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ID#199275
Sutherland, Dustin , SPANAWAY, WA, 98387
Cement Mason for Washington Cement Masons Apprenticeship Committee
.(program-details?programld=61&from=°%o2Fapprentice-details°%a3Fid°%o3D4303)
• ACTIVE
7/5/2018
TERM REGISTERED PROBATION TERM PROBATION PERIOD
6400 Hours 7/5/2018 1080 Hours 7/10/2018-1/24/2020
► Total hours: OJT 8991 RSI 632 Credited hours: OJT 3600 RSI 0
► Step: 6 (effective: 5/13/2019)
1 of 1 12/1/2022,3:05 PM
-
•
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: 7/28/2022 1252954 7/28/2022
Company Details
Company Name: TYEE CONCRETE CONSTRUCTION INC
Address: 11403 58th Ave E
Puyallup, WA, 98373
Contractor Registration No. TYEECCI994K5
WA UBI Number 602123519
Phone Number 253-507-8933
Industrial Insurance Account ID 40737002
OMWBE Certifications as of 7/28/2022 No active certifications existed when
Intent was submitted
Email Address Kristin@Tyeeconcrete.com
Filed By Kristin Force
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 &t EXCAVATING INC
Contractor Registration No. REEDTEI016JW
WA UBI Number 601915034
Payment Details
Check Number:
Transaction Id: 108815887
Intent Details
Expected project start date: (MM/DD/YYYY) 7/25/2022
In what county (or counties) will the work be King
performed?
In what city (or nearest city) will the work be Renton
performed?
What is the estimated contract amount? OR is $15,000.00
this a time and materials estimate?
Does your company intend to hire ANY No
subcontractors?
Will your company have employees perform Yes
work on this project?
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 Laborers Cement Finisher Tender $39.95 $12.44 5
King Cement Masons Journey Level $45.80 $18.54 5
Public Notes
El Show/Hide Existing Notes
No note exists
Certified Payroll Report
Department of Labor and ��F,•sTAr,�.�� Project Name County Project or Contract#
Industries � ,,, ;,y Prime Contractor O
:;: Duvall Avenue NE King CAG-20-065
PrevailingWage Program 4..., '
9 9 ,� .... .:;� Subcontractor
PO Box 44540 J-::: ' , Project Address
Olympia WA 98504-4540 y` `"�"�� Final Week of
(360) 902-5335 Payroll El
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TYEE CONCRETE CONSTRUCTION INC (253)507-8933
Month Day Year Awarding Agency Address Address City State Zip+4
1/29/2023 1055 S GRADY WAY RENTON,WA-98055 11403 58th Ave E Puyallup WA 98373
Day and Date Deductions
p
Work Classification Name O~ o Mon Tue Wed Thu Fri Sat Sun Gross Amount Total
and And a) E 1/23 1/24 1/25 1/26 1/27 1/28 1/29 Total Rate45 Earned/Gross Hourly Net Wages
E a Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address a) > 3 Benefits" Tax
W O o Hours Worked Each Day
0
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Kristin Force Payroll Admin.
1/30/2023
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TYEE CONCRETE CONSTRUCTION INC
employed by:
Project Name: For the week starting: For the week ending:
ivall Avenue NE 1/23/2023 1/29/2023
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
,,,'a`',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
Kristin Force Payroll Admin. Kristin Force
f
MB 1/30/23
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and TAT' Project Name County Project or Contract#
,`F �' ° Prime Contractor ❑
Industries `»I''' 4.
PrevailingWage Program -ill:, •`ll:= Duvall Avenue NE King CAG-20-065
g g ,. Subcontractor ►_�
PO Box 44540 ',�i°:�" ' Project Address
Olympia WA 98504-4540 y` 188" Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TYEE CONCRETE CONSTRUCTION INC (253)507-8933
Month Day Year Awarding Agency Address Address City State Zip+4
1/22/2023 1055 S GRADY WAY RENTON,WA-98055 11403 58th Ave E Puyallup WA 98373
Day and Date Deductions
p
Work Classification Name Cc ~O o Mon Tue Wed Thu Fri Sat Sun Total
a� Gross Amount
and And a> E 1/16 1/17 1/18 1/19 1/20 1/21 1/22 Total Rate Earned/Gross Hourly Net Wages
E Hours of Pay "Usual FICA Withholding Other
rn f a Payroll Benefits" Tax
Soc Sec#of Employee Address CD CD W O �33 Hours Worked Each Day
a
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Kristin Force Payroll Admin.
1/25/2023
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TYEE CONCRETE CONSTRUCTION INC
employed by:
Project Name: For the week starting: For the week ending:
Duvall Avenue NE 1/16/2023 1/22/2023
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
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.
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
Kristin Force Payroll Admin. Kristin Force
MB 1/25/23
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and C$.
'T"F Prime Contractor ❑ Project Name County Project or Contract#
Industries yDuvall Avenue NE King CAG-20-065
Prevailing Wage Program _`�_•• , SubcontractorPO Box 44540 ^y, Project Address
Olympia WA 98504-4540 18s9 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 TYEE CONCRETE CONSTRUCTION INC (253)507-8933
Month Day Year Awarding Agency Address Address City State Zip+4
1/15/2023 1055 S GRADY WAY RENTON,WA-98055 11403 58th Ave E Puyallup WA 98373
Day and Date Deductions
f=
Work Classification Name CO ~ o Mon Tue Wed Thu Fri Sat Sun Total
ce O a, Gross Amount
and And a) E 1/9 1/10 1/11 1/12 1/13 1/14 1/15 Total Rate Earned/Gross Hourly Net Wages
E is Hours of Pay "Usual FICA Withholding Other
rn f a, Payroll Benefits" Tax
Soc Sec#of Employee Address O o Hours Worked Each Day
a
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Kristin Force Payroll Admin.
1/25/2023
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TYEE CONCRETE CONSTRUCTION INC
employed by:
Project Name: For the week starting: For the week ending:
vall Avenue NE 1/9/2023 1/15/2023
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following:
(1j All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
i .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
Kristin Force - Payroll Admin. Kristin Force
MB 1/25/23
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and fit,3TATF Project Name County Project or Contract#
Industries 4^,; " "'is 4•
Prime Contractor El:,, in Duvall Avenue NE King CAG-20-065
Prevailing Wage Program .._. -; = SubcontractoriSi
PO Box 44540 ':;y'. Project Address
VP
Olympia WA 98504-4540 ` '"By Final Week of
(360)902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TYEE CONCRETE CONSTRUCTION INC (253)507-8933
Month Day Year Awarding Agency Address Address City State Zip+4
1/8/2023 1055 S GRADY WAY RENTON,WA-98055 11403 58th Ave E Puyallup WA 98373
Day and Date Deductions
p
Work Classification Name c9 0 o Mon Tue Wed Thu Fri Sat Sun Total
a> Gross Amount
and And a) E 1/2 1/3 1/4 1/5 1/6 1/7 1/8 Total Rate Earned/Gross Hourly Net Wages
E Hours of Pay "Usual FICA Withholding Other
Soc Sec#of Employee Address m w L Payroll Benefits" Tax
O o' Hours Worked Each Day
0
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Kristin Force Payroll Admin.
