Power Equipment Operators
Shovel,Excavator, Backhoe, $24.47 J $16.40 $7.32 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
401(k):$2.50/hr,
Schaun Brodie nebf:$2.12/hr,neca:
ctricians-Inside $0.71/hr,sap:
journey Level $27.34 $10.63 $10.35 $0.00 $0.00 $0.87 $0.05/hr,Imcc/nlmcc:
$0.11/hr
(King)
national training fund:
3.Chad Crandall $0.05/hr
Power Equipment Operators
Shovel,Excavator,Backhoe, $24.47 $16.40 $7.32 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
401(k):$2.50/hr,
4.Blake Ellis
nebf:$2.12/hr, neca:
Electricians-Inside $0.71/hr,sap:
Journey Level $27.34 $10.63 $10.35 $0.00 $0.00 $0.87 $0.05/hr,lmcc/nlmcc:
$0.11/hr
(King)
wcisap:$0.06/hr,
5.Brian Grohs nelecet:$0.14/hr
Laborers
General Laborer $14.00 $5.30 $7.55 $0.00 $0.00 $0.95
(King)
401(k):$2.50/hr,
Wade Sanders nebf:$2.32/hr, neca/
Electricians-Inside amf:$0.77/hr,lmcc/
Journey Level $27.60 $10.63 $10.35 $0.00 $0.00 $0.87 nlmcc:$0.11/hr,sap:
$0.05/hr
(King)
drug testing:
$0.06/hr,nwlecet:
7.Chad Turner $0.14/hr
Laborers
General Laborer $14.00 $5.30 $7.55 $0.00 $0.00 $0.95
(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.
(P'\.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
Jamie Gordon Payroll Jamie Gordon
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 ���,s.°�4 0� Prime Contractor ❑ Project Name County Project or Contract#
Industries a:iii ;:i f
o;,::•. Isla Duvall Avenue NE King CAG-20-065
"�'iii:. fiii7S
Prevailing Wage Program 4i .���� Subcontractor El
PO Box 44540 s t=''i' 'o'Y Project Address
Olympia WA 98504-4540 ,I 188e ao Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TOTEM ELECTRIC OF TACOMA INC (253)383-5022
Month Day Year Awarding Agency Address Address City State Zip+4
. 7/2/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1093 TACOMA WA 98401
i
Day and Date Deductions
F=
Work Classification Name e 8 o Sun Mon Tue Wed Thu Fri Sat Total
Gross Amount
and And a� E 6/26 6/27 6/28 6/29 6/30 7/1 7/2 Total Rate Earned/Gross Hourly Net Wages
E Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address m > y Benefits" Tax
O o Hours Worked Each Day
0
1. Power Equipment $2,084.8 Workers'
Operators RG 0.00 8.00 8.00 8.00 8.00 8.00 0.00 40.00 $52.12 0 Compensation:
Shovel,Excavator,Backhoe, $14.37,Paid
Tractors Under 15 Metric Tons Robert Arnold OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $78.18 $0.00 $2,084.80 Family Medical
(King) 5501 136th St.E. / $24.47/hr $159.49 $216.89 Leave:$9.16, $1,631.19
Puyallup,WA- $2,084.80 Union Dues:
Ir. .,:+,: 98373 $104 2 $41.70,nw fca:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 $12.00
2. Electricians-Inside RG 0.00 0.00 10.00 10.00 10.00 0.00 0.00 30.00 $70.74 $2'122./ Workers'
Journey Level 0 J Compensation:
i1' 3) Schaun Brodie $106.1 $2,122.20 $12.59,Paid
19309 SE 344th OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1 $0.00 / $27.34/hr $216.47 $380.74 Family Medical $2,037.59
" " ' Auburn,WA-98092 $2,829.60 Leave:$12.43,
$141.4 vacation:$169.78
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 8 $0.00
3. Power Equipment RG 0.00 0.00 10.00 10.00 10.00 0.00 0.00 30.00 $52.12 $1,563.6 Workers'
Operators 0 Compensation:
Shovel, Excavator,Backhoe, $14.37,Paid
Tractors Under 15 Metric Tons Chad Crandall OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $78.18 $0.00 $1,563.60 Family Medical
(King) 519 Maxwell St / $24.47/hr $159.49 $224.98 Leave:$9.16, $1,623.10
Davenport,WA- $2,084.80 Union Dues:
., .=r*,.x 99122-9432 $104.2 $41.70,nw fca:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 $12.00
4. Electricians-Inside Blake Ellis RG 0.00 8.00 0.00 8.00 8.00 8.00 0.00 32.00 $70.74 $2,263.6 Workers'
38303 238th Ave 8 $2,263.68 $27.34/hr $216.47 $463.68 Compensation: $1,671.13
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Journey Level Enumclaw,WA- $106 1 / $10.07,Paid
(King) 98022 OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1 $0.00 $2,829.60 Family Medical
Leave:$12.43,
*****-**** 401(k):$320.00,
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1$1.4 $0.00 vacation:$135.82
5. Laborers RG 0.00 0.00 10.00 10.00 10.00 0.00 0.00 30.00 $42.86 $1,285.8 Workers'
General Laborer 0 Compensation:
(King) $14.37,Paid
Brian Grohs OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $64.29 $0.00 $1,285.80 Family Medical
********* 2612 375th Pl. / $14.00/hrLeave:$7.53,
Federal Way,WA- $131.14 $217.82 Union Dues: $1,229.94
98003 $1,714.40
$71.60,vacation:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $85.72 $0.00 $42.00
s___Electricians-Inside Workers'
RG 0.00 0.00 3.00 0.00 0.00 0.00 0.00 3.00 $77.17 $231.51
!ney Level Compensation:
,•``r g) $115.7 $11.60,Paid
OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5 $0.00 Family Medical
****.**** Wade Sanders Leave:$12.54,
12502 118th St Ct E $231.51 I
Puyallup,WA- $2 855 29 $27.60/hr $218.43 $545.56 401(k):$4.50, $1,466.05
credit union:
98374
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $14.3 $0.00 Dues:$365.48,Union
Dues:$73.70,
vacation:$157.43
7. Laborers $1,714.4 Workers'
RG 0.00 8.00 8.00 8.00 8.00 8.00 0.00 40.00 $42.86
General Laborer 0 Compensation:
(King) Chad Turner $14.37,Paid
407 Valley Ave NE OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $64.29 $0.00 $1,714.40 Family Medical
********* Leave:$753
Apt T-305 / . ,$14.00/hr $131.16 $274.48 $1,173.26
Puyallup,WA- $1,714.40 Union Dues:
98372 $71.60,vacation:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $85.72 $0.00 $42.00
/
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
. l
• 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 Jamie Gordon Payroll
7/7/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TOTEM ELECTRIC OF TACOMA INC
employed by:
Project Name: For the week starting: For the week ending:
0r wall Avenue NE 6/26/2022 7/2/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice , Benefits
Benefits" Program
(A+B+C+D+E+F
national training:
1.Robert Arnold $0.05/hr
Power Equipment Operators
Shovel,Excavator, Backhoe, $24.47 $16.40 $7.32 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
401(k):$2.50/hr,
2 Schaun Brodie nebf:$2.12/hr,neca:
:ctricians-Inside $0.71/hr,sap:
i��urney Level $27.34J $10.63 $10.35 $0.00 $0.00 $0.87 $0.05/hr,Imcc/nlmcc:
$0.11/hr
(King)
national training fund:
3.Chad Crandall $0.05/hr
Power Equipment Operators
Shovel,Excavator, Backhoe, $24.47 $16.40 $7.32 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
401(k):$2.50/hr,
4.Blake Ellis
nebf:$2.12/hr,neca:
Electricians-Inside $0.71/hr,sap:
Journey Level $27.34 $10.63 $10.35 $0.00 $0.00 $0.87 $0.05/hr,Imcc/nlmcc:
$0.11/hr
(King)
wcisap:$0.06/hr,
5.Brian Grohs
nelecet:$0.14/hr
Laborers
General Laborer $14.00 $5.30 $7.55 $0.00 $0.00 $0.95
(King)
401(k):$2.50/hr,
nebf:$2.32/hr,neca/
,,.'Wade Sanders
Electricians-Inside
amf:$0.77/hr,Imcc/
Journey Level $27.60 $10.63 $10.35 $0.00 $0.00 $0.87 nlmcc:$0.11/hr,sap:
$0.05/hr
(King)
drug testing:
7.Chad Turner $0.06/hr,nwlecet:
Laborers $0.14/hr
General Laborer $14.00 $5.30 $7.55 $0.00 $0.00 $0.95
(King)
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
,=`Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and
ping Council.
Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties.
Printed name of party signing this report Title Signature
Jamie Gordon Payroll Jamie Gordon
. L
MB 7/11/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
•
Certified Payroll Report
Department of Labor and rArf Project Name County Project or Contract#
�.11 1i °F Prime Contractor ❑
Industries AI:.1' - , y Duvall Avenue NE King CAG-20-065
Prevailing Wage Program j1114,. ,.41i�t f Subcontractor LRJ
PO Box 44540 "yti� "�, w,y Project Address
Olympia WA 98504-4540 " Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TOTEM ELECTRIC OF TACOMA INC (253)383-5022
Month Day Year Awarding Agency Address Address City State Zip+4
6/25/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1093 TACOMA WA 98401
Day and Date Deductions
P
Work Classification Name C9 ~ o Sun Mon Tue Wed Thu Fri Sat Total
cC O a) Gross Amount
and And a) E 6/19 6/20 6/21 6/22 6/23 6/24 6/25 Total Rate Earned/Gross Hourly Net Wages
Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address o o Hours Worked Each Day Benefits" Tax
a
1. Power Equipment RG 0.00 4.00 8.00 8.00 8.00 8.00 0.00 36.00 $52.12 $1,876.3 Workers'
Operators 2 Compensation:
Shovel, Excavator,Backhoe, $14.37,Paid
Tractors Under 15 Metric Tons Robert Arnold OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $78.18 $0.00 $1,876.32 Family Medical
(King) 5501 136th St.E. - / $24.47/hr $159.48 $216.89 Leave:$9.16, $1,631.20
Puyallup,WA- Union Dues:
_ .. 98373 $2,084.80
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $14.2 $1$41.70,
$ ,nw fca:
2.00
2. Electricians-Inside RG 0.00 0.00 8.00 8.00 8.00 4.00 0.00 28.00 $70.74 $1,980.7 Workers'
Journey Level 2 Compensation:
g) Schaun Brodie $106.1 $2,192.94 $10.69,Paid
19309 SE 344th OT 0.00 0.00 1.00 1.00 0.00 0.00 0.00 2.00 1 $212.22 / $27.34/hr $189.40 $302.93 Family Medical $1,813.45
Auburn,WA-98092 $2,475.90 Leave:$10.88,
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1$1.4 $0.00 vacation:$148.55
3. Power Equipment RG 0.00 0.00 8.00 8.00 8.00 8.00 0.00 32.00 $52.12 $1,667.8 Workers'
Operators 4 Compensation:
Shovel, Excavator,Backhoe, $12.93,Paid
Tractors Under 15 Metric Tons Chad Crandall OT 0.00 0.00 1.00 1.00 0.00 0.00 0.00 2.00 $78.18 $156.36 $1,824.20 Family Medical
(King) 519 Maxwell St / $24.47/hr $151.50 $202.05 $1,554.97
Leave:$8.70,
Davenport,WA- Union Dues:
99122-9432 $1,980.56
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $14.2 0.81$0.00 $ ,nw fca:
$10.80
4. Electricians-Inside Blake Ellis RG 0.00 0.00 8.00 8.00 8.00 8.00 0.00 32.00 $70.74 $2,263.f J J Workers'
38303 238th Ave 8 J $2,263.68 $27.34/hr $216.46 $444.48 Compensation: $1,573.86
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Journey Level Enumclaw,WA- $106.1 / $12.59,Paid
(King) 98022 OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1 $0.00 $2,829.60 Family Medical
Leave:$12.43,
" ""'• 401(k):$400.00,
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1 81.4 $0.00 vacation:$169.78
5. Laborers RG 0.00 0.00 8.00 8.00 8.00 8.00 0.00 32.00 $42.86 $1,371.5 Workers'
General Laborer 2 Compensation:
$11.49,
(King) Brian Grohs OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $64.29 $0.00 Family Medical
2612 375th PI. $1,371.52 Leave:$6.03,
/ $14.00/hr $104.93 $176.68 $981.51
Federal Way,WA- Union Dues:
98003 $1,371.52
$57.28,vacation:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $85.72 $0.00 $33.60
electricians-Inside RG 0.00 0.00 4.00 0.00 0.00 0.00 0.00 4.00 $77.17 $308.68 Workers'
•ney Level Compensation:
trying) $115.7 $10.08,Paid
OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5 $0.00 Family Medical
«.._.._...* Wade Sanders
12502 118th St Ct E Leave:$10.85,
Puyallup,WA- $2,469.44 $27.60/hr $188.92 $451.16 401(k):$12.00, $1,301.31
credit union:
98374
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1544'3 Dues:$0.00 $316.09,Union
Dues:$67.91,
vacation:$111.12
7. Laborers RG 0.00 0.00 8.00 8.00 8.00 0.00 0.00 24.00 $42.86 $1,028.6 Workers'
General Laborer 4 Compensation:
(King) Chad Turner $11.49,Paid
407 Valley Ave NE OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $64.29 $0.00 $1,028.64 Family Medical
` �' Apt T-305 / $14.00/hr $104.92 $199.04 Leave:$6.03, $959.16
Puyallup,WA- $1,371.52 Union Dues:
98372 $57.28,vacation:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $85.72 $0.00 $33.60
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 Jamie Gordon Payroll
7/6/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TOTEM ELECTRIC OF TACOMA INC
employed by:
Project Name: For the week starting: For the week ending:
"gall Avenue NE 6/19/2022 6/25/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
national training:
1.Robert Arnold $0.05/hr
Power Equipment Operators
Shovel,Excavator,Backhoe, $24.47 $16.40 $7.32 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
401(k):$2.50/hr,
3chaun Brodie nebf:$2.12/hr,neca:
`;ctricians-Inside $0.71/hr,sap:
$0.05/hr,Imcc/nlmcc:
Journey Level $27.34 $10.63 $10.35 $0.00 $0.00 $0.87 $0.111hr
(King)
national training fund:
3.Chad Crandall $0.05/hr
Power Equipment Operators
Shovel,Excavator,Backhoe, $24.47 $16.40 $7.32 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
401(k):$2.50/hr,
4.Blake Ellis nebf:$2.12/hr, neca:
Electricians-Inside / $0.71/hr,sap:
Journey Level $27.34 v $10.63 $10.35 $0.00 $0.00 $0.87 $0.05/hr,lmcc/nlmcc:
$0.11/hr
(King)
wcisap:$0.06/hr,
5.Brian Grohs nelecet:$0.14/hr
Laborers
General Laborer $14.00 $5.30 $7.55 $0.00 $0.00 $0.95
(King)
401(k):$2.50/hr,
U.Wade Sanders nebf:$2.32/hr,neca/
Electricians-Inside amf:$0.77/hr,lmcc/
Journey Level $27.60 $10.63 $10.35 $0.00 $0.00 $0_87 nlmcc:$0.11/hr,sap:
$0.05/hr
(King)
drug testing:
7.Chad Turner $0.06/hr,nwlecet:
Laborers
$0.14/hr
General Laborer $14.00 $5.30 $7.55 $0.00 $0.00 $0.95
(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.
