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HomeMy WebLinkAboutCAG-20-065 - Duvall - Subcontractor W.E. Coates J.. - -a 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: 11/15/2021 1193285 11/15/2021 Company Details Company Name: W. E. Coates Surveying, LLC. Address: - 9825 Glory Drive SE Olympia, WA, 98513 Contractor Registration No. . WA UBI Number 602746960 . . . Phone Number 360-413-0510. Industrial Insurance Account ID 12885701 OMWBE Certifications as of 11/15/2021 Disadvantaged Business Enterprise (DBE) . Minority Business Enterprise (MBE) Email Address tericoates@wecoatessurveying.com Filed By Teri Coates. Prime Contractor Company Name REED TRUCKING Et EXCAVATING INC Contractor Registration No. REEDTEI016JW WA UBI Number 601915034 Phone Number 253-841-4837 Project Information Awarding Agency RENTON, CITY OF 1055 S GRADY WAY RENTON, WA- 98055 • Awarding Agency Contact Flora Lee Awarding Agency Contact Phone Number 425-430-7303 Contract Number CAG-20-065 Project Name Duvall Avenue NE Project Description This project includes but is not limited to: excavation; grading; removal of pavement; plaining pavement; paving with asphalt, curb and gutter; drainage; illumination; HAWK signal; sidewalk; walls; adjustments to utility frames, grates, and covers; property restoration; and other work. Contract Amount $5,218,171.95 Contract Type Description Bid-Build (Traditional) Bid due date 6/22/2021 Award Date 7/21/2021 Project Site Address or Directions Hiring Contractor Company Name REED TRUCKING Et EXCAVATING INC Contractor Registration No. REEDTEI016JW WA UBI Number 601915034 Payment Details Check Number: Transaction Id: 108385407 Intent Details Expected project start date: (MM/DD/YYYY) 11/22/2021 In what county (or counties) will the work be King performed? In what city (or nearest city) will the work be Renton performed? What is the estimated contract amount? OR is $61,500.00 this a time and materials estimate? Does your company intend to hire ANY No subcontractors? Yes Will your company have employees perform work on this project? Do you intend to use any apprentices? No (Apprentices are considered employees.) How many owner/operators performing work on 1 the project own 30% or more of the company? First Name Last Name Trade Wade Coates Surveyors Journey Level Wages County Trade Occupation Wage Fringe Workers King Surveyors Construction Site Surveyor $67.28 $6.21 1 King Surveyors Construction Site Surveyor $68.47 $5.02 1 Public Notes n Show/Hide Existing Notes No note exists State of Washington Department of Labor & Industries Prevailing Wage Section - Telephone 360-902-5335 PO Box 44540, Olympia, WA 98504-4540 Affidavit of Wages Paid Project Detail - Project Dashboard Document Received Date: Intent Id: Affidavit Id: 1270475 Status: Approved on 12/14/2023 1193285 12/14/2023 Company Details Name W. E. Coates Surveying, LLC Address 9825 Glory Drive SE Olympia,WA,98513 WA UBI no. 602746960 Contractor Registration no. Industrial Insurance Account Id 12885701 OMWBE Certifications as of 11/15/2021 Disadvantaged Business Enterprise (DBE) Minority Business Enterprise (MBE) Email Address tericoates®wecoatessurveying.corn Filed By Coates, Teri Prime Contractor Prime contractor name REED TRUCKING Et EXCAVATING INC Prime contractor registration no. REEDTEI016JW Prime contractor Phone Number 253-841-4837 Project Information Awarding agency: RENTON, CITY OF 1055 S GRADY WAY RENTON, WA - 98055 Awarding agency contact: Flora Lee Awarding agency contact phone number: 425-430-7303 Contract no. CAG-20-065 Project name Duvall Avenue NE Project Description This project includes but is not limited to: excavation; grading; removal of pavement; plaining pavement; paving with asphalt, curb and gutter; drainage; illumination; HAWK restoration; and other work. Dollar amount of your contract: $ 63,675.25 Bid due date 6/22/2021 Contract award date 7/21/2021 Job site address/directions: Hiring Contractor Company Name REED TRUCKING a EXCAVATING INC Contractor Registration No. REEDTEI016JW WA UBI Number 601915034 Payment Details Check Number: Transaction Id: 109731906 Project Details County where work was performed King City where work was performed Renton Prime contractor Intent form Id#for this 1170257 project Intent filed date 11/15/2021 Job start date:MM-DD-YYYY 1/4/2022 Date work completed:MM-DD-YYYY 5/19/2023 Project Completion Did your company hire any subcontractors? No Did your company have employees perform Yes work on this project? Did you use apprentice employees on this No project? Company Owner Information How many owner/operators performed work on 1 the project that own 30% or more of the company? First Name Last Name Trade Wade Coates Surveyors Affidavit Subcontractor(s) No subcontractor is selected for this affidavit. Journeylevel Wages County Trade Occupation Wages Fringes # # Workers Hours King Surveyors Construction Site 63.94 9.55 1 52.00 Surveyor King Surveyors Construction Site 68.09 5.40 1 153.00 Surveyor King Surveyors Construction Site 68.34 5.15 1 4.00 Surveyor King Surveyors Chainman 69.12 0.00 1 12.00 Apprentice Wages Public Notes o Show/Hide Existing Notes No note exists Certified Payroll Report Department of Labor and . ,1;TF Project Name County Project or Contract# ,s.,`'$' _. :- Prime Contractor ❑ Industries :,„.y r* °s;r Duvall Avenue NE King CAG-20-065 Prevailing Wage Program =,:z, l d i- IV Subcontractor 0 PO Box 44540 . `._ Project Address Olympia WA 98504-4540 ""° Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W.E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 5/27/2023 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions p Work Classification Name c7 ~ -caw Sun Mon Tue Wed Thu Fri Sat Total Gross Amount and And a) E 5/21 5/22 5/23 5/24 5/25 5/26 5/27 Total Rate Earned/Gross Hourly Net Wages co E Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address m Q) y Benefits" Tax D 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 Jasmine Neafus Office Administrator 5/31/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W.E.Coates Surveying, LLC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 5/21/2023 5/27/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. (g!