1/12/2023
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TYEE CONCRETE CONSTRUCTION INC
employed by:
Project Name: For the week starting: For the week ending:
Duvall Avenue NE 1/2/2023 1/8/2023
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
1ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and
ning Council.
Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties.
Printed name of party signing this report Title Signature
Kristin Force Payroll Admin. Kristin Force
MB 1/17/23
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and �t,StA:f Project Name County Project or Contract#
�.:::• Prime Contractor ❑
Industries .: _.y
-:_; _ii .r Duvall Avenue NE King CAG 20 065
Prevailing Wage Program E.liiii• 4iii F, Subcontractor
PO Box 44540 '',;; JY. Project Address
Olympia WA 98504-4540 4t '="" Final Week of
(360)902-5335 Payroll El
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TYEE CONCRETE CONSTRUCTION INC (253)507-8933
Month Day Year Awarding Agency Address Address City State Zip+4
1/1/2023 1055 S GRADY WAY RENTON,WA-98055 11403 58th Ave E Puyallup WA 98373
Day and Date Deductions
~ Mon Tue Wed Thu Fri Sat
Work Classification Name c� p Sun Total
ct o a> 12/2 12/2 12/2 12/2 12/3 12/3 Gross Amount
and And ki '' E 6 7 8 9 0 1 1/1 Total Rate Earned/Gross Hourly Net Wages
."Em Hours of Pay Payroll "Usual FICA Wit Taxding Other
Soc Sec#of Employee Address m > -IT)
cf O o Hours Worked Each Day
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries •
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Kristin Force Payroll Admin.
1/4/2023
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TYEE CONCRETE CONSTRUCTION INC
employed by:
Project Name: For the week starting: For the week ending:
Duvall Avenue NE 12/26/2022 1/1/2023
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms) _
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
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
Kristin Force Payroll Admin. Kristin Force
MB 1/10/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and F,'r, A , Prime Contractor ❑ Project Name County Project or Contract#
,.� ,< <;,�
Industries �_i y.
a@_�, Duvall Avenue NE King CAG-20-065
PrevailingWage Program _ . 7
9 9 :;� Subcontractor NI
PO Box 44540 " '•",aY TIC'
Project Address
Olympia WA 98504-4540 y` 16e" 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 TYEE CONCRETE CONSTRUCTION INC (253)507-8933
Month Day Year Awarding Agency Address Address City State Zip+4
12/25/2022 1055 S GRADY WAY RENTON,WA-98055 11403 58th Ave E Puyallup WA 98373
Day and Date Deductions
0 Mon Tue Wed Thu Fri Sat Sun
Work Classification Name C� Total
ec 9-' a) 12/1 12/2 12/2 12/2 12/2 12/2 12/2 Gross Amount
E Total Rate Hourly
and And `m E i= 9 0 1 2 3 4 5 Hours of Pay Earned/Gross Usual FICA Withholding Other Net Wages
Soc Sec#of Employee Address acn
) w a Payroll Benefits" Tax
o! 0 o Hours Worked Each Day
0
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Kristin Force Payroll Admin.
1/4/2023
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TYEE CONCRETE CONSTRUCTION INC
employed by:
Project Name: For the week starting: For the week ending:
r vall Avenue NE 12/19/2022 12/25/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" I Program
(A+B+C+D+E+F
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
15\ Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and
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
Kristin Force Payroll Admin. Kristin Force
MB 1/17/23
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and �F,.STATh•� Prime Contractor ❑ Project Name County Project or Contract#
.... !e..
Industries �:;' Duvall Avenue NE KingCAG-20-065
Prevailing Wage Program ," ;° Subcontractor N
PO Box 44540 °�' ....yam Project Address
Olympia WA 98504-4540 y� [b8!�� Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TYEE CONCRETE CONSTRUCTION INC (253)507-8933
Month Day Year Awarding Agency Address Address City State Zip+4
12/18/2022 1055 S GRADY WAY RENTON,WA-98055 11403 58th Ave E Puyallup WA 98373
Day and Date Deductions
Work Classification Name c� p o Mon Tue Wed Thu Fri Sat Sun Total
o
cr m 12/1 12/1 12/1 12/1 12/1 12/1 12/1 Gross Amount
�, E Total Rate Hourly
and And 2 3 4 5 6 7 8 Earned/Gross Net Wages
j E Hours of Pay "Usual FICA Withholding Other
Soc Sec#of Employee Address a-i CD - Payroll Benefits" Tax
Cr O o' Hours Worked Each Day
0
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Kristin Force Payroll Admin.