!FI;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
Jamie Gordon Payroll Jamie Gordon
MB 7/6/22
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 �;rnrf: Project Name County Project or Contract#
^
Industries ; rui,.°`f Prime Contractor El
-=arc• - ,.•,===;, Duvall Avenue NE King CAG-20-065
Prevailing Wage Program iiiit,' ,+,iii' Subcontractor ❑x
PO Box 44540 c' 8 : , 'Y Project Address
H� :rka`' Final Week of
Olympia WA 98504-4540
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TOTEM ELECTRIC OF TACOMA INC (253)383-5022
Month Day Year Awarding Agency Address Address City State Zip+4
6/18/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1093 TACOMA WA 98401
Day and Date Deductions
1---
Work Classification Name C7 ~O o Sun Mon Tue Wed Thu Fri Sat Total
a) Gross Amount
and And E 6/12 6/13 6/14 6/15 6/16 6/17 6/18 Total Rate Earned/Gross Hourly Net Wages
f a Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address ai O o Hours Worked Each Day Benefits" Tax
0
1. Power Equipment RG 0.00 0.00 8.00 0.00 8.00 8.00 0.00 24.00 $52.12 $1,250.8 Workers'
Operators 8 Compensation:
Shovel, Excavator, Backhoe, $14.37,Paid
Tractors Under 15 Metric Tons Chad Crandall OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $78.18 $0.00 $1 250 88 Family Medical
(King) 519 Maxwell St / $24.47/hr $159.49 $224.98 Leave:$9.16, $1,623.10
Davenport,WA- $2,084.80 Union Dues:
99122-9432 $104.2 $41.70,nw fca:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 $12.00
2. Laborers RG 0.00 0.00 8.00 0.00 8.00 8.00 0.00 24.00 $42.86 $1'028.� Workers'
4 4 Compensation:
J
General Laborer P
3) $14.37, Paid
Brian Grohs OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $64.29 $0.00 $1,028.64 J Family Medical
2612 375th PI. Leave: $7.53,
Federal Way,WA- / $14.00/hr $131.15 $217.82 Union Dues: $1,229.93
98003 $1,714.40
$71.60,vacation:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $85.72 $0.00 $42.00
3. Power Equipment Workers'
RG 0.00 8.00 0.00 0.00 0.00 0.00 0.00 8.00 $52.12 $416.96
Operators Compensation:
Shovel, Excavator,Backhoe, Grant Holder $14.36,Paid
Tractors Under 15 Metric Tons 38320 238th Ave OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $78.18 $0.00 Family Medical
$416.96/ Leave:$9.16,
(King) SE $2,084.80 $24.47/hr $159.48 $182.50 Union Dues: $1,665.60
Enumclaw,WA-
98022 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $14'2 $41.70,nw fca:
$0.00
4
$112.000
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
4. Electricians-Inside Workers'
RG 0.00 0.00 3.00 0.00 0.00 0.00 0.00 3.00 $77.17 $231.51
Journey Level Compensation:
(King) $115.7 $11.61,Paid
OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5 $0.00 Family Medical
1r Ir._ .... Wade Sanders Leave:$12.54,
12502 118th St Ct E $231.51 / $27.60/hr $218.43 $541.96 401(k):$19.50, $1,493.24
Puyallup,WA- $2,855.29 credit union:
98374 $154.3 $365.48,Union
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 Dues:$81.41,
vacation:$111.12
5. Electricians-Inside Workers'
RG 0.00 8.00 0.00 0.00 0.00 0.00 0.00 8.00 $73.96 $591.68
Journey Level Compensation:
(King) Robert Veltung $10.07,Paid
$110.9
PO Box 1295 OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 $591.68/ $27.47/hrFamily Medical$181.05 $439.39 $1,583.81
..... .... Buckley,WA- $2,366.72Leave:$10.40,
98321 $147.9 vacation:$142.00
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2 $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 Jamie Gordon Payroll
7/5/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TOTEM ELECTRIC OF TACOMA INC
employed by:
Project Name: For the week starting: For the week ending:
^-wall Avenue NE 6/12/2022 6/18/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
national training fund:
1.Chad Crandall $0.05/hr
Power Equipment Operators
Shovel,Excavator,Backhoe, $24.47 $16.40 $7.32 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
wcisap:$0.06/hr,
^,.Brian Grohs nelecet:$0.14/hr
)borers /
General Laborer $14.00 J $5.30 $7.55 $0.00 $0.00 $0.95
(King)
national training fund:
3.Grant Holder $0.05/hr
Power Equipment Operators
Shovel,Excavator,Backhoe, $24.47 $16.40 $7.32 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
401(k):$2.50/hr,
4.Wade Sanders nebf:$2.32/hr,neca/
Electricians Inside amf:$0.77/hr,Imcc/
Journey Level $27.60 $10.63 $10.35 $0.00 $0.00 $0.87
$0.05/$0.11/hr,sap:
0.05/hr
(King)
401(k):$2.50/hr,
5.Robert Veltung nebf:$2.22/hr,neca/
Electricians-Inside amf:$0.74/hr,sap:
Journey Level $27.47 $10.63 $10.35 $0.00 $0.00 $0.87 $0.05/hr,Imcc/
nlmcc:$0.11/hr
(King)
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
1.i;
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
-1ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and
?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
Jamie Gordon Payroll Jamie Gordon
MB 7/6/22
F700-065-000 certified payroll report 05-09 _ Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and :,�r� Project Name County Project or Contract
,,,0;,,,:, f OF Prime Contractor D
Industries , Si: _ _! f
.'_:__:' ===.r Duvall Avenue NE King CAG-20-065
Prevailing Wage Program '.l °i. ''i !x
PO Box 44540 y A. �s< Subcontractor
�.y,=; , y° Project Address
Olympia WA 98504-4540 ti,e 814'° Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TOTEM ELECTRIC OF TACOMA INC (253)383-5022
Month Day Year Awarding Agency Address Address City State Zip+4
6/11/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1093 TACOMA WA 98401
Day and Date Deductions -
H
Work Classification Name rt ~O Sun Mon Tue Wed Thu Fri Sat Total
Gross Amount
and And E 6/5 6/6 6/7 6/8 6/9 6/10 6/11 Total Rate Hourly
E i= Earned/Gross
Net Wages
Hours of Pay "Usual FICA Withholding Other
Soc Sec#of Employee Address o o Hours Worked Each Day Payroll Benefits" Tax
a
1. Power Equipment RG 0.00 8.00 0.00 8.00 8.00 8.00 0.00 32.00 $52.12 $1,667.8 Workers'
Operators 4 Compensation:
Shovel, Excavator,Backhoe, $18.31,Paid
Tractors Under 15 Metric Tons Grant Holder OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $78.18 $0.00 Family Medical
(King) 38320 238th Ave $1,667.84 Leave:$12.94,
SE / 824.47/hr $225.28 $369.70 Union Dues: $2,244.35
_Ink_ .. Enumclaw,WA- $2,944.78 $58.90,Paid
98022 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1 04.2 $0.00 Family Medical
Leave:$15.30
2. Electricians-Inside Workers'
RG 0.00 0.00 3.00 0.00 0.00 1.00 0.00 4.00 $77.17 $308.68
ley Level Compensation:
I) $115 7 $10.38,Paid
OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5 $0.00 Family Medical
...:.:... Wade Sanders Leave:$11.19,
12502 118th St Ct E $308.68/ 401(k):$9.00,
Puyallup,WA- $2,546.61 $27.60/hr $194.81 $470.40 credit union: $1,331.54
98374
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $14.3 $0.00 $325.97,Union
Dues:$68.30,
Ni vacation:$125.02
3. Electricians-Inside RG 0.00 8.00 8.00 8.00 8.00 8.00 0.00 40.00 $73.96 $2,95814 Workers'
J
Journey Level 0 / Compensation:
(King) Robert Veltung $110 9 $2,958.40 "- $12.59,Paid
PO Box 1295 OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 / $27,47/hr $226.32 $581.39 Family Medical $1,947.60
......... Buckley,WA- $2,958.40 Leave:$13.00,
98321 $147 9 vacation:$177.50
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2 $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 Jamie Gordon Payroll
6/14/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TOTEM ELECTRIC OF TACOMA INC
employed by:
Project Name: For the week starting:• For the week ending:
^ sall Avenue NE 6/5/2022 6/11/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
national training fund:
1.Grant Holder $0.05/hr
Power Equipment Operators
Shovel,Excavator,Backhoe, $24.47 $16.40 $7.32 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
401(k):$2.50/hr,
Wade Sanders nebf:$2.32/hr,neca/
-Inside amf:$0.77/hr,Imcc/
nlmcc-Journey Level $27.60 $10.63 $10.35 $0.00 $0.00 $0.87
$0.05/$0.11/hr,sap:
0.05/hr
(King)
401(k):$2.50/hr,
3.Robert Veltung nebf:$2.22/hr,neca/
Electricians-Inside amf:$0.74/hr,sap:
Journey Level $27.47 $10.63 $10.35 $0.00 $0.00 $0_87 $0.05/hr,Imcc/
nlmcc:$0.11/hr
(King)
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
'c`-",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
Jamie Gordon Payroll Jamie Gordon
MB 6/17/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and ,v 9TArg Project Name County Project or Contract#
p:
A? 9,, Prime Contractor ❑
Industries § °_r _ Duvall Avenue NE King CAG 20 065
0:i:::
as••:.