_A,ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and 'ling Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature Jasmine Neafus Office Administrator Jasmine Neafus MB 6/6/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side e Certified Payroll Report Department of Labor and t.=1,%7' Project Name County Project or Contract# Industries , _•'•' '•„`y Prime Contractor ❑ Prevailing Wage Program :uT l Duvall Avenue NE King GAG-20-065 li , - Subcontractor CM PO Box 44540 s 9: 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 W.E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 5/20/2023 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions p Work Classification Name c 0~O a�— Sun Mon Tue Wed Thu Fri Sat Total Gross Amount and And a) E 5/14 5/15 5/16 5/17 5/18 5/19 5/20 Total Rate Earned/Gross Hourly Net Wages p. E Hours of Pay Payroll "Usual FICA Withholding Other w a) y Benefits" Tax Soc Sec#of Employee Address cc O o Hours Worked Each Day 0 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 Jasmine Neafus Office Administrator 5/31/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W.E.Coates Surveying, LLC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 5/14/2023 5/20/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 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 ling Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature Jasmine Neafus Office Administrator Jasmine Neafus MB 6/6/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and .., ,7,A Project Name County Project or Contract# Industries ^? • Prime Contractor ❑ du --;'•`.p.:y Duvall Avenue NE King CAG-20-065 Prevailing Wage Program f' f�i I , •,fit Subcontractor IE PO Box 44540 .?;f 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 W. E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 5/13/2023 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions p Work Classification Name ~ 9- Sun Mon Tue Wed Thu Fri Sat Total O �, and And m Gross Amount E 5/7 5/8 5/9 5/10 5/11 5/12 5/13 Total Rate Hourly E Earned/GrossNet Wages Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address 0 - y Benefits" Tax f:C 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 Jasmine Neafus Office Administrator 5/23/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W. E.Coates Surveying, LLC employed by: Project Name: For the week starting: For the week ending: gall Avenue NE 5/7/2023 5/13/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. (5)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 • Jasmine Neafus Office Administrator Jasmine Neafus MB 5/30/23 • • F700-065-000 certified payroll report 05-09 U Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and F,,i V4 Project Name County Project or Contract# ,,. .i•••gi °, Prime Contractor ❑ Industries _ - -ii r Duvall Avenue NE King CAG-20-065 PrevailingWage Program =;!a} `< - 9 9 j.uu, f, ; Subcontractor PO Box 44540 ,,,„, ..,v Project Address Olympia WA 98504-4540 � '""" Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W. E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 5/6/2023 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions Work Classification Name c7 ~O 9- Sun Mon Tue Wed Thu Fri Sat Total a) Gross Amount and And m E 4/30 5/1 5/2 5/3 5/4 5/5 5/6 Total Rate Earned/Gross Hourly Net Wages `.. E a Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address cc O o Hours Worked Each Day Benefits" Tax 0 No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date Jasmine Neafus Office Administrator 5/11/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W. E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: niwvall Avenue NE 4/30/2023 5/6/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. (5)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 Jasmine Neafus Office Administrator Jasmine Neafus MB 5/30/23 F700-065-000 certified-payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and ,7?TTF Project Name County Project or Contract# &'?:___••___�.�, Prime Contractor ❑ Industries PrevailingWage Program =E=i. f `���= Duvall Avenue NE King CAG-20-065 9 9 <.. _::: . •. •i Subcontractor PO Box 44540 1,nle �,;v 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 W. E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 4/29/2023 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions Work Classification Name c9 O~ o Sun Mon Tue Wed Thu Fri Sat Total m Gross Amount and And au E 4/23 4/24 4/25 4/26 4/27 4/28 4/29 Total Rate Earned/Gross Hourly Net Wages E Hours of Pay "Usual FICA Withholding Other f m Payroll Benefits" Tax Soc Sec#of Employee Address X O -75 8 Hours Worked Each Day 0 No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date Jasmine Neafus Office Administrator 5/5/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W.E. Coates Surveying, LLC employed by: Project Name: For the week starting: For the week ending: n""vall Avenue NE 4/23/2023 4/29/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the. contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker; laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. (5)Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ling Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature Jasmine Neafus Office Administrator Jasmine Neafus MB 5/9/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �ai,'sT•A•T`'O� Project Name County Project or