12/20/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TYEE CONCRETE CONSTRUCTION INC
employed by:
Project Name: For the week starting: For the week ending:
n""vall Avenue NE 12/12/2022 12/18/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
,—,,Lokny 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
Kristin Force Payroll Admin. Kristin Force
MB 12/22/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and �� sTArh.� Project Name County Project or Contract#
Industries ,;i 4, Prime Contractor ❑
,e: ` Duvall Avenue NE King CAG-20-065
Prevailing Wage Program ,} Subcontractor im
PO Box 44540 '�' Qy� Project Address
Olympia WA 98504-4540 y` '"dy Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TYEE CONCRETE CONSTRUCTION INC (253)507-8933
Month Day Year Awarding Agency Address Address City State Zip+4
12/11/2022 1055 S GRADY WAY RENTON,WA-98055 11403 58th Ave E Puyallup WA 98373
Day and Date Deductions
~ Sat Sun
Work Classification Name (1 Mon Tue Wed Thu Fri Total
cr O~ o m 12/1 12/1 Gross Amount
and And a) E 12/5 12/6 12/7 12/8 12/9 1 Total Rate Earned/Gross Hourly Net Wages
E fcu Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address 0) > - y Benefits" Tax
IY O o' Hours Worked Each Day
a
1. Cement Masons Medicare:$16.83,
RG 0.00 0.00 8.00 0.00 0.00 0.00 0.00 8.00 $58.78 $470.24
Curb&Gutter,Sidewalks Gheorghe Balas SDI:$10.60
(King) 16704 80th Ave Ct $690.67/
E OT 0.00 0.00 2.50 0.00 0.00 0.00 0.00 2.50 $88.17 $220.43 $1 160.91 $19.59/hr $71.97 $153.00 $908.51
**.****** Puyallup,WA-
98375 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $11 5 $010
2. Cement Masons Medicare:$25.92,
Eduardo Camacho RG 0.00 0.00 8.00 8.00 0.00 0.00 0.00 16.00 $50.ID0 $80�.00 Union Dues:
Curb&Gutter,Sidewalks Gutierrez J
(King) 3720 S Thompson $987.50/ $19.78
Ave Apt213 OT 0.00 0.00 2.50 0.00 0.00 0.00 0.00 2.50 $75.00 $187.50 $1,787.50 $19.59/hr $110.82 $254.00 $1,376.98
* ** Tacoma,WA- $100.0
98418- DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0 $0.00
3. Cement Masons Alejandro RG 0.00 0.00 8.00 0.00 0.00 0.00 0.00 8.00 $50.00 $400.00 Medicare:$17.05,
Curb&Gutter,Sidewalks Castaneda Vera Union Dues:
(King) 9417 124th St Ct E $587.50/ $10.89
*********
#5 OT 0.00 0.00 2.50 0.00 0.00 0.00 0.00 2.50 $75.00 $187.50 $1 025.00 $19.59/hr $72.91 $0.00 $924.15
South Hill,WA- $100.0
98373 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0 $0.00
4. Cement Masons Medicare:$21.53,
RG 0.00 0.00 8.00 0.00 0.00 0.00 0.00 8.00 $55.00 $440.00
Curb&Gutter,Sidewalks Bradley Cheeseman Union Dues:
(King) 12607 125th AVe Ct $605.00/ $14.90
E OT 0.00 0.00 2.00 0.00 0.00 0.00 0.00 2.00 $82.50 $165.00 $1,485.00 $19.59/hr $92.07 $111.00 $1,245.50
Puyallup,WA-
98374 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1 0 10'0 $0.00
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
5. Cement Masons Ulises Hernandez RG 0.00 0.00 8.00 0.00 0.00 0.00 0.00 8.00 $50.00 $400.00 Medicare:$20.67,
Curb&Gutter,Sidewalks Reyes Union Dues:
(King) 5408 83rd St Ct SW $15.48
OT 0.00 0.00 2.50 0.00 0.00 0.00 0.00 2.50 $75.00 $187.50 $587.50/ $19.59/hr $88.35 $174.00 $1,126.50
********* 0-105 $1,425.00
Lakewood,WA- $100.0
98499 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0 $0.00
6. Cement Masons RG 0.00 0.00 8.00 8.00 0.00 0.00 0.00 16.00 $50.00 $800.00 Medicare:$20.12,
Curb&Gutter,Sidewalks Andres Melgoza Union Dues:
(King) Oseguera $987 50/ $15.19
2621 S 301st OT 0.00 0.00 2.50 0.00 0.00 0.00 0.00 2.50 $75.00 $187.50 $1,387.50 $19.59/hr $86.02 $22.00 $1,244.17
*****_ ** Federal Way,WA-
98003 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1000.0 $0.00
7. Cement Masons Medicare:$23.74,
RG 0.00 0.00 0.00 8.00 0.00 0.00 0.00 8.00 $50.00 $400.00
Curb&Gutter,Sidewalks Viviano Tapia Lopez Union Dues:
(King) 522 4th St SE Apt $18.63
OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $75.00 $0.00 $400.00/ $19.59/hr $101.53 $129.00 $1,364.60
* **
Auburn,WA-98002 $100.0
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0 $0.00
8. Cement Masons RG 0.00 0.00 8.00 0.00 0.00 0.00 0.00 8.00 $50.00 $400.00 Medicare:$14.32,
Curb&Gutter,Sidewalks Steven Teets Jr Union Dues:
(King) 11118 222nd Ave Ct $587.50/ $10.60
E OT 0.00 0.00 2.50 0.00 0.00 0.00 0.00 2.50 $75.00 $187.50 $987.50 $19.59/hr $61.23 $85.00 $816.35
**...*Ictle.. Buckley,WA-
98321 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1000.0 $0.00
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Kristin Force Payroll Admin.
12/15/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TYEE CONCRETE CONSTRUCTION INC
employed by:
Project Name: For the week starting: For the week ending:
°wall Avenue NE 12/5/2022 12/11/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
1.Gheorghe Balas
Cement Masons
Curb&Gutter,Sidewalks $19.59 $10.10 $8.09 $0.00 $0.50 $0.90
(King)
2.Eduardo Camacho Gutierrez
-,ment Masons
rb&Gutter,Sidewalks $19.59 J $10.10 $8.09 $0.00 $0.50 $0.90
(King)
3.Alejandro Castaneda Vera
Cement Masons
Curb&Gutter,Sidewalks $19.59 $10.10 $8.09 $0.00 $0.50 $0.90
(King)
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
4.Bradley Cheeseman
Cement Masons
Curb&Gutter,Sidewalks $19.59 $10.10 $8.09 $0.00 $0.50 $0.90
(King)
5.Ulises Hernandez Reyes
Cement Masons
Curb&Gutter,Sidewalks $19.59 $10.10 $8.09 $0.00 $0.50 $0.90
(King)
4ndres Melgoza Oseguera
Cement Masons
Curb&Gutter,Sidewalks $19.59 $10.10 $8.09 $0.00 $0.50 $0.90
(King)
7.Viviano Tapia Lopez
Cement Masons
Curb&Gutter,Sidewalks $19.59 $10.10 $8.09 $0.00 $0.50 $0.90
(King)
8.Steven Teets Jr
Cement Masons
rs-"!rb&Gutter,Sidewalks $19.59 $10.10 $8.09 $0.00 $0.50 $0.90
(King)
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
"fie.
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and
ning Council.
Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties.
Printed name of party signing this report Title Signature
Kristin Force Payroll Admin. Kristin Force
MB 12/15/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and �$sr�rea Project Name County Project or Contract#
Industries Q 4 Prime Contractor E
o,:;! Duvall Avenue NE King CAG-20-065
Prevailing Wage Program ft ;;`z Subcontractor N
PO Box 44540 ....le
ov° Project Address
Olympia WA 98504-4540 y` 188a Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TYEE CONCRETE CONSTRUCTION INC (253)507-8933
Month Day Year Awarding Agency Address Address City State Zip+4
12/4/2022 1055 S GRADY WAY RENTON,WA-98055 11403 58th Ave E Puyallup WA 98373
Day and Date Deductions
Mon Tue Wed
Work Classification Name C9 p Thu Fri Sat Sun Total
cc o a) 11/2 11/211/3 Gross Amount
E 12/1 12/2 12/3 12/4 Total Rate Hourly
and And
E i= 8 9 3 Hours of Pay Earned/Gross "Usual FICA Withholding Other Net Wages
Soc Sec#of Employee Address - CD - Payroll Benefits" Tax
W O o' Hours Worked Each Day
a
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Kristin Force Payroll Admin.