Prevailing Wage Program <;i:::. ..,, Subcontractor
`'•.i' Project Address
PO Box 44540 °';,- .y J
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 TOTEM ELECTRIC OF TACOMA INC (253)383-5022
Month Day Year Awarding Agency Address Address City State Zip+4
6/4/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1093 TACOMA WA 98401
Day and Date Deductions
t=
Work Classification Name c& ~O o Sun Mon Tue Wed Thu Fri Sat Total
ce a) Gross Amount
a> E 5/29 5/30 5/31 6/1 6/2 6/3 6/4 Total Rate Hourly
and And Earned/Gross
" Net Wages
E i= Hours of Pay Usual FICA Withholding Other
Soc Sec#of Employee Address f -0 Payroll Benefits" Tax
ce O o Hours Worked Each Day
a
1. Power Equipment Workers'
RG 0.00 0.00 10.00 0.00 0.00 0.00 0.00 10.00 $49.92 $499.20
Operators Compensation:
Shovel,Excavator,Backhoe, Grant Holder $16.52,Paid
Tractors Under 15 Metric Tons 38320 238th Ave OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $74.88 $0.00 $2,062.80 J Family Medical
(King) SE / $23.37/hr $193.44 $175.96 Leave:$11.11, $2,067.15
Enumclaw,WA- $2,528.55 Union Dues:
' -"" 98022 $50.57,nw fca:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $99.84 $0.00 $13.80
2. Power Equipment RG 0.00 0.00 0.00 10.00 10.00 10.00 0.00 30.00 552.12 $1,563.6 Workers'
Operators 0 Compensation:
vel,Excavator,Backhoe, Grant Holder $16.52,Paid
:tors Under 15 Metric Tons 38320 238th Ave OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 S78.18 $0.00 $2,062.80 Family Medical
1.utt9) SE / $24.47/hr $193.44 $175.96 Leave:$11.11, $2,067.15
Enumclaw,WA- $2,528.55 Union Dues:
*." 98022 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 S104.2 S0.00 $50.57,nw fca:
$13.80
3. Electricians-Inside Workers'
RG 0.00 0.00 3.00 0.00 0.00 0.00 0.00 3.00 $77.17 $231.51
Journey Level Compensation:
Kin $8.15,Paid
( g) Wade Sanders OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1 5'7 $0.00 Family Medical
*" `=""* 12502 118th St Ct E $231.51 / Leave:$11.53,
Puyallup,WA- $2,623.78 $27.60/hr $200.72 $488.92 401(k):$9.00, $1,501.25
98374 credit union:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5154.3 $0.00 $256 2,Union
4 Dues:Dues:$54.79,
vacation:$92.60
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
4. Electricians-Inside RG 0.00 0.00 10.00 10.00 10.00 10.00 0.00 40.00 $73.96 $2,958.4 Workers'
Journey Level 0 Compensation:
(King) Robert Veltung $110.9 $2,958.40 $14.48,Paid
PO Box 1295 OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $0.00 4 I $27.47/hr $277.24 $762.76 Family Medical $2,336.20
...:_.... Buckley,WA- $3,624.04 Leave:$15.92,
98321 $147 9 vacation:$217.44
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2 $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 Jamie Gordon Payroll
6/6/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TOTEM ELECTRIC OF TACOMA INC
employed by:
Project Name: For the week starting: For the week ending:
^.Fvall Avenue NE 5/29/2022 6/4/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms)
p
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
national training fund:
1.Grant Holder $0.05/hr
Power Equipment Operators
Shovel,Excavator, Backhoe, $23.37 J $15.65 $6.97 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
national training fund:
$0.05/hr
Grant Holder
ewer Equipment Operators
�'iovel,Excavator,Backhoe, $24.47 $16.40 $7.32 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
401(k):$2.50/hr,
3.Wade Sanders nebf:$2.32/hr,neca/
Electricians Inside amf:$0.77/hr,Imcc/
Journey Level $27.60 $10.63 $10.35 $0.00 $0.00 $0.87 nlmcc:$0.11/hr,sap:
$0.05/hr
(King)
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
401(k):$2.50/hr,
4.Robert Veltung nebf:$2.22/hr,neca/
Electricians-Inside amf:$0.74/hr,sap:
Journey Level $27.47 $10.63 $10.35 $0.00 $0.00 $0.05/hr,lmccI
$0.87 nlmcc:$0.11/hr
(King)
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
! `\\ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and
,+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
Jamie Gordon Payroll Jamie Gordon
i
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 �,5,�*E� Project Name County Project or Contract#
Industries A+°"' "''(%% Prime Contractor ❑
?i' a f.
?:� t:r„`` Duvall Avenue NE King CAG-20-065
Prevailing Wage Program ;i ;; ; �I Subcontractor
PO Box 44540 °�y`�i` .cy�. 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 TOTEM ELECTRIC OF TACOMA INC (253)383-5022
Month Day Year Awarding Agency Address Address City State Zip+4
5/28/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1093 TACOMA WA 98401
Day and Date Deductions
1-1-
Work Classification Name C7 ~O o Sun Mon Tue Wed Thu Fri Sat Total
tY a> Gross Amount
and And a> E 5/22 5/23 5/24 5/25 5/26 5/27 5/28 Total Rate Hourly
Earned/Gross Net Wages
j E Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address cc o o Hours Worked Each Day y Benefits" Tax
0
1. Electricians-Inside Workers'
RG 0.00 4.00 0.00 0.00 0.00 0.00 0.00 4.00 $77.17 $308.68
Journey Level Compensation:
(King) $115.7 $10.08,Paid
OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5 $0.00 Family Medical
Wade Sanders Leave:$10.85,
12502 118th St Ct E $308.68/ 401(k):$6.00,
Puyallup,WA- $2,469.44 $27.60/hr $188.91 $452.60 credit union: $1,290.44
98374
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1�4.3 Dues:
$0.00 $316.09, Union
Dues:$64.82,
vacation:$129.65
Electricians-Inside RG 0.00 0.00 0.00 0.00 0.00 8.00 0.00 8.00 $73.96 $591.68' Workers'
rney Level Compensation:
Kin Robert Veltung .1 $12.59,Paid
(King) 9
PO Box 1295 OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $110. $0.00 $591.68/ Family Medical
_ _ _, Buckley,WA- 4 $2,958.40 $27.47/hr $226.32 $581.39 Leave:$13.00, $1,947.60
98321 $147 9 vacation:$177.50
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2 $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 Jamie Gordon Payroll
6/1/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TOTEM ELECTRIC OF TACOMA INC
employed by:
Project Name: For the week starting: For the week ending:
n.ivall Avenue NE 5/22/2022 5/28/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
401(k):$2.50/hr,
1.Wade Sanders nebf:$2.32/hr,neca/
Electricians-Inside amf:$0.77/hr,Imcc/
Journey Level $27.60 $10.63 $10.35 $0.00 $0.00 $0 87 nlmcc:$0.11/hr,sap:
$0.05/hr
(King)
401(k):$2.50/hr,
2. Robert Veltung nebf:$2.22/hr,neca/
Electricians-Inside amf:$0.74/hr,sap:
urney Level $27.47 4 $10.63 $10.35 $0.00 $0.00 $0.87 $0.05/hr,Imcc!
nlmcc:$0.11/hr
(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.
1, \Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and
fining Council.
Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties.
Printed name of party signing this report Title Signature
Jamie Gordon Payroll Jamie Gordon
f
MB 6/6/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and ..;+.,,F Project Name County Project or Contract#
tlfl" �4' Prime Contractor ❑
Industries t{? Duvall Avenue NE KingCAG-20-065
Prevailing Wage Program �''i lt'='
PO Box 44540 <.uiIitJ iir Subcontractor
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 TOTEM ELECTRIC OF TACOMA INC (253)383-5022
Month Day Year Awarding Agency Address Address City State Zip+4
5/21/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1093 TACOMA WA 98401
Day and Date Deductions
F
Work Classification Name c9 ~O o Sun Mon Tue Wed Thu Fri Sat Total
cr a> Gross Amount
and And E 5/15 5/16 5/17 5/18 5/19 5/20 5/21 Total Rate Earned/Gross Hourly Net Wages
E Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address O o Hours Worked Each Day Benefits" Tax
a
1. Electricians-Inside Workers'
RG 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $77.17 $0.00
Journey Level Compensation:
(King) Christopher Bond $115.7 $18.09,Paid
26306 173rd St E OT 0.00 0.00 2.00 0.00 0.00 0.00 0.00 2.00 6 $231.52 $231.52/ $27.60/hr $411.78 $1,349.88 Family Medical $3,256.25
Buckley,WA- $5,382.61 Leave:$23.65,
98321 $154.3 vacation:$322.96
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00
2. Power Equipment Workers'
RG 0.00 3.00 8.00 0.00 0.00 0.00 0.00 11.00 $49.92 $549.12
Operators Compensation:
Shovel, Excavator,Backhoe, Grant Holder $16.90,Paid
Tractors Under 15 Metric Tons 38320 238th Ave OT 0.00 0.00 3.00 0.00 0.00 0.00 0.00 3.00 $74.88 $224.64 Family Medical
i) SE $773.76/ $23.37/hr $192.85 $276.46 Leave:$11.08, $1,959.15
Enumclaw,WA- $2,520.96 Union Dues:
98022 $50.42,nw fca:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $99.84 $0.00 $14.10
3. Electricians-Inside Workers'
RG 0.00 0.00 2.00 0.00 0.00 0.00 0.00 2.00 $70.74 $141.48
Journey Level Compensation:
Kin $13.53,Paid
( g) Casey Liesberg OT 0.00 0.00 2.00 0.00 0.00 0.00 0.00 2.00 $106.1 $212.22 Family Medical
5632 208th St.Ct. Leave:$13.68,
E. $495.18/ $27.34/hr $238.25 $580.74 401(k):$117.00, $1,851.64
Spanaway,WA- $3,114.34 Union Dues:
98387 $141.4 $82.82,payroll
DT 0.00 0.00 1.00 0.00 0.00 0.00 0.00 1.00 8 $141.48 savings:$59.64,
vacation:$157.04
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
°--- .-..r
4. Power Equipment J J I Workers'
Operators RG 0.00 0.00 2.00 0.00 0.00 0.00 0.00 2.00 $49.92 $99.84 Compensation:
Shovel, Excavator,Backhoe, J J J $17.77,Paid
Tractors Under 15 Metric Tons Levi Nims OT 0.00 0.00 3.00 0.00 0.00 0.00 0.00 3.00 $74.88 $224.64 J Family Medical
(King) 6220 Waller Rd.E. $324.48/ $23.37/hr $207.03 $491.03 Leave:$11.89, $1,909.54
Tacoma,WA- $2,706.24 Union Dues:
......... 98443
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $99.84 $0.00 $14.85
5. Electricians-Inside Workers'
RG 0.00 0.00 3.00 0.00 0.00 0.00 0.00 3.00 $77.17 $231.51
Journey Level Compensation:
(King) $115.7 $10.66,Paid
OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5 $0.00 Family Medical
......... Wade Sanders Leave:$11.53,
12502 118th St Ct E $231.51 / 401(k):$4.50,
Puyallup,WA- $2,623.78 $27.60/hr $200.72 $490.00 credit union: $1,359.09
98374 $154.3 $335.84,Union
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 Dues:$67.90,
vacation:$143.54
6. Electricians-Inside Workers'
RG 0.00 3.00 8.00 0.00 0.00 0.00 0.00 11.00 $73.96 $813.56
Journey Level Compensation:
(King) Robert Veltung $15.56,Paid
$110 9 $1,183.36
PO Box 1295 OT 0.00 0.00 2.00 0.00 0.00 0.00 0.00 2.00 4 ' $221.88 / $27.47/hr $309.77 $898.85 Family Medical $2,564.38
...�..... Buckley,WA- Leave:$17.79,
98321 $4,049.31
$147 9 vacation:$242.96
DT 0.00 0.00 1.00 0.00 0.00 '0.00 0.00 1.00 2 ' $147.92
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 Jamie Gordon Payroll
5/24/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TOTEM ELECTRIC OF.TACOMA INC
employed by:
Project Name: For the week starting: For the week ending:
p ,:all Avenue NE 5/15/2022 5/21/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F)Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
•
401(k):$2.50/hr,
1.Christopher Bond nebf:$2.32/hr,
Electricians-Inside neca/amf:$0.77/hr,
sap:$0.05/hr,
Journey Level $27.60 $10.63 $10.35 $0.00 $0.00 $0.87
Imcc/nlmcc:$0.11/hr
•
(King)
national training fund:
2.Grant Holder $0.05/hr
\ver Equipment Operators
rvel,Excavator,Backhoe, $23.37 $15.65 $6.97 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
401(k):$2.50/hr,
3.Casey Liesberg nebf:$2.12/hr,
Electricians-Inside neca/amf:$0.71/hr,
sap:$0.05/hr,
Journey Level $27.34 $10.63 $10.35 $0.00 $0.00 $0.87
Imcc/nlmcc:$0.11/hr
(King)
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
t� �J
national training fund:
4.Levi Nims $0.05/hr
Power Equipment Operators
Shovel,Excavator,Backhoe, $23.37 J $15.65 $6.97 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
401(k):$2.50/hr,
5.Wade Sanders nebf:$2.32/hr,neca/
amf:$0.77/hr,Imcc/
Electricians-Inside
Journey Level $27.60 $10.63 $10.35 $0.00 $0.00 $0.87 nlmcc:$0.11/hr,sap:
$0.05/hr
ng)
401(k):$2.50/hr,
6.Robert Veltung
nebf:$2.22/hr,neca/
Electricians-Inside amf:$0.74/hr,sap:
Journey Level $27.47 $10.63 $10.35 $0.00 $0.00 $0.87 $0.05/hr,Imcc/
nlmcc:$0.11/hr
(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
Jr-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
Jamie Gordon Payroll Jamie Gordon
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 ,�F. Project Name County Project or Contract#
t' Prime Contractor ❑
Industries �� ' „ `f
�;; ''r4Q1l?;r„ Duvall Avenue NE King CAG-20-065
Prevailing Wage Program < �,, ;: ,'= Subcontractor
�'4"' .` Project Address
PO Box 44540 °�y��y a�v 1
Olympia WA 98504-4540 "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 TOTEM ELECTRIC OF TACOMA INC (253)383-5022
Month Day Year Awarding Agency Address Address City State Zip+4
5/14/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1093 TACOMA WA 98401
Day and Date Deductions
p
Work Classification Name c7 ~O o Sun Mon Tue Wed Thu Fri Sat Total
m Gross Amount
and And m E 5/8 5/9 5/10 5/11 5/12 5/13 5/14 Total Rate Earned/Gross Hourly Net Wages
Eco m Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address m > Benefits"
cC O o Hours Worked Each Day
0 J
1. Power Equipment RG 0.00 8.00 8.00 8.00 5.00 0.00 0.00 29.00 $49.92 $1 447.6 Workers'
Operators g� Compensation:
Shovel, Excavator,Backhoe, Grant Holder $11.50,Paid
Tractors Under 15 Metric Tons 38320 238th Ave OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $74.88 $0.00 $1,447.68 .' Family Medical
Kin Leave:$8.77,
(King) SE / $23.37/hr $152.76 $171.94 $1,610.28
Enumclaw,WA- $1,996.80 Union Dues:
98022 $31.95,nw fca:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $99.84 $0.00 $9.60
2. Electricians-Inside Workers'
RG 0.00 4.00 0.00 0.00 0.00 0.00 0.00 4.00 $77.17 $308.68
Journey Level Compensation:
$10.08,Paid
I) OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $115.7 $0.00 Family Medical
Wade Sanders 5 Leave:$10.85,
12502 118th St Ct E $308.68/ $27.60/hr $188.91 $451.16 401(k):$12.00, $1,301.32
Puyallup,WA- $2,469.44 credit union:
98374 $154.3 $316.09,Union
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 Dues:$67.91,
vacation:$111.12
3. Electricians-Inside RG 0.00 8.00 8.00 8.00 5.00 0.00 0.00 29.00 $73.96 $2,144.8 Workers'
Journey Level 4 Compensation:
(King) Robert Veltung
$110.9 $2,144.84 $10.06,Paid
PO Box 1295 OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 / $27,47/hr $226.32 $581.39 Family Medical $1,985.63
_= Buckley,WA- - $2 958 40 Leave:$13.00,
98321 $147 9 vacation:$142.00
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2 $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 Jamie Gordon Payroll
5/17/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TOTEM ELECTRIC OF TACOMA INC
employed by:
Project Name: For the week starting: For the week ending:
Avenue NE 5/8/2022 5/14/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
)
national training fund:
1.Grant Holder $0.05/hr
Power Equipment Operators
Shovel,Excavator,Backhoe, $23.37 J $15.65 $6.97 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
401(k):$2.50/hr,
Wade Sanders nebf:$2.32/hr,neca/
ctricians-Inside amf:$0.77/hr,Imcc/
nlmcc4-6urney Level $27.60 $10.63 $10.35 $0.00 $0.00 $0.87
$0.05/$0.11/hr,sap:
0.05/hr
(King)
401(k):$2.50/hr,
3.Robert Veltung nebf:$2.22/hr,neca/
Electricians-Inside amf:$0.74/hr,sap:
Journey Level $27.47 $10.63 $10.35 $0.00 $0.00 $0.87 $0.05/hr,Imcc/
nlmcc:$0.11/hr
(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.
,1,`1-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
Jamie Gordon Payroll Jamie Gordon
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 �.sserf Project Name County Project or Contract#
sA:E,..iliV2A Prime Contractor ❑
Industries L v.,,y
Prevailing Wage Program ,ii==. ,iiiiS Duvall Avenue NE King CAG 20 065
,ulr� �14 Subcontractor IZI
PO Box 44540 r D4 Project Address
Olympia WA 98504-4540 ` 'ges Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TOTEM ELECTRIC OF TACOMA INC (253)383-5022
Month Day Year Awarding Agency Address Address City State Zip+4
5/7/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1093 TACOMA WA 98401
Day and Date Deductions
Work Classification Name c7 ~ o Sun Mon Tue Wed Thu Fri Sat Total
cC O au Gross Amount
and And ` E 5/1 5/2 5/3 5/4 5/5 5/6 5/7 Total Rate
Eamed/Gross Hourly
Hours of Pay "Usual Withholding Net Wages
m
a) Payroll FICA Other
Soc Sec#of Employee Address CD O o Hours Worked Each Day Benefits" Tax
a
1. Power Equipment RG 0.00 8.00 8.00 8.00 8.00 8.00 0.00 40.00 $49.92 $1,996.8 Workers'
Operators 0 Compensation:
Shovel,Excavator,Backhoe, Grant Holder $14.37,Paid
Tractors Under 15 Metric Tons 38320 238th Ave OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $74.88 $0.00 $1,996.80 Family Medical
(King) SE / $23.37/hr $152.76 $171.94 Leave:$8.77, $1,597.02
Enumclaw,WA- $1,996.80 Union Dues:
rrr_rr-rrrr 98022 $39.94,nw fca:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $99.84 $0.00 $12.00
2. Electricians-Inside RG 0.00 1.00 0.00 1.00 0.00 2.00 0.00 4.00 $77 17 $308.68 Workers'
Journey Level J Compensation:
rg) $115.7 $11.00,Paid
OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5 $0.00 ✓ Family Medical
' rrr rr rrrr Wade Sanders
Leave:$11.87,
12502 118th St Ct E
$308.68/ 401k 50$27.60/hr $206.62 $507.08 ( ):$10. , $1,405.58
Puyallup,WA- $2,700.95 credit union:
98374
,Union
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $14'3 $0.00 Dues:$72.93,
Dues:
vacation:$129.65
3. Electricians-Inside RG 0.00 8.00 8.00 8.00 8.00 8.00 0.00 40.00 $73.96 $2,958.4 Workers'
Journey Level 0 Compensation:
(King) Robert Veltung $110.9 $2,958.40 $12.58,Paid
PO Box 1295 OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $0.00 Family Medical
rrr.r„rr. Buckley,WA- 4 / $27.47/hr $226.31 $581.39 Leave:$13.00, $1,947.62
98321 $2,958.40 vacation:$177.50
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $147.9 $0.00
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Jamie Gordon Payroll
5/11/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TOTEM ELECTRIC OF TACOMA INC
employed by:
Project Name: For the week starting: For the week ending:
' vall Avenue NE 5/1/2022 5/7/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
national training fund:
1.Grant Holder $0.05/hr
Power Equipment Operators
Shovel,Excavator,Backhoe, $23.37 $15.65 $6.97 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
401(k):$2.50/hr,
,Wade Sanders nebf:$2.32/hr,neca/
:ctricians-Inside amf:$0.77/hr,Imcc/
Journey Level $27.60 $10.63 $10.35 $0.00 $0.00 $0.87 nlmcc:$0.11/hr,sap:
$0.05/hr
•
(King)
401(k):$2.50/hr,
3.Robert Veltung nebf:$2.22/hr,neca/
Electricians-Inside amf:$0.74/hr,sap:
Journey Level $27.47 $10.63 $10.35 $0.00 $0.00 $0.87 $0.05/hr,Imcc/
nlmcc:$0.11/hr
(King)
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
,'any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and
,fining Council.
Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties.
Printed name of party signing this report Title Signature
Jamie Gordon Payroll Jamie Gordon
MB 5/17/22
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 -.1\'6 . Project Name County Project or Contract#
,�;:r�l.,`< Prime Contractor
Industries _:#:..
PrevailingWage Program I Duvall Avenue NE King CAG-20-065
g ^,l1�:.. r�� Subcontractor !
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 TOTEM ELECTRIC OF TACOMA INC (253)383-5022
Month Day Year Awarding Agency Address Address City State Zip+4
4/30/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1093 TACOMA WA 98401
Day and Date Deductions
Work Classification Name c9 p o Sun Mon Tue Wed Thu Fri Sat Total
Gross Amount
and And d
16 E i Hours of Pay Earned/Gross "Usual Withholding Net Wages
r w Payroll FICA Other
Soc Sec#of Employee Address a, 8 Hours Worked Each Day Benefits" Tax
ce O
I No Employees performed work on this project during this reporting period.
t _ c2-c
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 Jamie Gordon Payroll
5/3/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TOTEM ELECTRIC OF TACOMA INC
employed by:
Project Name: For the week starting: For the week ending:
Duvall Avenue NE 4/24/2022 4/30/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
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
Jamie Gordon Payroll Jamie Gordon
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and ��arF Project Name County Project or Contract#
p ,S:`i' °F Prime Contractor ❑
Industries ,.
` '" �.` � Duvall Avenue NE King CAG-20-065
::::.
Prevailing Wage Program a� Subcontractor
PO Box 44540 °k;.. ., �,y Project Address
Olympia WA 98504-4540 "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 TOTEM ELECTRIC OF TACOMA INC (253)383-5022
Month Day Year Awarding Agency Address Address City State Zip+4
4/23/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1093 TACOMA WA 98401
Day and Date Deductions
p
Work Classification Name a ~o o Sun Mon Tue Wed Thu Fri Sat Total
Gross Amount
and And E 4/17 4/18 4/19 4/20 4/21 4/22 4/23 Total Rate Earned/Gross Hourly Net Wages
>= Hours of Pay "Usual FICA Withholding Other
Soc Sec#of Employee Address f 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 Jamie Gordon Payroll
4/27/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TOTEM ELECTRIC OF TACOMA INC
employed by:
Project Name: For the week starting: For the week ending:
all Avenue NE 4/17/2022 4/23/2022
"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.