Contract# Industries .... s Prime Contractor ❑ °:::: Duvall Avenue NE King CAG-20-065 Prevailing Wage Program ;;z Subcontractor PO Box 44540 °',' y Project Address Olympia WA 98504-4540 y` '"ey 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 W. E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 4/22/2023 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions p Work Classification Name oo o Sun Mon Tue Wed Thu Fri Sat Total Gross Amount and And a� ` Hours of Pay Earned/Gross "Usual Withholding Net Wages —° E f m 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 Jasmine Neafus Office Administrator 4/26/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W.E.Coates Surveying, LLC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 4/16/2023 4/22/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms) _ Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work 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 Tr' 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 Jasmine Neafus Office Administrator Jasmine Neafus MB 5/1/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �F,<1.‘,F Project Name County Project or Contract# Industries 4...isms° y Prime Contractor ❑ Prevailing Wage Program iii:.- �`.:iiii_ Duvall Avenue NE King CAG 20 065 ;`� ia_ Subcontractor PO Box 44540 1,212: y Project Address Olympia WA 98504-4540 � `""" Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W. E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 4/15/2023 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions ~ Work Classification Name & ~O o Sun Mon Tue Wed Thu Fri Sat Total a) Gross Amount and And a) E 4/9 4/10 4/11 4/12 4/13 4/14 4/15 Total Rate Earned/Gross Hourly Net Wages E Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address w Payroll Benefits" Tax (X 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 Jasmine Neafus Office Administrator 4/20/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W. E.Coates Surveying, LLC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 4/9/2023 4/15/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly I (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual j Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. (F\A,ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and iing Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature Jasmine Neafus Office Administrator Jasmine Neafus MB 4/20/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and sT.orF' Prime Contractor ❑ Project Name County Project or Contract# Industries Air ,..E 9 Duvall Avenue NE King CAG-20-065 Prevailing Wage Program ' Efi, ? { Subcontractor PO Box 44540 �',�' v' Project Address Olympia WA 98504-4540 H` t8e8 a0 Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W. E.Coates Surveying, LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 4/8/2023 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions Work Classification Name C9 ~O 9- Sun Mon Tue Wed Thu Fri Sat Total rY a) Gross Amount and And a) E 4/2 4/3 4/4 4/5 4/6 4/7 4/8 Total Rate Earned/Gross Hourly Net Wages E a - Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address CD o o Hours Worked Each Day Benefits" Tax 0 1. Surveyors • • Dental:$12.52, RG 0.00 0.00 0.00 0.00 7.00 0.00 0.00 7.00 $63.94 $447.58 WA Workers: Construction Site Surveyor TRENT COATES (King) 1625 7TH AVE SW $447.58/ $4.27 * ** PUYALLUP,WA- OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $95.91 $0.00 $1,583.82 $9.55/hr $116.38 $188.87 $1,261.78 98371 $127.8 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 8 $0.00 2. Surveyors WA Workers: RG 0.00 0.00 0.00 0.00 6.00 0.00 0.00 6.00 $69.12 $414.72 Chainman Dane Hoover $5.66 (King) 15421 Sunny Cover $103.6 $414.72/ DR SE OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 8 $0.00 $2 818 12 $0.00/hr $211.76 $489.62 $2,111.08 * ** Olalla,WA-98359 $138.2 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 s. surveyors Dental:$12.52, Construction Site Surveyor ZACHARY MALLOY RG 0.00 0.00 0.00 0.00 7.00 0.00 0.00 7.00 $67.26 $470.82 Health:$167.17, _ . (King) 12922 Rocky Creek $100.8 $470.82/ WA Workers: Rd NW OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 9 $0.00 $2 843.62 $6.23/hr $199.97 $432.91 $5.65 $2,025.40 * *_**.*** Gig Harbor,WA- 98329 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $134.5 $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 Jasmine Neafus Office Administrator 4/14/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W. E.Coates Surveying, LLC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 4/2/2023 4/8/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.TRENT COATES Surveyors Construction Site Surveyor $9.55 J $0.00 $5.77 $1.99 $1.79 $0.00 (King) 2.Dane Hoover Surveyors ainman $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 (King) 3.ZACHARY MALLOY Surveyors Construction Site Surveyor $6.23 $0.00 $4.46 $0.63 $1.14 $0.00 (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. ( Y-ony apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and icing 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 Jasmine Neafus Office Administrator Jasmine Neafus MB 4/20/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �,F, �F Project Name County Project or Contract# Industries 4^, ;. Prime Contractor ❑ Prevailing Wage Program -A, 1 . Duvall Avenue NE King CAG 20-065 i= Subcontractor PO Box 44540 '.y, - Project Address Olympia WA 98504-4540 k"` Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W.E.Coates Surveying, LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 4/1/2023 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions i= Work Classification Name cc b o Sun Mon Tue Wed Thu Fri Sat Total Gross Amount and And m E 3/26 3/27 3/28 3/29 3/30 3/31 4/1 Total Rate Earned/Gross Hourly Net Wages