12/8/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TYEE CONCRETE CONSTRUCTION INC
employed by:
Project Name: For the week starting: For the week ending:
fall Avenue NE 11/28/2022 12/4/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
!c1_Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and
`Wing Council.
Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties.
Printed name of party signing this report Title Signature
Kristin Force Payroll Admin. Kristin Force
MB 12/15/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
...
Certified Payroll Report
Department of Labor and ,TAT F Project Name County Project or Contract#
j 1 Prime Contractor ❑
Industries •�iik.- s.
:�sb- , r Duvall Avenue NE King CAG-20-065
Prevailing Wage Program jlliii' fq1 Subcontractor ►�
PO Box 44540 ''.;H.� 0,v' Project Address
Olympia WA 98504-4540 ` '"B"° Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TYEE CONCRETE CONSTRUCTION INC (253)507-8933
Month Day Year Awarding Agency Address Address City State Zip+4
11/27/2022 1055 S GRADY WAY RENTON,WA-98055 11403 58th Ave E Puyallup WA 98373
Day and Date Deductions
a p ~ Mon Tue Wed Thu Fri Sat Sun
Work Classification Name Total
2 a) 11/2 11/2 11/2 11/2 11/2 11/2 11/2 Gross Amount
a) E Total Rate Hourly
and And m E 1 2 3 4 5 6 7 Hours of PayEarned/Gross °Usual Withholding Net Wages
a f a, Payroll Benefits" FICA Tax Other
Soc Sec#of Employee Address a, > a
IY O o' Hours Worked Each Day
0
1. Cement Masons Medicare:
Eduardo Camacho RG 0.00 0.00 8.00 0.00 0.00 0.00 0.00 8.00 $50.00 $400.00 $11.60,
$9.17
SDI:
Curb&Gutter,Sidewalks Gutierrez
(King) 3720 S Thompson OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $75.00 $0.00 $400.00/ $19.59/hr $49.60 $62.00 $667.63
Ave Apt 213 $800.00
Tacoma,WA- $100.0
98418- DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0 $0.00
2. Laborers RG 0.00 0.00 8.00 0.00 0.00 0.00 0.00 8.00 $43.90 $351.20 Medicare:
Cement Finisher Tender Michael Christensen SDDI:
$5.09,
$4.59
(King) 15423 Griggs Rd E $351.20/
Graham,WA- OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $65.85 $0.00 $351.20 $14.00/hr $21.78 $18.00 $301.74
** 98338
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $87.80 $0.00
3. Cement Masons RG 0.00 0.00 8.00 0.00 0.00 0.00 0.00 8.00 $52.00 $416.00 Medicare:$12.06,
Curb&Gutter,Sidewalks Pedro Navarro SDI:$9.17
(King) 6435 S Pine St OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $78.00 $0.00 $416.00/ $19.59/hr $51.58 $86.00 $673.19
Tacoma,WA- $832.00
98409 $104.0
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $0V.90
4. Cement Masons RG 0.00 0.00 8.00 0.00 0.00 0.00 0.00 8.00 $47.50 $380.00 Medicare:$5.51,
Apprentice SDI:$4.59
Cement Mason Indentured On Dustin Sutherland �J
or After 4/21/2011 11102 79th Ave E OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $71.25 $0.00 $380.00/ $19.59/hr $23.56 $1.00 $345.34
Step 1 Puyallup,WA- $380.00
(King) 98373
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $95.00 $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 Kristin Force Payroll Admin.
11/30/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TYEE CONCRETE CONSTRUCTION INC
employed by:
Project Name: For the week starting: For the week ending:
^."vall Avenue NE 11/21/2022 11/27/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
1.Eduardo Camacho Gutierrez
Cement Masons
Curb&Gutter,Sidewalks $19.59 $10.10 $8.09 $0.00 $0.50 $0.90
(King)
2.Michael Christensen
'?,horers
'ment Finisher Tender $14.00 $5.30 $7.55 $0.00 $0.20 $0.95
(King)
3.Pedro Navarro
Cement Masons
Curb&Gutter,Sidewalks $19.59 $10.10 $8.09 $0.00 $0.50 $0.90
(King)
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
4.Dustin Sutherland
Cement Masons.
$19.59 $10.10 $8.09 $0.00 $0.50 $0.90
Apprentice
Cement Mason Indentured On or
After 4/21/2011
Step 1
(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.
rs' 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
Kristin Force Payroll Admin. Kristin Force
Michael Ballard
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Washington State Department of
"Labor&Industries (https://Ini.wa.gov
�■ Back To Search (#/?fromApprenticeDetails=true)
ID#199275
Sutherland, Dustin , SPANAWAY, WA, 98387
Cement Mason for Washington Cement Masons Apprenticeship Committee
.program-details?programId=61&from=°%o2Fapprentice-details°%o3Fid°%o3D4303).
• ACTIVE
l
7/5/2018
TERM REGISTERED PROBATION TERM PROBATION PERIOD
6400 Hours 7/5/2018 1080 Hours 7/10/2018- 1/24/2020
► Total hours: OJT 8991 RSI 632 Credited hours: OJT 3600 RSI 0
► Step: 6 (effective: 5/13/2019)
Certified Payroll Report
Department of Labor and t,STATF' Project Name County Project or Contract#
4,\ fs ., Prime Contractor ❑
Industries ;ii. #il:f
e �iY Duvall Avenue NE King CAG-20-065
Prevailing Wage Program :ii"i•,• {HIV Subcontractor
V,k;.:F E, Project Address
PO Box 44540 IIII4t
Fyn j
Olympia WA 98504-4540 y� '"�y T. Final Week of
(360) 902-5335 Payroll El
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TYEE CONCRETE CONSTRUCTION INC (253)507-8933
Month Day Year Awarding Agency Address Address City State Zip+4
11/20/2022 1055 S GRADY WAY RENTON,WA-98055 11403 58th Ave E Puyallup WA 98373
Day and Date Deductions
~ Mon Tue Wed Thu Fri Sat Sun
Work Classification Name C9 p Total
a> 11/1 11/1 11/1 11/1 11/1 11/1 11/2 Gross Amount
a, E Total Rate Hourly
and And E 4 5 6 7 8 9 0 Hours of Pa Earned/Gross Usual Withholding Net Wages
3 r a, y Payroll FICA Other
Soc Sec#of Employee Address a) a) a Benefits" Tax
l:K O o Hours Worked Each Day
0
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Kristin Force Payroll Admin.
11/28/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TYEE CONCRETE CONSTRUCTION INC
employed by:
Project Name: For the week starting: For the week ending:
vall Avenue NE 11/14/2022 11/20/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
-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
Kristin Force Payroll Admin. Kristin Force
MB 12/1/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
ti
Certified Payroll Report
Department of Labor and E,aTATA. Project Name County Project or Contract#
?;:i <f3::`� Prime Contractor ❑
Industries s.