' `.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
Jamie Gordon Payroll Jamie Gordon
MB 4/28/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and t.,,, Project Name County Project or Contract#
\: itii "t Prime Contractor El
Industries _. ,.o 0+.1`;, Duvall Avenue NE King CAG-20-065
PrevailingWage Program 9 9 �.��� ���. Subcontractor
PO Box 44540 yy_ 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 TOTEM ELECTRIC OF TACOMA INC (253)383-5022
Month Day Year Awarding Agency Address Address City State Zip+4
4/16/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1093 TACOMA WA 98401
Day and Date Deductions
H
Work Classification Name 6 ~O o Sun Mon Tue Wed Thu Fri Sat Total
Gross Amount
and And a> E 4/10 4/11 4/12 4/13 4/14 4/15 4/16 Total Rate Hourly
Earned/Gross WithholdingNet Wages
E H Hours of Pay
"Usual FICA Other
Soc Sec#of Employee Address ce o o Hours Worked Each Day Payroll Benefits" Tax
a .1 J
1. Power Equipment Workers'
RG 0.00 4.00 0.00 0.00 0.00 0.00 0.00 4.00 $49.92 $199.68
Operators Compensation:
Shovel,Excavator,Backhoe, Grant Holder r $14.37,Paid
Tractors Under 15 Metric Tons 38320 238th Ave OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $74.88 $0.00 �1 J Family Medical
$199.68/ $23.37/hr $152.75 $171.94 Leave:$8.77,
(King) SE $1,597.03
$1,996.80 Union Dues:
Enumclaw,WA-
. 98022 $39.94,nw fca:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $99.84 $0.00 $12.00
2. Electricians-Inside RG 0.00 0.00 3.00 0.00 0.00 0.00 0.00 3.00 $77.17 $231.51 401(k):$15.00,
Journey Level creditcredit union:
3) $115.7 $355.60, Union
OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5 $0.00 Dues:$77.17,
` "' Wade Sanders vacation:
12502 118th St Ct E $231.51 / $120.39,
Puyallup,WA- $2 778 12 $27.60/hr $212.53 $524.52 Workers' $1,449.41
98374 $154.3 Compensation:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 $11.30,Paid
Family Medical
Leave:$12.20
3. Electricians-Inside Workers'
RG 0.00 4.00 0.00 0.00 0.00 0.00 0.00 4.00 $73.96 $295.84
Journey Level Compensation:
(King) Robert Veltung $110.9 $12.59,Paid
PO Box 1295 OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 $295.84/ $27.47/hr $226.33 $581.39 Family Medical $1,947.59
_ _ .. Buckley,WA- ,$2,958.40 Leave:$13.00,
98321 $147.9 vacation:$177.50
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2 $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 Jamie Gordon Payroll
4/27/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TOTEM ELECTRIC OF TACOMA INC
employed by:
Project Name: For the week starting: For the week ending:
^.^call Avenue NE 4/10/2022 4/16/2022
"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
national training fund:
1.Grant Holder $0.05/hr
Power Equipment Operators
Shovel,Excavator,Backhoe, $23.37 J $15.65 $6.97. $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
• 401(k):$2.50/hr,
�":1Vade Sanders nebf:$2.32/hr,neca/
ctricians-Inside amf:$0.77/hr,Imcc/
'aoumey Level $27.60 $10.63 $10.35 $0.00 $0.00 $0.87
$0.05/$0.11/hr,sap:
0.05/hr
(King)
• 401(k):$2.50/hr,
3.Robert Veltung nebf:$2.22/hr,neca/
Electricians-Inside amf:$0.74/hr,sap:
Journey Level $27.47 $10.63 $10.35 $0.00 $0.00 $0.87 $0.05/hr,Imcc/
nlmcc:$0.11/hr
(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.
!RI 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
Jamie Gordon Payroll Jamie Gordon
MB 4/28/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and �a.c.5T"rrilii.I;
;�,� Prime Contractor ❑ Project Name County Project or Contract#
Industries ',? Duvall Avenue NE King CAG-20-065
Prevailing Wage Program 4. :, :1:.-- Subcontractor
PO Box 44540 'P .,y". Project Address
Olympia WA 98504-4540 y'` `"ka'` Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TOTEM ELECTRIC OF TACOMA INC (253)383-5022
Month Day Year Awarding Agency Address Address City State Zip+4
4/9/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1093 TACOMA WA 98401
Day and Date Deductions
Work Classification Name 0 ~O o Sun Mon Tue Wed Thu Fri Sat Total
Gross Amount
E 4/3 4/4 4/5 4/6 4/7 4/8 4/9 Total Rate Hourly
and And Earned/Gross Net Wages
co Hours of Pay Payroll Net FICA Withholding Other
Soc Sec#of Employee Address cC o o Hours Worked Each Day y Benefits" Tax
a
1. Power Equipment Workers'
RG 0.00 0.00 0.00 4.00 0.00 0.00 0.00 4.00 $49.92 $199.68
Operators Compensation:
Shovel, Excavator,Backhoe, $14.37,Paid
Tractors Under 15 Metric Tons Robert Arnold OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $74.88 $0.00 Family Medical
(King) 5501 136th Si.E. $199.68/ $23.37/hr $152.75 $197.53 Leave:$8.77, $1,571.44
Puyallup,WA- $1,996.80 Union Dues:
_ _ ** 98373 $39.94,nw fca:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $99.84 $0.00 $12.00
2. Power Equipment RG 0.00 0.00 0.00 8.00 8.00 8.00 0.00 24.00 $49.92 $1,198.0 Workers'
Operators 8 Compensation:
vel, Excavator,Backhoe, Jeff Craig $14.37,Paid
:tors Under 15 Metric Tons 29016 Ben Howard OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $74.88 $0.00 $1,198.08 Family Medical
(King) Rd / $23.37/hr $152.76 $282.03 Leave:$8.77, $1,486.93
Monroe,WA- $1,996.80 Union Dues:
» ** 98272 $39.94,nw fca:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $99.84 $0.00 $12.00
3. Power Equipment RG 0.00 8.00 8.00 8.00 8.00 8.00 0.00 40.00 $49.92 $1,996.8 Workers'
Operators 0 Compensation:
Shovel,Excavator,Backhoe, Grant Holder $14.37,Paid
Tractors Under 15 Metric Tons 38320 238th Ave OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $74.88 $0.00 $1,996.80 Family Medical
(King) SE / $23.37/hr $152.76 $171.94 Leave:$8.77, $1,597.02
Enumclaw,WA- $1,996.80 Union Dues:
` ,,*.*** 98022 $39.94,nw fca:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $99.84 $0.00 $12.00
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
4. Electricians-Inside RG 0.00 0.00 4.00 0.00 0.00 0.00 0.00 4.00 $77.17 $308.68 Workers'
Journey Level Compensation:
(King) $115 7 $11.34,Paid
OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5 $0.00 Family Medical
_ _ .« Wade Sanders
12502 118th St Ct E Leave:$12.20,
$308.68/ $27.60/hr $212.53 $525.24 401(k):$12.00,
Puyallup,WA- $2,778.12 credit union: $1,443.93
98374
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1 '3 $0.00 $355.60, Union
Dues:$75.63,
vacation:$129.65
5. Electricians-Inside RG 0.00 8.00 8.00 8.00 8.00 8.00 0.00 40.00 $73.96 $2,958.4 Workers'
Journey Level 0 Compensation:
(King) Robert Veltung $110.9 $2,958.40 $12.58,Paid
PO Box 1295 OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 / $27.47/hr $226.31 $581.39 Family Medical $1,947.62
« «« Buckley,WA- Leave:$13.00,
98321 $2,958.40 vacation:$177.50
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $147'9 $0.00
6. Electricians-Inside NI
RG 0.00 0.00 0.00 8.00 8.00 8.00 0.00 24.00 $70.74 $1,697// Workers'
Journey Level 6\/ J Compensation:
(King) $106.1 `� $7.55, Paid
Jason Viveiros OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1 $0.00 $1,697.76 Family Medical
` _ .-"««« 2302 Rainier Ave I $27.34/hr $129.88 $234.43 Leave:$7.46, $1,174.12
Everett,WA-98201 $1,697.76 Union Dues:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1 81'4 $0.00 $42.45,vacation:
$101.87
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 Jamie Gordon Payroll
4/20/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TOTEM ELECTRIC OF TACOMA INC
employed by:
Project Name: For the week starting: For the week ending:
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
national training fund:
1.Robert Arnold $0.05/hr
Power Equipment Operators
Shovel,Excavator,Backhoe, $23.37 $15.65 $6.97 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
training fund:
Jeff Craig $0.05/hr
'Fier Equipment Operators
shovel,Excavator,Backhoe, $23.37 $15.65 $6.97 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
national training fund:
3.Grant Holder $0.05/hr
Power Equipment Operators
Shovel,Excavator,Backhoe, $23.37 $15.65 $6.97 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
401(k):$2.50/hr,
4.Wade Sanders
nebf:$2.32/hr,neca/
Electricians-Inside
amf:$0.77/hr,Imcc/
Journey Level $27.60 $10.63 $10.35 $0.00 $0.00 $0.87 nlmcc:$0.11/hr,sap:
$0.05/hr
(King)
401(k):$2.50/hr,
nebf:$2.22/hr,neca/
5.Robert Veltung amf:$0.74/hr,sa
Electricianss-Inside P
Journey Level $27.47 $10.63 $10.35 $0.00 $0.00 $0.87 $0.05/hr,Imcc/
nlmcc:$0.11/hr
(King)
401(k):$2.50/hr,
Jason Viveiros nebf:$2.12/hr,
Electricians-Inside
neca/amf:$0.71/hr,
Journey Level $27.34 $10.63 $10.35 $0.00 $0.00 $0.87 sap:$0.05/hr,Imcc/
nlmcc:$0.11/hr
(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.
7 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
Jamie Gordon Payroll Jamie Gordon
_ 1
MB 4/26/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
.0.
Certified Payroll Report
Department of Labor and ,t ,I,r, Project Name County Project or Contract#
i '', Prime Contractor ❑
Industries =:`i. 1::.
r V.:'P..ra! . Duvall Avenue NE King CAG-20-065
Prevailing Wage Program .? :,' i z Subcontractor
PO Box 44540 '.y;°, Project Address
Olympia WA 98504-4540 Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TOTEM ELECTRIC OF TACOMA INC (253)383-5022
Month Day Year Awarding Agency Address Address City State Zip+4
4/2/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1093 TACOMA WA 98401
Day and Date Deductions
Work Classification Name c7 � e Sun Mon Tue Wed Thu Fri Sat Total
ce O a) Gross Amount
and And E 3/27 3/28 3/29 3/30 3/31 4/1 4/2 Total Rate Earned/Gross Hourly Net Wages
f0 E H Hours of Pay "Usual Withholding
a) Payroll FICA Other
Soc Sec#of Employee Address 0 o Hours Worked Each Day Benefits" Tax
a
1. Power Equipment RG 0.00 0.00 0.00 0.00 0.00 2.50 0.00 2.50 $49.92 $124.80 Workers'
Operators Compensation:
Shovel,Excavator,Backhoe, $14.37,Paid
Tractors Under 15 Metric Tons Robert Arnold OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $74.88 $0.00 Family Medical
(King) 5501 136th St.E. $124.80/ $23.37/hr $152.76 $197.53 Leave:$8.77, $1,571.43
Puyallup,WA- $1,996.80 Union Dues:
_ _ .. 98373 $39.94,nw fca:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $99.84 $0.00 $12.00
2. Laborers RG 0.00 0.00 0.00 0.00 0.00 2.50 0.00 2.50 $41.29 $103.23 Workers'
General Laborer Compensation:
••-• i) ' $8.63,Paid
Victor Olvera- OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $61.94 $0.00 `� J Family Medical
_ _ .. Sandoval $103.23/ $13.39/hr $75.81 $41.32 Leave:$4.35, $794.38
13624 1st Ave SW $990.97 Union Dues:
Burien,WA-98166 $41.28,vacation:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $82.58 $0.00 $25.20
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 Jamie Gordon Payroll
4/5/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TOTEM ELECTRIC OF TACOMA INC
employed by:
Project Name: For the week starting: For the week ending:
^ "all 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
national training fund:
1.Robert Arnold $0.05/hr
Power Equipment Operators
Shovel,Excavator,Backhoe, $23.37 $15.65 $6.97 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
WCISAP:$0.06/hr,
nwlecet:$0.14/hr
`lictor Olvera-Sandoval
lorers
'uieral Laborer $13.39 J $5.04 $7.20 $0.00 $0.00 $0.95
(King)
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker,laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
( -Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and
-ping Council.
Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties.
Printed name of party signing this report Title Signature
Jamie Gordon Payroll Jamie Gordon
j4/ 1
MB 4/8/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
a _
Certified Payroll Report
Department of Labor and ���_3;T"r:�,� Prime Contractor ❑ Project Name County Project or Contract#
Industries 4:=:: =t:.f.
�;:�•- "u=:r Duvall Avenue NE King CAG 20 065
Prevailing Wage Program <=ij=;. j Iii1 s Subcontractor XI
::: Project Address
PO Box 44540 °,IH'.' a�1
Olympia WA 98504-4540 !SRO ' Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TOTEM ELECTRIC OF TACOMA INC (253)383-5022
Month Day Year Awarding Agency Address Address City State Zip+4
3/26/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1093 TACOMA WA 98401
Day and Date Deductions
p
Work Classification Name C7 ~O o Sun Mon Tue Wed Thu Fri Sat Total
m Gross Amount
and And a) E 3/20 3/21 3/22 3/23 3/24 3/25 3/26 Total Rate Earned/Gross Hourly Net Wages
E Hours of Pay "Usual FICA Withholding Other
Soc Sec#of Employee Address o IX o Hours Worked Each Day Payroll Benefits" Tax
0
1. Power Equipment Workers'
RG 0.00 0.00 0.00 0.00 0.00 4.00 0.00 4.00 $49.92 $199.68
Operators Compensation:
Shovel, Excavator,Backhoe, $14.38,Paid
Tractors Under 15 Metric Tons Robert Arnold OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $74.88 $0.00 Family Medical
(King) 5501 136th St.E. $199.68/ $23.37/hr $152.76 $197.53 Leave:$8.77, $1,571.42
Puyallup,WA- $1,996.80 Union Dues:
98373 $39.94,nw fca:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $99.84 $0.00 $12.00
2. Power Equipment Workers'
RG 0.00 0.00 0.00 8.00 8.00 4.00 0.00 20.00 $49.92 $998.40
Operators Compensation:
iel, Excavator,Backhoe, Grant Holder $11.49,Paid
tors Under 15 Metric Tons 38320 238th Ave OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $74.88 $0.00 Family Medical
(King) SE $998.40/ $23.37/hr $152.75 $171.94 Leave:$8.77, $1,610.30
Enumclaw,WA $1,996.80 Union Dues:
98022 $31.95,nw fca:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $99.84 $0.00 $9.60
3. Electricians-Inside Workers'
RG 0.00 2.00 0.00 2.00 0.00 0.00 0.00 4.00 $77.17 $308.68
Journey Level Compensation:
(King) $115.7 $12.60,Paid
Wade Sanders OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5 $0.00 Family Medical
12502 118th St Ct E '- $308.68/ Leave:$13.56,
Puyallup,WA- $3,086.80 $27.60/hr $236.14 $602.21 credit union: $1,587.94
98374 $154.3 $395.11,Union
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 Dues:$81.81,
vacation:$157.43
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
4. Electricians-Inside RG 0.00 0.00 0.00 8.00 8.00 0.00 0.00 16.00 $73.96 $1,183 3 Workers'
Journey Level 6 J J Compensation:
(King) Robert Veltung $110.9 $1,183.36 Ni $10.08,Paid
PO Box 1295 OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 / $27.47/hr $226.32 $581.39 Family Medical $1,985.61
Buckley,WA- Leave:$13.00,
98321 $2,958.40 vacation:$142.00
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $127 9 $0.00
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
r -
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 Jamie Gordon Payroll
4/1/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TOTEM ELECTRIC OF TACOMA INC
employed by:
Project Name: For the week starting: For the week ending:
"'yell Avenue NE 3/20/2022 3/26/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms)
Work Classification Total Hourly (A) Hourly i (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
national training fund:
1.Robert Arnold $0.05/hr
Power Equipment Operators
Shovel,Excavator,Backhoe, $23.37 $15.65 $6.97 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
national training fund:
lrant Holder $0.05/hr
ver Equipment Operators
Shovel,Excavator,Backhoe, $23.37 $15.65 $6.97 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
401(k):$2.50/hr,
3.Wade Sanders nebf:$2.32/hr,neca/
Electricians-Inside amf:$0.77/hr,Imcc/
Journey Level $27.60 $10.63 $10.35 $0.00 $0.00 $0.87 nlmcc:$0.11/hr,sap:
$0.05/hr
(King) I ;
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
401(k):$2.50/hr,
nebf:$2.22/hr,neca/
4.Robert Veltung amf:$0.74/hr,sap:
-Inside
Journey Level $27.47,J $10.63 $10.35 $0.00 $0.00 $0.87 $0.05/hr,lmcc/
nlmcc:$0.11/hr
(King)
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)_The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either.directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned..
`any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and
' .fining Council.
Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties.
Printed name of party signing this report Title Signature
Jamie Gordon Payroll Jamie Gordon
MB 4/5/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and t,,�+T�.� Project Name County Project or Contract#
F.?..: :r°F Prime Contractor ❑
Industries ;;° „'i Duvall Avenue NE King CAG-20-065
Prevailing Wage Program I� Subcontractor IN
PO Box 44540 ':;:, . .,,Y Project Address
Olympia WA 98504-4540 Final Week of
(360)902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TOTEM ELECTRIC OF TACOMA INC (253)383-5022
Month Day Year Awarding Agency Address Address City State Zip+4
3/19/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1093 TACOMA WA 98401
Day and Date Deductions
p _
Work Classification Name c7 ~O o Sun Mon Tue Wed Thu Fri Sat Total
a) Gross Amount
and And U) E 3/13 3/14 3/15 3/16 3/17 3/18 3/19 Total Rate Earned/Gross Hourly Net Wages
E Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address cC O o Hours Worked Each Day Benefits" Tax
0 J
1. Power Equipment RG 0.00 8.00 8.00 8.00 0.00 0.00 0.00 24.00 $49.92 $1,198p Workers'
Operators g . Compensation:
Shovel,Excavator,Backhoe, Grant Holder 4 $14.36,Paid
Tractors Under 15 Metric Tons 38320 238th Ave OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $74.88 $0.00 $1 198 08 Family Medical
Kin Leave: $8.77,
(King) SE - / $23.37/hr $152.77 $171.94 $1,597.02
Enumclaw,WA- $1,996.80 Union Dues:
* _= 98022 $39.94,nw fca:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $99.84 $0.00 $12.00
2. Electricians-Inside Workers'
RG 0.00 0.00 0.00 3.00 1.00 0.00 0.00 4.00 $77.17 $308.68
Journey Level Compensation:
3) $115.7 $10.07,Paid
Wade Sanders OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5 $0.00 Family Medical
_ _` 12502 118th St Ct E $308.68/ Leave:$10.85,
Puyallup,WA $2,469.44 $27.60/hr $188.92 $454.04 credit union: $1,325.88
98374 $154.3 $316.09,Union
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 Dues:$70.99,
vacation:$92.60
3. Electricians-Inside RG 0.00 8.00 8.00 8.00 0.00 0.00 0.00 24.00 $73.96 $1,775.0 Workers'
Journey Level 4 Compensation:
(King) Robert Veltung
$110.9 $1,775.04 $12.59,Paid
PO Box 1295 OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 / $27.47/hr $226.31 $581.39 Family Medical $1,947.61
Buckley,WA- $2,958.40 Leave:$13.00,
98321 $147 9 vacation:$177.50
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2 $0.00
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
w
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 Jamie Gordon Payroll
3/24/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TOTEM ELECTRIC OF TACOMA INC
employed by:
Project Name: For the week starting: For the week ending:
riall Avenue NE 3/13/2022 3/19/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms)
Work Classification Total Hourly I (A) Hourly (B) Hourly (C) Hourly i (D) Hourly (E)Approved (F)Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
)
national training fund:
1.Grant Holder $0.05/hr
Power Equipment Operators
Shovel,Excavator,Backhoe, $23.37 $15.65 $6.97 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
401(k):$2.50/hr,
'-,Wade Sanders nebf:$2.32/hr,neca/
actricians-Inside amf:$0.77/hr,Imcc/
Journey Level $27.60 $10.63 $10.35 $0.00 $0.00 $0_87 nlmcc:$0.11/hr,sap:
$0.05/hr
(King)
401(k):$2.50/hr,
nebf:$2.22/hr,neca/
3.Robert Veltung
Electricians-Inside amf:$0.74/hr,sap:
Journey Level $27.47 $10.63 $10.35 $0.00 $0.00 $0.87 lmcc:
nhr,Imcc/
lmcc:$0.11/hr
(King)
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
'c` 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
Jamie Gordon Payroll Jamie Gordon
MB 4/4/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and t \„ Project Name County Project or Contract#
Industries : l
,vn °- Prime Contractor
PrevailingWage Program Duvall Avenue NE King CAG-20-065
g g �. �I I' 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 TOTEM ELECTRIC OF TACOMA INC (253)383-5022
Month Day Year Awarding Agency Address Address City State Zip+4
3/12/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1093 TACOMA WA 98401
Day and Date Deductions
Work Classification Name C. ~O o Sun Mon Tue Wed Thu Fri Sat Total
a)and And E 3/6 3/7 3/8 3/9 3/10 3/11 3/12 Total Rate Gross Amount
Earned/Gross Hourly Net Wages
- d E. d Hours of Pay Payroll "Usual FICA Wit holding Other
Soc Sec#of Employee Address $ Tax
O Hours Worked Each Day Benefits"
1. Power Equipment RG 0.00 8.00 8.00 8.00 8.00 8.00 0.00 40.00 $49.92 $1,996.8 Workers'
Operators 0 Compensation:
Shovel,Excavator,Backhoe, Grant Holder $14.36, Paid
Tractors Under 15 Metric Tons 38320 238th Ave OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $74.88 $0.00 $1,996.80 Family Medical
77$8. ,
(King) SE / $23.37/hr $152.75 $171.94 Leave: $1,597.04
Enumclaw,WA- $1,996.80 Union Dues:
** 98022 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $99.84 $0.00 $39.94,nw fca:
$12.00
2. Electricians-Inside RG 0.00 0.00 0.00 3.00 0.00 1.00 0.00 4.00 $7�7 $308.68 Workers'
Journey Level Compensation:
(King) $115.7 $11.30, Paid
OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $0.00 Ni / Family Medical
Wade Sanders 5 V
12502 118th St Ct E $308.68! Leave:$12.20,
Puyallup,WA- $2 778 12 $27.60/hr $212.53 $528.12 credit union: $1,445.37
98374 $154.3 $355.60,Union
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 Dues:$74.09,
vacation:$138.91
3. Electricians-Inside RG 0.00 8.00 8.00 8.00 8.00 8.00 0.00 40.00 $73.96 $2,958.4 Workers'
Joumey Level 0 Compensation:
(King) Robert Veltung $12.59, Paid
$110.9 $2,958.40
PO Box 1295 OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $0.00
Buckley,WA- Family Leave:Medical Medical $1,947.60
$13.00,
98321 $2'958.40 vacation:$177.50
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $127.9 $0.00
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Jamie Gordon Payroll
3/17/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TOTEM ELECTRIC OF TACOMA INC
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
national training fund:
1.Grant Holder $0.05/hr
Power Equipment Operators -
Shovel,Excavator,Backhoe, $23.37 $15.65 $6.97 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
401(k):$2.50/hr,
2.Wade Sanders nebf:$2.32/hr,neca/
Electricians-Inside amf:$0.77/hr,Imcc/
_ Journey Level $27.60✓ $10.63 $10.35 $0.00 $0.00 $0.87 nlmcc:$0.11/hr,sap:
$0.05/hr
(King)
401(k):$2.50/hr,
3.Robert Veltung nebf:$2.22/hr,neca/
Electricians-Inside amf:$0.74/hr,sap:
Journey Level $27.47 $10.63 $10.35 $0.00 $0.00 $0.87 $0.05/hr,Imcc/
nlmcc:$0.11/hr
(King)
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s)have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
(5)Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and
Training Council.
Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties.
Printed name of party signing this report Title Signature
Jamie Gordon Payroll - Jamie Gordon
M B 3/18/22
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 ;,'" Project Name County Project or Contract#
Industries '°;`,, Prime Contractor
{ i {.; Duvall Avenue NE King CAG-20-065
Prevailing Wage Program -ll - ,s� r� 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 TOTEM ELECTRIC OF TACOMA INC (253)383-5022
Month Day Year Awarding Agency Address Address City State Zip+4
3/5/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1093 TACOMA WA 98401
Day and Date Deductions
H
Work Classification Name (9 ~O o Sun Mon Tue Wed Thu Fri Sat Total
re - w Gross Amount
d 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
'-Ea) Payroll FICA Other
Soc Sec#of Employee Address ce O w 8 Hours Worked Each Day Benefits" Tax
1. Power Equipment $1,597.4 Workers'
Operators RG 0.00 0.00 8.00 8.00 8.00 8.00 0.00 32.00 $49.92 4 Compensation:
Shovel,Excavator,Backhoe, Grant Holder $14.37, Paid
Tractors Under 15 Metric Tons 38320 238th Ave OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $74.88 $0.00 $1 597 44 Family Medical
77 8. ,
(King) SE / $23.37/hr $152.76 $171.94 Leave:$ $1,597.02
Enumclaw,WA- $1 996 80 Union Dues:
98022 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $99.84 $0.00 $$12.2.00 rev/fca:
2. Electricians-Inside Workers'
RG 0.00 0.00 0.00 2.00 2.00 2.00 0.00 6.00 $77.17 $463.02
Journey Level Compensation:
(King) $115 7 $11.02, Paid
Wade Sanders OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5 $0.00 Family Medical
12502 118th St Ct E $463.02/ Leave:$11.87,
Puyallup,WA- $2,700.95 $27.60/hr $206.63 $509.60 credit union: $1,386.53
98374 $345.72,Union
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $14.3 $0.00 Dues:$67.52,
4 vacation:$162.06
3. Electricians-Inside RG 0.00 0.00 8.00 8.00 8.00 8.00 0.00 32.00 $73.96 $2'366/7 Workers'
Journey Level 2 ✓ / Compensation:
(King) Robert Veltung $110 9 $2,366.72 V $12.58, Paid
PO Box 1295 OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 ! $27.47/hr $226.32 $581.39 Family Medical $1,947.61
Buckley,WA- $2 958 40 Leave:$13.00,
98321 $147.9 vacation:$177.50
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2 $0.00
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Jamie Gordon Payroll
3/17/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TOTEM ELECTRIC OF TACOMA INC
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
national training fund:
1.Grant Holder $0.05/hr
Power Equipment Operators
Shovel,Excavator,Backhoe, $23.37 $15.65 $6.97 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
401(k):$2.50/hr,
2.Wade Sanders nebf:$2.32/hr,neca/
Electricians-Inside amf:$0.77/hr,Imcc/
Journey Level $27.60 $10.63 $10.35 $0.00 $0.00 $0.87 nlmcc:$0.11/hr,sap:
$0.05/hr
(King)
401(k):$2.50/hr,
3.Robert Veltung nebf:$2.22/hr,neca/
Electricians-Inside amf:$0.74/hr,sap:
Journey Level $27.47 J $10.63 $10.35 $0.00 $0.00 $0.87 $0.05/hr,Imcc/
nlmcc:$0.11/hr
(King)
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s)have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
(5)Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and
• Training Council.
Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties.
Printed name of party signing this report Title Signature
Jamie Gordon Payroll Jamie Gordon
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 �F ;", � Prime Contractor ❑ Project Name County Project or Contract#
lioill
Industries ,4.1:, I•W!i.t. Duvall Avenue NE King CAG-20-065
Prevailing Wage Program 4i iL i:iiii'
w in dti, Subcontractor El Proect Address
PO Box 44540 °'''F Ay`-) 1
Olympia WA 98504-4540 �r` '"89 Final Week of
(360)902-5335 - Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TOTEM ELECTRIC OF TACOMA INC (253)383-5022
Month Day Year Awarding Agency Address i Address City State Zip+4
2/26/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1093 TACOMA WA 98401
_ Day and Date Deductions
Work Classification Name CO H I• Sun Mon Tue Wed Thu Fri Sat Total
Gross Amount
and And ; a) E 2/20 2/21 2/22 2/23 2/24 2/25 2/26 Total Rate Earned/Gross Hourly Net Wages
j E I= Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address fCD o Hours Worked Each Day y Benefits" Tax
0
1. Power Equipment J $1,597A Workers'
Operators RG 0.00 0.00 8.00 8.00 8.00 8.00 0.00 32.00 $49.92 4�// Compensation:
Shovel, Excavator,Backhoe, Grant Holder si $14.37,Paid
Tractors Under 15 Metric Tons 38320 238th Ave OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $74.88 $0.00 $1,597.44 J Family Medical
(King) SE / $23.37/hr $152.75 $171.94 Leave:$8.77, $1,597.03
Enumclaw,WA- $1,996.80 Union Dues:
...*:.... 98022 $39.94,nw fca:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $99.84 $0.00 $12.00
2. Electricians-Inside Workers'
RG 0.00 2.00 2.00 2.00 2.00 0.00 0.00 8.00 $77.17 $617.36
Compensation:
Jo_urney Level
1L .I) $115.7 $8.50,Paid
OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $0.00 Family Medical
.....:.. Wade Sanders 5 Leave:$9.15,
12502 118th St Ct E $617.36/ 401(k):$3.00,
Puyallup,WA- $2,083.59 $27.60/hr $159.39 $360.72 credit union: $1,106.74
98374 $154.3 $266.70,Union
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 Dues:$53.63,
vacation:$115.76
•
3. Electricians-Inside RG 0.00 0.00 8.00 8.00 8.00 8.00 0.00 32.00 $73.96 $2,366.7 Workers'
Journey Level 2 Compensation:
(King) Robert Veltung
$110.9 $2,366.72 $12.57,Paid
PO Box 1295 OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 / $27,47/hr $226.31 $581.39 Family Medical $1,947.63
......... Buckley,WA- $2,958.40 Leave:$13.00,
98321 $147 9 vacation:$177.50
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2 $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 Jamie Gordon Payroll
3/3/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TOTEM ELECTRIC OF TACOMA INC
employed by:
Project Name: For the week starting: For the week ending:
'wall 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 I (C) Hourly (D) Hourly (E)Approved (F)Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
national training fund:
1.Grant Holder $0.05/hr
Power Equipment Operators
Shovel,Excavator,Backhoe, $23.37J $15.65 $6.97 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
401(k):$2.50/hr,
+'Nade Sanders nebf:$2.32/hr,neca/
ctricians-Inside amf:$0.77/hr,Imcc/
Journey Level $27.60 $10.63 $10.35 $0.00 $0.00 $0.87
$0.05/$0.11/hr,sap:
0.05/hr
(King)
401(k):$2.50/hr,
3.Robert Veltung nebf:$2.22/hr,neca/
•
Electricians-Inside amf:$0.74/hr,sap:
Journey Level $27.47 $10.63 $10.35 $0.00 $0.00 $0.87 $0.05/hr,Imcc/
nlmcc:$0.11/hr
(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.
tc\.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
Jamie Gordon Payroll Jamie Gordon
MB 3/5/22
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,35?art�,F Project Name County Project or Contract#
Industries i:. ,.f Prime Contractor Cl
r Duvall Avenue NE King CAG-20-065
Prevailing Wage Program <"'Vii_ :ji=) Subcontractor
PO Box 44540 ;: , ,sy Project Address
Olympia WA 98504-4540 y'` '"KW ' Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TOTEM ELECTRIC OF TACOMA INC (253)383-5022
Month Day Year Awarding Agency Address Address City State Zip+4
2/19/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1093 TACOMA WA 98401
Day and Date Deductions
p
Work Classification Name c7 ~o o Sun Mon Tue Wed Thu Fri Sat Total
Gross Amount
and And E 2/13 2/14 2/15 2/16 2/17 2/18 2/19 Total Rate Hourly
Earned/Gross Net Wages
m` r Hours of Pay Payroll "Usual FICA Withholding Other g
Soc Sec#of Employee Address O o Hours Worked Each Day Benefits" Tax
0
1. Power Equipment Workers'
RG 0.00 0.00 0.00 8.00 0.00 8.00 0.00 16.00 $49.92 $798.72
Operators Compensation:
Shovel, Excavator,Backhoe, Grant Holder / $14.37,Paid
Tractors Under 15 Metric Tons 38320 238th Ave OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $74.88 $0.00 �/ J Family Medical
(King) SE $798.72/ Leave:$8.77,
Enumclaw,WA- $23.37/hr $152.75 $171.94 $1,597.03
$1,996.80 Union Dues:
98022 $39.94,nw fca:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $99.84 $0.00 $12.00
2. Electricians-Inside RG 0.00 0.00 0.00 2.00 1.00 1.00 0.00 4.00 $77.17 $308.68 Workers'
Journey Level Compensation:
g) $115.7 $10.06,Paid
Wade Sanders OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5 $0.00 Family Medical
12502 118th St Ct E $308.68/ Leave:$10.85,
Puyallup,WA $2,469.44 $27.60/hr $188.90 $454.04 credit union: $1,318.18
98374 $316.09,Union
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $14'3 $0.00 Dues:$69.46,
vacation:$101.86
3. Electricians-Inside RG 0.00 8.00 0.00 8.00 0.00 8.00 0.00 24.00 $73.96 $1,775.0 Workers'
Journey Level 4 Compensation:
(King) Robert Veltung $12.59,Paid
$110.9 $1,775.04
PO Box 1295 OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 / $27.47/hr $226.32 $581.39 Family Medical $1 947 60
Buckley,WA- Leave:$13.00,
98321 $2,958.40
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $127'9 $0.00 vacation:$177.50
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 Jamie Gordon Payroll
2/23/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TOTEM ELECTRIC OF TACOMA INC
employed by:
Project Name: For the week starting: For the week ending:
pvall 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
national training fund:
1.Grant Holder $0.05/hr
Power Equipment Operators
Shovel,Excavator,Backhoe, $23.37 J $15.65 $6.97 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
401(k):$2.50/hr,
Wade Sanders nebf:$2.32/hr,neca/
,,.ctricians-Inside •
amf:$0.77/hr,Imcc/
Journey Level $27.60 $10.63 $10.35 $0.00 $0.00 $0.87 nlmcc:$0.11/hr,sap:
$0.05/hr
(King)
401(k):$2.50/hr,
3.Robert Veltung nebf:$2.22/hr,neca/
Electricians-Inside amf:$0.74/hr,sap:
Journey Level $27.47 $10.63 $10.35 $0.00 $0.00 $0.87 $0.05/hr,Imcc/
nlmcc:$0.11/hr
(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.