Ecu Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address ! c a) z Benefits" Tax 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 Jasmine Neafus Office Administrator 4/14/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W.E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 3/26/2023 4/1/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. (c)4ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ;ling Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature Jasmine Neafus Office Administrator Jasmine Neafus MB 4/20/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �t, ,a�F, Project Name County Project or Contract# Industries _.s.;•,•.' Et,;:s Prime Contractor El Prevailing Wage Program : ii:._ r,tr,= Duvall Avenue NE King CAG-20-065 _:$;,l, . •:4% Subcontractor PO Box 44540 '.f4.: 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 W. E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 3/25/2023 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions Work Classification Name ace ~O o Sun Mon Tue Wed Thu Fri Sat Total Gross Amount and And a� E 3/19 3/20 3/21 3/22 3/23 3/24 3/25 Total Rate Earned/Gross Hourly Net Wages E iz Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address 0 CD a Payroll Benefits" Tax o_ O o Hours Worked Each Day 0 No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date Jasmine Neafus Office Administrator 3/29/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W.E.Coates Surveying, LLC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 3/19/2023 3/25/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. (51 °,ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ,:ing Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature Jasmine Neafus Office Administrator Jasmine Neafus MB 4/20/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and ��ST"TE o Prime Contractor ❑ Project Name County Project or Contract# Industries 4:;; y. y Duvall Avenue NE King CAG-20-065 Prevailing Wage Program W!li ;, ,six Subcontractor PO Box 44540 °.;;;74 ' 'w° Project Address Olympia WA 98504-4540 y` '"'"—a'aJ Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone FOr the week ending: RENTON,CITY OF (425)430-7303 W. E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 3/18/2023 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date 1 Deductions p Work Classification Name c9 ~o o. Sun Mon Tue Wed Thu Fri Sat Total Gross Amount and And a> E 3/12 3/13 3/14 3/15 3/16 3/17 3/18 Total Rate Earned/Gross Hourly Net Wages E Hours of Pay "Usual f FICA Withholding Other Soc Sec#of Employee Address - a Payroll Benefits" Tax X 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 Jasmine Neafus Office Administrator 3/29/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W.E.Coates Surveying, LLC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 3/12/2023 3/18/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. h1-A,ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ;ling Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature Jasmine Neafus Office Administrator Jasmine Neafus MB 4/20/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and 6T�rF. Project Name County Project or Contract# es�... :°� Prime Contractor ❑ Industries Duvall Avenue NE King CAG-20-065 Prevailing Wage Program W':: Subcontractor L PO Box 44540 77:Ar v o Project Address Olympia WA 98504-4540 y` 'aes 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 W.E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 3/11/2023 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date . Deductions F Work Classification Name c- b ° Sun Mon Tue Wed Thu Fri Sat Total O m Gross Amount and And a) E 3/5 3/6 3/7 3/8 3/9 3/10 3/11 Total Rate Earned/Gross Hourly Net Wages E03 Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address ci a E Benefits" O 'o Hours Worked Each Day a 1. Surveyors Ni JWorkers' RG 0.00 0.00 0.00 0.00 6.00 0.00 0.00 6.00 $69.12 $414.72 / Chainman Dane Hoover J Compensation: (King) 15421 Sunny Cover $103.6 $414.72/ $5.19,Union DR SE OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 8 $0.00 $2 273.35 $0.00/hr $150.55 $295.57 Dues:$19.70 $1,802.34 Olalla,WA-98359 $138.2 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 2. Surveyors Workers' RG 0.00 0.00 0.00 0.00 6.00 0.00 0.00 6.00 $67.26 $403.56 Compensation: Construction Site Surveyor ZACHARY MALLOY $5.19,Spouse (King) 12922 Rocky Creek OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $100.8 9 $0.00 Health:$167.17, Rd NW $403.56/ $6.23/hr $138.41 $242.60 Dental:$12.52, $1,452.84 Gig Harbor,WA- $2,039.00 Union Dues: 98329 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $134.52 $0.00 $20.27 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 Jasmine Neafus Office Administrator 3/20/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W.E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 3/5/2023 3/11/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.Dane Hoover Surveyors Chainman $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 (King) 2.ZACHARY MALLOY Surveyors Construction Site Surveyor $6.23 $0.00 $4.46 $0.63 $1.14 $0.00 (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s)have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. 5)Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and draining 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 Jasmine Neafus Office Administrator Jasmine Neafus MB 3/23/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and E.