,y!. Duvall Avenue NE King CAG-20-065
Prevailing Wage Program 4=!°=• ::_.i=
3!!!3• "fil.t Subcontractor IZ
PO Box 44540 "�::•,,' v' Project Address
Olympia WA 98504-4540 H� '"F"�° Final Week of
(360)902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TYEE CONCRETE CONSTRUCTION INC (253)507-8933
Month Day Year Awarding Agency Address Address City State Zip+4
11/13/2022 1055 S GRADY WAY RENTON,WA-98055 11403 58th Ave E Puyallup WA 98373
Day and Date Deductions
Work Classification Name C5 ~ o Mon Tue Wed Thu Fri Sat Sun Total
cr o a> 11/1 11/1 11/1 11/1 Gross Amount
and And a) E 11/7 11/8 11/9 Total Rate Hourly
`m E r 0 1 2 3 Hours of Pay Earned/Gross °Usual FICA Withholding Other Net Wages
Soc Sec#of Employee Address aa) a) 7 Payroll Benefits" Tax
o: O o Hours Worked Each Day
a
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Kristin Force Payroll Admin.
11/17/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TYEE CONCRETE CONSTRUCTION INC
employed by:
Project Name: For the week starting: For the week ending:
Duvall Avenue NE 11/7/2022 11/13/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
•
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
(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
Kristin Force Payroll Admin. Kristin Force
MB 11/21/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and sT�r� Project Name County Project or Contract#
?... °� Prime Contractor ❑
Industries Duvall Avenue NE King CAG-20-065
Prevailing Wage Program Q=.'•;ii. "'x Subcontractor El
PO Box 44540 '',;j•4,0 Jv° Project Address
Olympia WA 98504-4540 y't 18$9 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 TYEE CONCRETE CONSTRUCTION INC (253)507-8933
Month Day Year Awarding Agency Address Address City State Zip+4
11/6/2022 1055 S GRADY WAY RENTON,WA-98055 11403 58th Ave E Puyallup WA 98373
Day and Date Deductions
Work Classification Name C7 p o Mon Tue Wed Thu Fri Sat Sun Total
fx o a) 10/3 Gross Amount
and And E E 11/1 11/2 11/3 11/4 11/5 11/6 Total Rate Hourly
E i= 1 Hours of Pay Earned/Gross 'Usual FICA Withholding Other Net Wages
Soc Sec#of Employee Address Payroll Benefits" Tax
i 0 o Hours Worked Each Day
0
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Kristin Force Payroll Admin.
11/14/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TYEE CONCRETE CONSTRUCTION INC
employed by:
Project Name: For the week starting: For the week ending:
Duvall Avenue NE 10/31/2022 11/6/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
-,.-- -
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
5)Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and
I-raining Council.
Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties.
Printed name of party signing this report Title Signature
Kristin Force Payroll Admin. Kristin Force
•
MB 1.1/21/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and $STA,F Project Name County Project or Contract#
?;:� ", Prime Contractor ❑
Industries �.
o,;., -•,y�: i.r Duvall Avenue NE King CAG-20-065
Prevailing Wage Program 4is:i=• ••'•si=
iiis:• ••1L Subcontractor El
PO Box 44540 s'�,_:le �y Project Address
Olympia WA 98504-4540 H` '�6"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 TYEE CONCRETE CONSTRUCTION INC (253)507-8933
Month Day Year Awarding Agency Address Address City State Zip+4
10/30/2022 1055 S GRADY WAY RENTON,WA-98055 11403 58th Ave E Puyallup WA 98373
Day and Date Deductions
Work Classification Name c� o Mon Tue Wed Thu Fri Sat Sun Total
cc o e 10/2 10/2 10/2 10/2 10/2 10/2 10/3 Gross Amount
�, iE Total Rate Hourly
and And 4 5 6 7 8 9 0 Earned/Gross Net Wages
r Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address 0 Benefits"
O o Hours Worked Each Day
a
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Kristin Force Payroll Admin.
11/8/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TYEE CONCRETE CONSTRUCTION INC
employed by:
Project Name: For the week starting: For the week ending:
Duvall Avenue NE 10/24/2022 10/30/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s)have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
(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
Kristin Force Payroll Admin. Kristin Force
MB 11/21/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and Project Name County Project or Contract#
Industries p -'t,'', Prime Contractor ❑
,i::e- ,;;Ito; Duvall Avenue NE King CAG-20-065
Prevailing Wage Program 31 ij;,' ,!11 Subcontractor ►�
PO Box 44540 " Project Address
Olympia WA 98504-4540 .f `"�"v. Final Week of
(360)902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TYEE CONCRETE CONSTRUCTION INC (253)507-8933
Month Day Year Awarding Agency Address Address City State Zip+4
10/23/2022 1055 S GRADY WAY RENTON,WA-98055 11403 58th Ave E Puyallup WA 98373
Day and Date Deductions
Work Classification Name ;7 p o Mon Tue Wed Thu Fri Sat Sun Total
c' o a) 10/1 10/1 10/1 10/2 10/2 10/2 10/2 Gross Amount
and And a) E 7 $ 9 0 1 2 3 Total Rate Earned/Gross Hourly Net Wages
E is Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address m > " Tax
I 0 0 Hours Worked Each Day
a
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Kristin Force Payroll Admin.
10/31/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TYEE CONCRETE CONSTRUCTION INC
employed by:
Project Name: For the week starting: For the week ending:
nt'vall Avenue NE 10/17/2022 10/23/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
(\i\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
Kristin Force Payroll Admin. Kristin Force
MB 11/21/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and - At*� Project Name County Project or Contract#
A Prime Contractor ❑
Industries
�. Duvall Avenue NE King CAG-20-065
Prevailing Wage Program ` Subcontractor
PO Box 44540 , `�► Project Address
Olympia WA 98504-4540 `�e89 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 TYEE CONCRETE CONSTRUCTION INC (253)507-8933
Month Day Year Awarding Agency Address Address City State Zip+4
10/16/2022 1055 S GRADY WAY RENTON,WA-98055 11403 58th Ave E Puyallup WA 98373
Day and Date Deductions
Work Classification Name C9 I- o Mon Tue Wed Thu Fri Sat Sun Total
ix 2, a) 10/1 10/1 10/1 10/1 10/1 10/1 10/1 Gross Amount
a> E Total Rate Hourly
and And `m E F= 0 1 2 3 4 5 6 Hours of PayEarned/Gross °Usual Withholding Net Wages
o) f a) Payroll Benefits" FICA Tax Other
Soc Sec#of Employee Address a) >
o' O 'o Hours Worked Each Day
0
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Kristin Force Payroll Admin.