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
Jamie Gordon Payroll Jamie Gordon
MB 3/1/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and f,a nrf,:� Project Name County Project or Contract#
Prime Contractor ❑
Industries i` Duvall Avenue NE King CAG-20-065
Prevailing Wage Program 1::::: t.::;.� Subcontractor
PO Box 44540 4.4- k ;2 Project Address
Olympia WA 98504-4540 y� 'a'"a� Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TOTEM ELECTRIC OF TACOMA INC (253)383-5022
Month Day Year Awarding Agency Address Address City State Zip+4
2/12/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1093 TACOMA WA 98401
Day and Date Deductions
P
Work Classification Name c9 ~ o Sun Mon Tue Wed Thu Fri Sat Total
ce O a) Gross Amount
and And o) E 2/6 2/7 2/8 2/9 2/10 2/11 2/12 Total Rate Earned/Gross Hourly Net Wages
• E Hours of Pay "Usual FICA Withholding Other
Soc Sec#of Employee Address aa) a Payroll Benefits" Tax
cC O o Hours Worked Each Day
0
1. Power Equipment Workers'
RG 0.00 0.00 0.00 0.00 2.00 0.00 0.00 2.00 $49.92 $99.84
Operators Compensation:
Shovel, Excavator,Backhoe, $14.37,Paid
Tractors Under 15 Metric Tons Robert Arnold OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $74.88 $0.00 Family Medical
(King) 5501 136th St.E. $99.84/ $23.37/hr $152.76 $197.53 Leave:$8.77, $1,571.43
Puyallup,WA- $1,996.80 Union Dues:
.. 98373 $39.94,nw fca:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $99.84 $0.00 $12.00
2. Power Equipment Workers'
RG 0.00 0.00 0.00 0.00 8.00 0.00 0.00 8.00 $49.92 $399.36
Operators Compensation:
vel, Excavator,Backhoe, Grant Holder $11.49,Paid
:tors Under 15 Metric Tons 38320 238th Ave OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $74.88 $0.00 Family Medical
(King) SE $399'36/ $23.37/hr $152.76 $171.94 Leave:$8.77, $1,610.29
Enumclaw,WA $1,996.80 Union Dues:
•• 98022 $31.95,nw fca:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $99.84 $0.00 $9.60
3. Electricians-Inside Workers'
RG 0.00 0.00 0.00 0.00 1.00 0.00 0.00 1.00 $77.17 $77.17
Journey Level Compensation:
Kin $12.58,Paid
( 9) Wade Sanders OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $115.7 $0.00 Family Medical
12502 118th St Ct E $77.17/ Leave:$13.56,
Puyallup,WA- $3,086.80 $27.60/hr $236.14 $602.21 credit union: $1,564.82
98374 $154.3 $395.11, Union
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 Dues:$77.17,
vacation:$185.21
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
J j
4. Electricians-Inside RG 0.00 0.00 0.00 0.00 8.00 8.00 0.00 16.00 $73.96 $1,183.3
Journey Level 6 J Workers'
Compensation:
(King) Robert Veltung $110.9 $1,183.36 $12.58, Paid
PO Box 1295 OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 / $27.47/hr $226.32 $581.39 Family Medical $1,947.61
_ _ ,.= Buckley,WA- Leave:$13.00,
98321 $2,958.40 vacation:$177.50
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $127.9 $0.00
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Jamie Gordon Payroll
2/16/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TOTEM ELECTRIC OF TACOMA INC
employed by:
Project Name: For the week starting: For the week ending:
'-uwall Avenue NE 2/6/2022 2/12/2022
"U
SUAL BENEFITSrf "per(Please report in 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
national training fund:
1.Robert Arnold $0.05/hr
Power Equipment Operators
Shovel,Excavator,Backhoe, $23.37 $15.65 $6.97 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King) _ —
national training fund:
Grant Holder $0.05/hr
ewer Equipment Operators
Shovel,Excavator,Backhoe, $23.37 $15.65 $6.97 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
401(k):$2.50/hr,
3.Wade Sanders nebf:$2.32/hr,neca/
Electricians Inside amf:$0.77/hr,Imcc/
Journey Level $27.60 $10.63 $10.35 $0.00 $0.00 $0_87 nlmcc:$0.11/hr,sap:
$0.05/hr
(King)
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
401(k):$2.50/hr,
nebf:$2.22/hr,neca/
4.Robert Veltung
Electricians-Inside amf:$0.74/hr,sap:
Journey Level $27.47J $10.63 $10.35 $0.00 $0.00 $0.87 $0.05/hr,Irmo/
nlmcc:$0.11/hr
(King)
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
•\ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and
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
Jamie Gordon Payroll Jamie Gordon
MB.3/1/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and , Project Name County Project or Contract#
Industries mot;' `'` Prime Contractor ❑
�„ r. Duvall Avenue NE King CAG-20-065
Prevailing Wage Program
y.i=.: .•ll.4 Subcontractor
PO Box 44540 _ Project Address
Olympia WA 98504-4540 �� '"'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 TOTEM ELECTRIC OF TACOMA INC (253)383-5022
Month Day Year Awarding Agency Address Address City State Zip+4
2/5/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1093 TACOMA WA 98401
Day and Date Deductions
p
Work Classification Name C9 O~ o Sun Mon Tue Wed Thu Fri Sat Total
ce and And Gross Amount
a, 1/301/31 2/1 2/2 2/3 2/4 2/5 Total Rate Hourly
Earned/Gross Net Wa es
f0 f Hours of Pay Payroll Net FICA Withholding Other g
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 Jamie Gordon Payroll
2/8/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TOTEM ELECTRIC OF TACOMA INC
employed by:
Project Name: For the week starting: For the week ending:
Duvall Avenue NE 1/30/2022 2/5/2022
"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.
4 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
Jamie Gordon Payroll Jamie Gordon
•
MB 2/11/22
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�T� Project Name County Project or Contract#
Industries 4 i;: �f, Prime Contractor ❑
'..ii Duvall Avenue NE King CAG-20-065
Prevailing Wage Program I y:::.. " I` Subcontractor
PO Box 44540 °�y Project Address
Olympia WA 98504-4540 `"�d w,y Final Week of
(360) 902-5335 Payroll E
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TOTEM ELECTRIC OF TACOMA INC (253)383-5022
Month Day Year Awarding Agency Address Address City State Zip+4
1/29/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1093 TACOMA WA 98401
Day and Date Deductions
i=
Work Classification Name c7 ~▪ O o Sun Mon Tue Wed Thu Fri Sat Total
Gross Amount
and And m a) E 1/23 1/24 1/25 1/26 1/27 1/28 1/29 Total Rate Earned/Gross Hourly 9 Net Wages
fE a Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address ▪ O o Hours Worked Each Day Benefits" Tax
a
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Jamie Gordon Payroll
2/1/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TOTEM ELECTRIC OF TACOMA INC
employed by:
Project Name: For the week starting: For the week ending:
Duvall Avenue NE 1/23/2022 1/29/2022
"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. -
,,,"�\ny 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
Jamie Gordon Payroll Jamie Gordon
r
MB 2/2/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and Project Name County Project or Contract#
p �?`:.'.:" ":'GF Prime Contractor ❑
Industries ;.::: i.f.
.:'u1;r Duvall Avenue NE King CAG-20-065
Prevailing Wage Program <1p ,E ,_ .
PO Box 44540 p• I,(:. Subcontractor
°°°� Project Address
Olympia WA 98504-4540 4,4 ;"5," Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TOTEM ELECTRIC OF TACOMA INC (253)383-5022
Month Day Year Awarding Agency Address Address City State Zip+4
1/22/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1093 TACOMA WA 98401
Day and Date Deductions
p _
Work Classification Name C7 ~O 9 Sun Mon Tue Wed Thu Fri Sat Total
Gross Amount
and And E 1/16 1/17 1/18 1/19 1/20 1/21 1/22 Total Rate Eamed/Gross Hourly Net Wages
m f a Hours of Pay Payroll "Usual FICA Withholding Other 9
Soc Sec#of Employee Address O o Hours Worked Each Day Benefits" Tax
0
1. Electricians-Inside Ni Ni Workers'
RG 0.00 0.00 0.00 2.00 0.00 0.00 0.00 2.00 $74.72 $149.44
Journey Level Compensation:
(King) $112.0 $8.18, Paid
Wade Sanders OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 8 $0.00 ✓ Family Medical
12502 118th St Ct E $149.44/ Ni Leave: $8.53,
Puyallup,WA- $1,942.72 $26.81/hr $148.62 $327.63 credit union: $1,035.96
98374 $248.67,Union
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $149.4 $0.00 Dues:$48.57,
4 vacation:$116.56
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 Jamie Gordon Payroll
1/26/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TOTEM ELECTRIC OF TACOMA INC
employed by:
Project Name: For the week starting: For the week ending:
"wall Avenue NE 1/16/2022 1/22/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
401(k):$2.25/hr,
1.Wade Sanders
nebf:$2.24/hr,neca/
Electricians-Inside amf:$0.75/hr,lmcc/
Journey Level $26.81 ✓ $10.38 $10.20 $0.00 $0.00 $0.83 nlmcc:$0.11/hr,sap:
$0.05/hr
(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.
«l4ny 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
Jamie Gordon Payroll Jamie Gordon
MB 2/1/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
A.
Certified Payroll Report
Department of Labor and t, �,, Project Name County Project or Contract#
4e itV '',, Prime Contractor ❑
Industries 4 :. y.
*., ;,:1=r Duvall Avenue NE King CAG-20-065
Prevailing Wage Program lit,+- = Subcontractor M
PO Box 44540 "'.:! yr Project Address
Olympia WA 98504-4540 y� taa�•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 TOTEM ELECTRIC OF TACOMA INC (253)383-5022
Month Day Year Awarding Agency Address Address City State Zip+4
1/15/2022 1055 S GRADY WAY RENTON,WA-98055 PO BOX 1093 TACOMA WA 98401
Day and Date Deductions
F _
Work Classification Name E. ~O o Sun Mon Tue Wed Thu Fri Sat Total
EGross Amount
and And E 1/9 1/10 1/11 1/12 1/13 1/14 1/15 Total Rate Earned/Gross Hourly Net Wages
r a.) Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address O o Hours Worked Each Day Benefits" Tax
a
1. Power Equipment RG 0.00 0.00 0.00 0.00 2.00 0.00 0.00 2.00 $49.92 $99.84 Workers'
Operators Compensation:
Shovel, Excavator,Backhoe, Grant Holder $14.37,Paid
Tractors Under 15 Metric Tons 38320 238th Ave OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $74.88 $0.00 NiFamily Medical
(King) SE $99.84/ $23.37/hr $152.76 $171.94 Leave:$8.77, $1,597.02
Enumclaw,WA- $1,996.80 Union Dues:
98022 $39.94,nw fca:
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $99.84 $0.00 $12.00
2. Electricians-Inside Workers'
RG 0.00 0.00 0.00 0.00 0.00 1.00 0.00 1.00 $74.72 $74.72
Journey Level Compensation:
9) $112.0 $10.04,Paid
Wade Sanders OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 8 $0.00 Family Medical
* ** 12502 118th St Ct E $74.72/ Leave:$10.50,
Puyallup,WA $2,391.04 $26.81/hr $182.91 $435.22 credit union: $1,243.08
98374 $149.4 $306.05, Union
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $0.00
4 Dues:$59.78,
4 �// vacation:$143.46
3. Electricians-Inside Workers'
RG 0.00 0.00 0.00 0.00 2.00 0.00 0.00 2.00 $71.61 $143.22
Journey Level / Compensation:
(King) Robert Veltung $107.4 d J $12.58,Paid
PO Box 1295 OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2 $0.00 $143.22/ $26.69/hr $219.14 $558.83 Family Medical $1,889.41
Buckley,WA- $2,864.40 Leave:$12.58,
98321 $143.2 vacation:$171.86
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2 $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 Jamie Gordon Payroll
1/25/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TOTEM ELECTRIC OF TACOMA INC
employed by: _
Project Name: For the week starting: For the week ending:
--^wall Avenue NE '1/9/2022 1/15/2022
"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
)
national training fund:
1.Grant Holder $0.05/hr
Power Equipment Operators
Shovel,Excavator,Backhoe, $23.37 $15.65 $6.97 $0.00 $0.00 $0.70
Tractors Under 15 Metric Tons
(King)
401(k):$2.25/hr,
-4,Wade Sanders nebf:$2.24/hr,neca/
llectricians-Inside
amf:$0.75/hr,Imcc/
"Journey Level $26.81 ' $10.38 $10.20 $0.00 $0.00 $0.83 nlmcc:$0.11/hr,sap:
$0.05/hr
•
(King)
401(k):$2.25/hr,
3.Robert Veltung nebf:$2.15/hr,neca/
Electricians-Inside amf:$0.72/hr,sap:
Journey Level $26.69 J $10.38 $10.20 $0.00 $0.00 $0.83 $0.05/hr,Imcc/
nlmcc:$0.11/hr
•
(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
' wining 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
Jamie Gordon Payroll Jamie Gordon
MB 2/1/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side