>TAT4 Project Name County Project or Contract# .s,,:: ,eqt°A Prime Contractor ❑ Industries Duvall Avenue NE King CAG-20-065 Prevailing Wage Program °;;;;;, - ;f' Subcontractor IZ PO Box 44540 YHA•::. y Project Address Olympia WA 98504-4540 'hkq ° 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 W.E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 3/4/2023 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions p Work Classification Name (� ~O o Sun Mon Tue Wed Thu Fri Sat Total a) Gross Amount and And ai E 2/26 2/27 2/28 3/1 3/2 3/3 3/4 Total Rate Earned/Gross Hourly Net Wages 0 E Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address rY O o Hours Worked Each Day y Benefits" Tax a No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date Jasmine Neafus Office Administrator 3/13/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W.E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 2/26/2023 3/4/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s)have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. 5)Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and "raining Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature Jasmine Neafus Office Administrator Jasmine Neafus MB 3/23/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and 4..TArF, Project Name County Project or Contract# ?.. u!i:.i Prime Contractor ❑ Industries �,; ;' ,!;; Duvall Avenue NE King CAG-20-065 Prevailing Wage Program fAii _ !!!f?. "!!r^ Subcontractor PO Box 44540 r'��•�' v Project Address Olympia WA 98504-4540 H` '"'"—e°a° Final Week of (360)902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W.E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 2/25/2023 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions p • Work Classification Name c7 ~O 9- Sun Mon Tue Wed Thu Fri Sat Total m Gross Amount and And E 2/19 2/20 2/21 2/22 2/23 2/24 2/25 Total Rate Earned/Gross Hourly Net Wages a r iz m Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address O o Tax Hours Worked Each Day Benefits" 0 No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date Jasmine Neafus Office Administrator 3/13/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W.E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 2/19/2023 2/25/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s)have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. ,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 Jasmine Neafus Office Administrator Jasmine Neafus MB 3/23/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and ST.A?F Project Name County Project or Contract# ?_!_._ ____°,, Prime Contractor ❑ Industries 4 »= ===•f Prevailing Wage Program �;:::: ' Vi Duvall Avenue NE King CAG-20-065 ,,;;;; ;;z Subcontractor CSI PO Box 44540 Jyy,� ,ovn Project Address Olympia WA 98504-4540 ` ""'c Final Week of (360) 902-5335 Payroll ►z� Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W.E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 2/18/2023 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions H Work Classification Name c7 ~O g- Sun Mon Tue Wed Thu Fri Sat Total ct a) Gross Amount and And m E 2/12 2/13 2/14 2/15 2/16 2/17 2/18 Total Rate Earned/Gross Hourly Net Wages ail E � Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address CD > a Payroll Benefits" Tax W O o Hours Worked Each Day a No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date Jasmine Neafus Office Administrator 2/24/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W.E.Coates Surveying, LLC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 2/12/2023 2/18/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. '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 Jasmine Neafus Office Administrator Jasmine Neafus MB 2/27/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side --4 Certified Payroll Report Department of Labor and .,sure Project Name County Project or Contract# Industries 4 (30 Prime Contractor ❑ II Duvall Avenue NE King CAG-20-065 Prevailing Wage Program II_ �. ;"'t Subcontractor ►� PO Box 44540 4: �► y� Project Address Olympia WA 98504-4540 y` 18ss 03 Final Week of (360)902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W. E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 2/11/2023 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions i= Work Classification Name c9 O~ o Sun Mon Tue Wed Thu Fri Sat Total a> Gross Amount and And a) E 2/5 2/6 2/7 2/8 2/9 2/10 2/11 Total Rate Earned/Gross Hourly Net Wages E i Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address HourBenefits"s 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 Jasmine Neafus Office Administrator 2/16/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W.E.Coates Surveying, LLC employed by: Project Name: For the week starting: For the week ending: "-yell Avenue NE 2/5/2023 2/11/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly I (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers,laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. ,'any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ,'ping Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature Jasmine Neafus Office Administrator Jasmine Neafus MB 2/23/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �,',, rF Project Name County Project or Contract# =i _� , Prime Contractor E Industries ;•; _ __=�f -::;.? Duvall Avenue NE King CAG-20-065 Prevailing Wage Program 4,f==• '_'�'= Subcontractor EKI vi Hiii =a:r` PO Box 44540 '' '"� w� Project Address Olympia WA 98504-4540 y` '"�y" Final Week of (360) 902-5335 Payroll E Awarding Agency Name Phone Company Name Phone FOr the week ending: RENTON,CITY OF (425)430-7303 W. E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 2/4/2023 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions p Work Classification Name C o G. Sun Mon Tue Wed Thu Fri Sat Total Gross Amount and And m E 1/29 1/30 1/31 2/1 2/2 2/3 2/4 Total Rate Earned/Gross Hourly Net Wages fO E is Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address ce 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 Jasmine Neafus Office Administrator 2/10/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W. E.Coates Surveying, LLC employed by: Project Name: For the week starting: For the week ending: ^..vall Avenue NE 1/29/2023 2/4/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. 