10/31/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TYEE CONCRETE CONSTRUCTION INC
employed by:
Project Name: For the week starting: For the week ending:
^..vall Avenue NE 10/10/2022 10/16/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
!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
Kristin Force Payroll Admin. Kristin Force
MB: 1:1/2/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and srerg Project Name County Project or Contract#
Industries . ° Prime Contractor ❑
,,
," Duvall Avenue NE King CAG-20-065
Prevailing Wage Program a . Ey - Subcontractor El
PO Box 44540 �'",� • Project Address
Olympia WA 98504-4540 ` 1889 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 TYEE CONCRETE CONSTRUCTION INC (253)507-8933
Month Day Year Awarding Agency Address Address City State Zip+4
10/9/2022 1055 S GRADY WAY RENTON,WA-98055 11403 58th Ave E Puyallup WA 98373
Day and Date Deductions
Work Classification Name a 8 —a Mon Tue Wed Thu Fri Sat Sun Gross Amount Total
and And a) E 10/3 10/4 10/5 10/6 10/7 10/8 10/9 Total Rate Hourly
`m E i= Hours of Pay Earned/Gross "Usual g Net Wages
Withholdin
Soc Sec#of Employee Address 0 w Payroll Benefits" FICA Tax Other
0 O o' Hours Worked Each Day
a
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Kristin Force Payroll Admin.
10/31/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TYEE CONCRETE CONSTRUCTION INC
employed by:
Project Name: For the week starting: For the week ending:
n ivall Avenue NE 10/3/2022 10/9/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits aslisted 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.
! ,,qny 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
Kristin Force - Payroll Admin. Kristin Force
MB.`11/2/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and $.srarF Prime Contractor ❑ Project Name County Project or Contract#
Industries §.r 1
PrevailingWage Program <" Duvall Avenue NE King CAG-20-065
9 9 1;,: °g Subcontractor ►'�
PO Box 44540 "�H�., .,y Project Address
Olympia WA 98504-4540 '�e3` Final Week of
(360)902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TYEE CONCRETE CONSTRUCTION INC (253)507-8933
Month Day Year Awarding Agency Address Address City State Zip+4
10/2/2022 1055 S GRADY WAY RENTON,WA-98055 11403 58th Ave E Puyallup WA 98373
Day and Date Deductions
P
Work Classification Name & ~O o Mon Tue Wed Thu Fri Sat Sun Total
cC a> Gross Amount
and And E 9/26 9/27 9/28 9/29 9/30 10/1 10/2 Total Rate Earned/Gross Hourly Net Wages
E i-= Hours of Pay Payroll Net FICA Withholding Other
Soo Sec#of Employee Address c a) .n y Benefits" Tax
o O o Hours Worked Each Day
a
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Kristin Force Payroll Admin.
10/10/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TYEE CONCRETE CONSTRUCTION INC
employed by:
Project Name: For the week starting: For the week ending:
Duvall Avenue NE 9/26/2022 10/2/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s)have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
(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
Kristin Force Payroll Admin. Kristin Force
MB 10/11/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and �t�T�rF Project Name County Project or Contract#
i`: 6,, Prime Contractor ❑
Industries 4;n1' "• y Duvall Avenue NE King CAG-20-065
Prevailing Wage Program i;i, ,;: ';,_
0! •K Subcontractor L Project Address
PO Box 44540 f° ���yo
Olympia WA 98504-4540 '6'' ' Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TYEE CONCRETE CONSTRUCTION INC (253)507-8933
Month Day Year Awarding Agency Address Address City State Zip+4
9/25/2022 1055 S GRADY WAY RENTON,WA-98055 11403 58th Ave E Puyallup WA 98373
Day and Date Deductions
F
Work Classification Name c9 ~O o Mon Tue Wed Thu Fri Sat Sun Total
a) Gross Amount
and And — a) E 9/19 9/20 9/21 9/22 9/23 9/24 9/25 Total Rate Earned/Gross Hourly Net Wages
E i= Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address > a y Benefits" Tax
O o Hours Worked Each Day
0
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Kristin Force Payroll Admin.
10/10/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TYEE CONCRETE CONSTRUCTION INC
employed by:
Project Name: For the week starting: For the week ending:
Duvall Avenue NE 9/19/2022 9/25/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
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.
(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
Kristin Force Payroll Admin. Kristin Force
MB 10/11/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and �+E•,ST";,,�. Prime Contractor ❑ Project Name County Project or Contract#
Industries 4.sip IL*.
3..... r„ 'Duvall Avenue NE King CAG-20-065
Prevailing Wage Program ? ' `'.iiii
,� ._ �°!ll`� Subcontractor
PO Box 44540 °,..:::i ` a`45 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 TYEE CONCRETE CONSTRUCTION INC (253)507-8933
Month Day Year Awarding Agency Address Address City State Zip+4
9/18/2022 1055 S GRADY WAY RENTON,WA-98055 11403 58th Ave E Puyallup WA 98373
Day and Date Deductions
Work Classification Name C7 ~O o Mon Tue Wed Thu Fri Sat Sun Total
Gross Amount
and And E 9/12 9/13 9/14 9/15 9/16 9/17 9/18 Total Rate Earned/Gross Hourly Net Wages
co E is Hours of Pay Payroll "Usual FICA Withholding Other g
Soc Sec#of Employee Address cK O o Hours Worked Each Day Benefits" Tax
0
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Kristin Force Payroll Admin.
9/26/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TYEE CONCRETE CONSTRUCTION INC
employed by:
Project Name: For the week starting: For the week ending:
ivall Avenue NE 9/12/2022 9/18/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
'a' 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
Kristin Force Payroll Admin. Kristin Force
MB 9/28/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and �nrf Project Name County Project or Contract#
.<$.j ,';t",, Prime Contractor ❑
Industries ,. i ,, 4..
.i::, nr, Duvall Avenue NE King CAG-20-065
Prevailing Wage Program lilt. ;'iii1 Subcontractor
PO Box 44540 ;y , 0y° 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 TYEE CONCRETE CONSTRUCTION INC (253)507-8933
Month Day Year Awarding Agency Address Address City State Zip+4
9/11/2022 1055 S GRADY WAY RENTON,WA-98055 11403 58th Ave E Puyallup WA 98373
Day and Date Deductions
1---
Work Classification Name c7 o Mon Tue Wed Thu Fri Sat Sun Total
O m Gross Amount
and And E 9/5 9/6 9/7 9/8 9/9 9/10 9/11 Total Rate Earned/Gross Hourly Net Wages
.E a Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address CK 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 Kristin Force Payroll Admin.
9/19/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TYEE CONCRETE CONSTRUCTION INC
employed by:
Project Name: For the week starting: For the week ending:
niivall Avenue NE 9/5/2022 9/11/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
•
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
>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
Kristin Force Payroll Admin. Kristin Force
MB 9/28/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and �a�.3ster�.`'F Project Name County Project or Contract#
Industries �..... ; 4. Prime Contractor ❑
�.:21 r„ Duvall Avenue NE King CAG-20-065
Prevailing Wage Program ,'fill {:iii` 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 TYEE CONCRETE CONSTRUCTION INC (253)507-8933
Month Day Year Awarding Agency Address Address City State Zip+4
9/4/2022 1055 S GRADY WAY RENTON,WA-98055 11403 58th Ave E Puyallup WA 98373
Day and Date Deductions
,
Work Classification Name c9 ~O 9-a) Mon Tue Wed Thu Fri Sat Sun Total
Gross Amount
and And a� E 8/29 8/30 8/31 9/1 9/2 9/3 9/4 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
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 Kristin Force Payroll Admin.
9/7/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TYEE CONCRETE CONSTRUCTION INC
employed by:
Project Name: For the week starting: For the week ending:
ntivall Avenue NE 8/29/2022 9/4/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
«)Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and
.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
Kristin Force Payroll Admin. Kristin Force
MB 9/28/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
.
Certified Payroll Report
Department of Labor and srerf• Prime Contractor ❑ Project Name County Project or Contract#
Industries vaii =..4.
i Duvall Avenue NE King CAG-20-065
Prevailing Wage Program �Fllhi ,.tit i n Subcontractor
PO Box 44540 d'�"`. . ,� Project Address
Olympia WA 98504-4540 y` , 0�, Final Week of
(360) 902-5335 Payroll
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TYEE CONCRETE CONSTRUCTION INC (253)507-8933
Month Day Year Awarding Agency Address Address City State Zip+4
8/28/2022 1055 S GRADY WAY RENTON,WA-98055 11403 58th Ave E Puyallup WA 98373
_ Day and Date Deductions
Work Classification Name C7 ~O o Mon Tue Wed Thu Fri Sat Sun Total '
a> Gross Amount
a> E 8/22 8/23 8/24 8/25 8/26 8/27 8/28 Total Rate Hourly
and And i Hours of PayEarned/Gross "Usual Withholding Net Wages
a> Payroll FICA Other
Soc Sec#of Employee Address o o Hours Worked Each Day Benefits" Tax
0
No Employees performed work on this project during this reporting period.
•
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Kristin Force Payroll Admin.
8/31/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TYEE CONCRETE CONSTRUCTION INC
employed by:
Project Name: For the week starting: For the week ending:
Duvall Avenue NE 8/22/2022 8/28/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
,?.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
Kristin Force Payroll Admin. Kristin Force
MB 9/6/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and `,� �. ,f Project Name County Project or Contract#
47,: Prime Contractor ❑
Industries ::: _=f
3::::.� -� �`::.•� Duvall Avenue NE King CAG-20-065
Prevailing Wage Program 33jj,; ,,<;j4�'� Subcontractor M
PO Box 44540 '' :i4r y2. Project Address
Olympia WA 98504-4540 �y` '��y�° Final Week of
(360) 902-5335 Payroll
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON, CITY OF (425)430-7303 TYEE CONCRETE CONSTRUCTION INC (253)507-8933
Month Day Year Awarding Agency Address Address City State Zip+4
8/21/2022 1055 S GRADY WAY RENTON,WA-98055 11403 58th Ave E Puyallup WA 98373
Day and Date Deductions
p
Work Classification Name 0 ~O 9-a) Mon Tue Wed Thu Fri Sat Sun Total
Gross Amount
and And E 8/15 8/16 8/17 8/18 8/19 8/20 8/21 Total Rate Earned/Gross Hourly Net Wages
r Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address c > Benefits" Tax
I O o Hours Worked Each Day
0
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Kristin Force Payroll Admin.
8/31/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TYEE CONCRETE CONSTRUCTION INC
employed by:
Project Name: For the week starting: For the week ending:
^•••'all Avenue NE 8/15/2022 8/21/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
^,ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and
Wing Council.
Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties.
Printed name of party signing this report Title Signature
Kristin Force Payroll Admin. Kristin Force
MB 9/6/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and $."•ST"'"' Prime Contractor IDProject Name County Project or Contract#
Industries _ Duvall Avenue NE King CAG-20-065
Prevailing Wage Programlit.'
<:ir Subcontractor M
PO Box 44540 °. "'. , y° Project Address
Olympia WA 98504-4540 tit 186N 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 TYEE CONCRETE CONSTRUCTION INC (253)507-8933
Month Day Year Awarding Agency Address Address City State Zip+4
8/14/2022 1055 S GRADY WAY RENTON,WA-98055 11403 58th Ave E Puyallup WA 98373
Day and Date Deductions
P
Work Classification Name ( o Mon Tue Wed Thu Fri Sat Sun Total
O a> Gross Amount
and And E 8/8 8/9 8/10 8/11 8/12 8/13 8/14 Total Rate Earned/Gross Hourly Net Wages
E a Hours of Pay Payroll "Usual FICA Withholding Other
Soc Sec#of Employee Address O o Hours Worked Each Day Benefits" Tax
0
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Kristin Force Payroll Admin.
8/22/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TYEE CONCRETE CONSTRUCTION INC
employed by:
Project Name: For the week starting: For the week ending:
n all Avenue NE 8/8/2022 8/14/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following:
(1)All-information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and
' ding Council.
Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties.
Printed name of party signing this report Title Signature
Kristin Force Payroll Admin. Kristin Force
•
MB 9/6/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and `*y�T�rE. Project Name County Project or Contract#
. .::_• • ), Prime Contractor ❑
Industries v.:.: =.c.f
o•••• "'.'.':? Duvall Avenue NE King CAG 20 065
Prevailing Wage Program lit 'iii1 Subcontractor NI
PO Box 44540 ;: 05� Project Address
Olympia WA 98504-4540 d 'S"°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 TYEE CONCRETE CONSTRUCTION INC (253)507-8933
Month Day Year Awarding Agency Address Address City State Zip+4
8/7/2022 1055 S GRADY WAY RENTON,WA-98055 11403 58th Ave E Puyallup WA 98373
Day and Date Deductions
Work Classification Name C7 ~O ?-a Mon Tue Wed Thu Fri Sat Sun Total
� Gross Amount
and And E 8/1 8/2 8/3 8/4 8/5 8/6 8/7 Total Rate Earned/Gross Hourly Net Wages
E i Hours of Pay "Usual:E. a) PayrollFICA Withholding Other
Benefits" Tax
Soc Sec#of Employee Address O o Hours Worked Each Day
a
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Kristin Force Payroll Admin.