'Rt;4ny 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 Jasmine Neafus Office Administrator Jasmine Neafus MB 2/13/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �$STA7 Project Name County Project or Contract# .... Prime Contractor ❑ Industries a:::: �:::: z Duvall Avenue NE King CAG 20 065 PrevailingWage Program a ""'i= 9 9 .,,r Subcontractor PO Box 44540 ..40 y� Project Address Olympia WA 98504-4540 y` 18as,1° Final Week of (360)902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W. E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 1/28/2023 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions H Work Classification Name c 0 Sun Mon Tue Wed Thu Fri Sat Gross Amount Total and And a, E 1/22 1/23 1/24 1/25 1/26 1/27 1/28 Total Rate Earned/Gross Hourly Net Wages m E i Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address aa) a) a Payroll Benefits" Tax ce O o Hours Worked Each Day a 1. Surveyors v Ni Dental:$12.52, Construction Site Surveyor ZACHARY MALLOY RG 0.00 0.00 6.00 4.00 0.00 0.00 0.00 10.00 $67.26 $672.60 J Health:$167.17, (King) 12922 Rocky Creek $100.8 $672.60/ WA Workers: Rd NW OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 9 $0.00 $1,488.90 $6.23/hr $100.15 $129.67 $4.58 $1,074.81 *****_ ** Gig Harbor,WA- 98329 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1 34.5 $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 Jasmine Neafus Office Administrator 1/31/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W.E.Coates Surveying, LLC employed by: Project Name: For the week starting: For the week ending: ^.rvall Avenue NE 1/22/2023 1/28/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.ZACHARY MALLOY Surveyors Construction Site Surveyor $6.23 $0.00 $4.46 $0.63 $1.14 $0.00 (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side • r The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and dining Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature Jasmine Neafus Office Administrator Jasmine Neafus li MB 2/1/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side • Certified Payroll Report Department of Labor and �STATF� Project Name County Project or Contract# Industries 4: 4. Prime Contractor ❑ o,: :::.7 Duvall Avenue NE King CAG-20-065 Prevailing Wage Program ,::::• '��'� Subcontractor ►_� Project Address PO Box 44540y'�1'. -,y' j Olympia WA 98504-4540 ` 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 W. E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 1/21/2023 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions p Work Classification Name a ~ o Sun Mon Tue Wed Thu Fri Sat Total ct O a: Gross Amount and And a: E 1/15 1/16 1/17 1/18 1/19 1/20 1/21 Total Rate Earned/Gross Hourly Net Wages E i Hours of Pay "Usual FICA Withholding Other rn r a) Payroll Benefits" Tax Soc Sec#of Employee Address w O o Hours Worked Each Day ° J J 1. Surveyors RG 0.00 0.00 0.00 0.00 6.00 0.00 0.00 6.00 $63.94 $383.64 j J Dental:$12.52, WA Workers: Construction Site Surveyor TRENT COATES (King) 1625 7TH AVE SW $383.64/ $3.67, DUES: PUYALLUP,WA- OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $95.91 $0.00 $1,631.96 $9.55/hr $123.89 $201.22 $14.85, UNION: $1,271.01 -* **** $4.80 98371 $12 7.8 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 8 $0.00 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date Jasmine Neafus Office Administrator 1/27/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W.E.Coates Surveying, LLC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 1/15/2023 1/21/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.TRENT COATES Surveyors Construction Site Surveyor $9.55 j $0.00 $5.77 $1.99 $1.79 $0.00 (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side '- The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and I. :lining Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature Jasmine Neafus Office Administrator Jasmine Neafus MB 1/31/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and ��ST�r�o Project Name County Project or Contract# Industries 4 s Prime Contractor ❑ a::::' r, Duvall Avenue NE King CAG-20-065 Prevailing Wage Program `s Subcontractor PO Box 44540 �y �' ::' a" Project Address Olympia WA 98504-4540 ` 'e8y Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W.E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 1/14/2023 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions p Work Classification Name c7 ~O o Sun Mon Tue Wed Thu Fri Sat Total a) Gross Amount and And a) E 1/8 1/9 1/10 1/11 1/12 1/13 1/14 Total Rate Earned/Gross Hourly Net Wages E Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address cr o o Hours Worked Each Day Payroll Benefits" Tax 0 L No Employees performed work 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 Jasmine Neafus Office Administrator 1/22/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W.E.Coates Surveying, LLC employed by: Project Name: For the week starting: For the week ending: n'rvall Avenue NE 1/8/2023 1/14/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have-been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and wining Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature Jasmine Neafus Office Administrator Jasmine Neafus MB 1/23/23 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and yArF. Project Name County Project or Contract# -.�='' .. Prime Contractor ❑ Industries 4! =...4. PrevailingWage Program 4isi:. !