8/22/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TYEE CONCRETE CONSTRUCTION INC
employed by:
Project Name: For the week starting: For the week ending:
n all Avenue NE 8/1/2022 8/7/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following: •
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
( .qny 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
Kristin Force Payroll Admin. Kristin Force
MB 9/6/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Certified Payroll Report
Department of Labor and �,t, ��rF Project Name County Project or Contract#
Industries `,:t.;: •t:=;f, Prime Contractor ❑
�:iP. -i :li. , Duvall Avenue NE King CAG-20-065
Prevailing Wage Program iiiiiit= ,;illi;` Subcontractor Fl
PO Box 44540 °' t°,� 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 TYEE CONCRETE CONSTRUCTION INC (253)507-8933
Month Day Year Awarding Agency Address Address City State Zip+4
7/31/2022 1055 S GRADY WAY RENTON,WA-98055 11403 58th Ave E Puyallup WA 98373
Day and Date Deductions
F=
Work Classification Name ( ~O o Mon Tue Wed Thu Fri Sat Sun Total
cC a) Gross Amount
and And E 7/25 7/26 7/27 7/28 7/29 7/30 7/31 Total Rate Earned/Gross Hourly Net Wages
E Hours of Pay "Usual FICA Withholding Other
r a, Payroll Benefits" Tax
Soc Sec#of Employee Address O o Hours Worked Each Day
0
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
Affirmation
Department of Labor and Industries
Prevailing Wage Program
PO Box 44540
Olympia WA 98504-4540
Today's Printed name of party signing this report Title
Date Kristin Force Payroll Admin.
8/2/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TYEE CONCRETE CONSTRUCTION INC
employed by:
Project Name: For the week starting: For the week ending:
n.Nall Avenue NE 7/25/2022 7/31/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other
"Usual Pension Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
)
No Employees performed work on this project during this reporting period.
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
The party signing below AFFIRMS the following:
(1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete.
(2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the
- contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic.
(3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees.
(4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or
indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally
permissible, have been made by any person either directly or indirectly from the full wages earned.
,,c`,„ ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and
.fining Council.
Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties.
Printed name of party signing this report Title Signature
Kristin Force Payroll Admin. Kristin Force
•
MB 8/4/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
-ip. -
Certified Payroll Report
Department of Labor and serf Project Name County Project or Contract#
.s0'��•" ,�;."F Prime Contractor ❑
Industries ,€, <«f
3;i;, :�.r� Duvall Avenue NE King CAG-20-065
Prevailing Wage Program LI"`l j;"= Subcontractor
1.111 ali.
PO Box 44540 , , ,y,�. Project Address
Olympia WA 98504-4540 y� 'a""` Final Week of
(360) 902-5335 Payroll ❑
Awarding Agency Name Phone Company Name Phone
For the week ending: RENTON,CITY OF (425)430-7303 TYEE CONCRETE CONSTRUCTION INC (253)507-8933
Month Day Year Awarding Agency Address Address City State Zip+4
7/24/2022 1055 S GRADY WAY RENTON,WA-98055 11403 58th Ave E Puyallup WA 98373
Day and Date Deductions
p
Work Classification Name c7 ~O 9- Mon Tue Wed Thu Fri Sat Sun Total
rY Gross Amount
and And m E 7/18 7/19 7/20 7/21 7/22 7/23 7/24 Total Rate Earned/Gross Hourly Net Wages
E Hours of Pay "Usual FICA Withholding Other
5 a) Payroll Benefits" Tax
Soc Sec#of Employee Address rY o o Hours Worked Each Day
0 I
1. Cement Masons `� ' Medicare:$28.09,
Eduardo Camacho RG 0.00 0.00 5.00 6.00 0.00 0.00 0.00 11.00 $50.00 $550.00 Union Dues:
Curb&Gutter,Sidewalks Gutierrez J I
(King) 3720 S Thompson $550.00/ v $22 07
* ** Ave Apt 213 OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $75.00 $0.00 $1,937.50 $19.59/hr $120.13 $287.00 $1,480.21
Tacoma,WA- $100.0
98418- DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 V0
2. Cement Masons Alejandro RG 0.00 0.00 0.00 6.00 0.00 0.00 0.00 6.00 $50.00 $300.00
Medicare:$36.08,
Curb&Gutter,Sidewalks Castaneda Vera J / Union Dues:
(King) 9417 124th St Ct E $300.00/ v $22.07
#5 OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $75.00 $0.00 $2 337.50 $19.59/hr $154.28 $284.00 $1,841.07
* *' South Hill,WA- $100.0
98373 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $0.00
01
3. Laborers V J Medicare:$25.94,
RG 0.00 0.00 5.00 6.00 0.00 0.00 0.00 11.00 $43.90 $482.90 / Union Dues:
Cement Finisher Tender Michael Christensen V
(King) 15423 Griggs Rd E $482.90/ J $23.21
Graham,WA- OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $65.85 $0.00 $1 788 93 $14.00/hr $110.92 $273.00 $1,355.86
* ** 98338
DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $87.80 $0.00
4. Cement Masons J J Medicare:$30.09,
Curb&Gutter,Sidewalks
Nelson Velarde RG 0.00 0.00 5.00 0.00 0.00 0.00 0.00 5.00 $50.00 $250.00 J J Union Dues:
(King) Bohorquez $250.00/
$23.50
9912 24th Ave Ct S OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $75.00 $0.00 $2 075.00 $19.59/hr $128.65 $181.00 $1,711.76
Tacoma,WA-
98444 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1000.0 $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 Kristin Force Payroll Admin.
8/1/2022
The party signing this report pays or (Name of contractor or subcontractor)
supervises the payment of the persons TYEE CONCRETE CONSTRUCTION INC
employed by:
Project Name: For the week starting: For the week ending:
" E;rall Avenue NE 7/18/2022 7/24/2022
"USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms)
Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F)Other
"Usual Pension • Medical Vacation Holiday Apprentice Benefits
Benefits" Program
(A+B+C+D+E+F
1.Eduardo Camacho Gutierrez
Cement Masons
Curb&Gutter,Sidewalks $19.59 J $10.10 $8.09 $0.00 $0.50 $0.90
(King)
2.Alejandro Castaneda Vera
iv-" -anent Masons
1 a;b&Gutter,Sidewalks $19.59 $10.10 $8.09 $0.00 $0.50 $0.90
(King)
3.Michael Christensen
Laborers
Cement Finisher Tender $14.00 J $5.30 $7.55 $0.00 $0.20 $0.95
(King)
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side
, 4.Nelson Velarde Bohorquez
Cement Masons
Curb&Gutter,Sidewalks $19.59 $10.10 $8.09 $0.00 $0.50 $0.90
(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.
apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and
_ ,ding Council.
Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties.
Printed name of party signing this report Title Signature
Kristin Force Payroll Admin. Kristin Force
MB 8/4/22
F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side