``t_ Duvall Avenue NE King CAG-20-065 9 g ;,� Subcontractor ►_� PO Box 44540 , ,•'•' , oy� Project Address Olympia WA 98504-4540 H` '"B"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 W.E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 1/7/2023 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions p Work Classification Name c9 O~ Sun Mon Tue Wed Thu Fri Sat Total a> Gross Amount and And a� E 1/1 1/2 1/3 1/4 1/5 1/6 1/7 Total Rate Earned/Gross Hourly Net Wages E iz Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address > ,n 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 Jasmine Neafus Office Administrator 1/11/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W.E.Coates Surveying, LLC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 1/1/2023 1/7/2023 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �t,�TArF� Project Name County Project or Contract# Industries ;;." Prime Contractor ❑ Duvall Avenue NE King CAG-20-065 Prevailing Wage Program <'.. .. s Subcontractor El PO Box 44540 ".y '',' wit Project Address Olympia WA 98504-4540 'ady Final Week of (360)902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone FOr the week ending: RENTON,CITY OF (425)430-7303 W. E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 12/31/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions o Sun Mon Tue Wed Thu Fri Sat Work Classification Name c7 Total re 2- CD 12/2 12/2 12/2 12/2 12/2 12/3 12/3 Gross Amount Total Rate Hourly and And ? E R. Earned/Gross 5 6 7 8 9 0 1 Hours of Pay Pa roll "Usual FICA Withholding Other Net Wages Soc Sec#of Employee Address a, a) y 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 Jasmine Neafus Office Administrator 1/11/2023 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W. E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: nuvall Avenue NE 12/25/2022 12/31/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. t 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 Jasmine Neafus Office Administrator Jasmine Neafus 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 �. STAT•h o Project Name County Project or Contract# Industries Q,;;:: y Prime Contractor ❑ :il z-, Duvall Avenue NE King CAG-20-065 Prevailing Wage Program <''' _ 1,,:::: �:.1•, Subcontractor NI PO Box 44540 ,� a' c,y Project Address Olympia WA 98504-4540 y` `"BV a Final Week of (360) 902-5335 Payroll El Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W.E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 12/24/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions Work Classification Name c� E= o Sun Mon Tue Wed Thu Fri Sat Total ct 2- a) 12/1 12/1 12/2 12/2 12/2 12/2 12/2 Gross Amount a, E Total Rate Hourly and And @ E 8 9 0 1 2 3 4 Hours of Pay Earned/Gross °Usual FICA Withholding Other Net Wages Soc Sec#of Employee Address a) a 7 Payroll Benefits" Tax r O oo Hours Worked Each Day 0 No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date Jasmine Neafus Office Administrator 12/30/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W.E.Coates Surveying, LLC employed by: Project Name: For the week starting: For the week ending: wall Avenue NE 12/18/2022 12/24/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: • (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. "N4ny 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 Jasmine Neafus Office Administrator Jasmine Neafus 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 „STATA.� Project Name County Project or Contract# ?... .;.9. Prime Contractor E Industries 4,:;"•' t Duvall Avenue NE King CAG-20-065 PrevailingWage Program �::..• ••`•_ 9 9 „;r Subcontractor PO Box 44540 °ii°:�' v" Project Address Olympia WA 98504-4540 y� `""y 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 W. E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 12/17/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions ~ c9 p Sun Mon Tue Wed Thu Fri Sat Work Classification Name Total c o w 12/1 12/1 12/1 12/1 12/1 12/1 12/1 Gross Amount H E Total Rate ourly and And ili Earned/Gross Net Wages a= 1 2 3 4 5 6 7 Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address , a> a Payroll Benefits" Tax rt O o Hours Worked Each Day 0 / 1. Surveyors 1 `� J WA Workers: RG 0.00 0.00 6.00 0.00 0.00 3.00 0.00 9.00 $66.93 $602.37 / $4.04 Construction Site Surveyor TRENT COATES I (King) 1625 7TH AVE SW OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $100.4 $0.00 $602.37/ $6.56/hr $130.89 $214.93 $1,361.09 PUYALLUP,WA- 0 $1,710.95 ......."" 98371 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $163.8 $0.00 2. Surveyors Dental:$10.69, RG 0.00 0.00 6.00 0.00 0.00 3.00 0.00 9.00 $68.09 $612.81 Health:$126.85, Construction Site Surveyor ZACHARY MALLOY (King) 12922 Rocky Creek $102.1 WA Workers: Rd NW OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 $612.81 / $5.40/hr $157.26 $304.22 $5.48,DUES: $1,440.78 Gig Harbor,WA- $2,055.65 $7.97, UNION: 98329 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1 $2.40 $6.1 $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 Jasmine Neafus Office Administrator 12/21/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W.E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: ^ vall Avenue NE 12/11/2022 12/17/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.TRENT COATES Surveyors Construction Site Surveyor $6.56 $0.00 $3.94 $1.54 $1.08 $0.00 (King) 2.ZACHARY MALLOY c.irveyors )nstruction Site Surveyor $5.40 $0.00 $3.94 $0.61 $0.85 $0.00 (King) 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�ST^TFo Prime Contractor ❑ Project Name County Project or Contract# Industries '•' Duvall Avenue NE King CAG-20-065 .Prevailing Wage Program 4"' Subcontractor PO Box 44540 �,yi4ir aov°` 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 W.E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 12/10/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions H Work Classification Name ace 8 o Sun Mon Tue Wed Thu Fri Sat Total 12/1 Gross Amount E 12/4 12/5 12/6 12/7 12/8 12/9 Total Rate Hourly and And 0 Earned/Gross WithholdingNet Wages f E ) Hours of Pay "Usual FICA Other Soc Sec#of Employee Address a a 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 Jasmine Neafus Office Administrator 12/15/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W. E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: "—tall Avenue NE 12/4/2022 12/10/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. r,'Xny 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 Jasmine Neafus , Office Administrator Jasmine Neafus 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 �4,STAN. Project Name County Project or Contract# Industries 4 4 Prime Contractor ❑ o,,,• Duvall Avenue NE King CAG-20-065 Prevailing Wage Program z Subcontractor ® PO Box 44540 .'if Project Address Olympia WA 98504-4540 y` �eB"a y Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone FOr the week ending: RENTON,CITY OF (425)430-7303 W.E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 12/3/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions Sun Mon Tue Wed Work Classification Name 0 ~ o Thu Fri Sat Total ct O w 11/2 11/2 11/2 11/3 Gross Amount and And w E 7 8 9 0 12/1 12/2 12/3 Total Rate Earned/Gross Hourly Net Wages cisE �= Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address - a) - Payroll Benefits" Tax w O o' Hours Worked Each Day 0 1. Surveyors `I Dental:$10.69, RG 0.00 0.00 2.00 0.00 0.00 0.00 0.00 2.00 $68.09 $136.18 Health:$126.85, Construction Site Surveyor ZACHARY MALLOY (King) 12922 Rocky Creek $102.1 WA Workers: Rd NW OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 $136.18/ $5.40/hr $131.86 $229.52 $5.21,DUES: $1,188.41 "`-.'.... Gig Harbor,WA- $1,723.66 $23.92,UNION: 98329 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1386.1 $0.00 $7.20 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date Jasmine Neafus Office Administrator 12/15/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W.E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: rh.vall Avenue NE 11/27/2022 12/3/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.ZACHARY MALLOY Surveyors Construction Site Surveyor $5.40 $0.00 $3.94 $0.61 $0.85 $0.00 (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and 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 Jasmine Neafus Office Administrator Jasmine Neafus MB 12/15/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and ,I Mc. Project Name County Project or Contract# Industries Y`.' ,�, {i ..1 :',. Prime Contractor ❑ -:rii:6 ,,,i ,-. Duvall Avenue NE King CAG-20-065 Prevailing Wage Program `jl„' "{'� Subcontractor El PO Box 44540 '.,,' . w Project Address Olympia WA 98504-4540 �� """ Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W. E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 11/26/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions p o Sun'Mon Tue Wed Thu Fri Sat Work Classification Name c9Total - a) 11/2 11/2 11/2 11/2 11/2 11/2 11/2 Gross Amount Total Rate Hourly Earned/Gross Net Wages and And ? E i= 0 1 2 3 4 5 6 Hours of Pay Payroll "Usual FICA Withholding Other g Soc Sec#of Employee Address y Benefits" Tax o' O P, 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 Jasmine Neafus Office Administrator 11/30/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W.E.Coates Surveying, LLC employed by: Project Name: For the week starting: For the week ending: r)'"all Avenue NE 11/20/2022 11/26/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. t".,Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and 5ning 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 Jasmine Neafus Office Administrator Jasmine Neafus MB 12/1/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and +wsTn,:o, Project Name County Project or Contract# Industries 4 Prime Contractor El: + Duvall Avenue NE King CAG-20-065 PrevailingWage Program 4'=,,ii':. " x 9 9 Subcontractor ❑x i' sl r Project Address PO Box 44540 d ;'Z' 'y� Olympia WA 98504-4540 y` `""y'� Final Week of (360) 902-5335 Payroll III Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W. E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 11/19/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions ~ Sun Mon Tue Wed Thu Fri Sat Work Classification Name C� Total 9. ly a) 11/1 11/1 11/1 11/1 11/1 11/1 11/1 Gross Amount and And @E Total Rate Hourly 3 4 5 6 7 8 9 Hours of Pay Earned/Gross °Usual Withholding Net Wages Soc Sec#of Employee Address 0 Other w Payroll Benefits" FICA Tax 0 0 Hours Worked Each Day a 1. Surveyors `j Ni Dental:$10.69, RG 0.00 0.00 0.00 0.00 0.00 6.00 0.00 6.00 $68.09 $408.54 / Health:$126.85, Construction Site Surveyor ZACHARY MALLOY Ni / (King) 12922 Rocky Creek $102.1 �/ WA Workers: Rd NW OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 $408.54/ $5.40/hr $162.42 $320.73 $5.34,DUES: $1,476.39 -' '"* Gig Harbor,WA- $2,123.17 $15.95, UNION: 98329 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1 8 36'1 $4.80 $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 Jasmine Neafus Office Administrator 11/30/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W. E.Coates Surveying, LLC employed by: Project Name: For the week starting: For the week ending: n"vall Avenue NE 11/13/2022 11/19/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.ZACHARY MALLOY Surveyors Construction Site Surveyor $5.40 $0.00 $3.94 $0.61 $0.85 $0.00 (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s)have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. . ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and (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 Jasmine Neafus Office Administrator Jasmine Neafus • MB 12/1/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse.Side Certified Payroll Report Department of Labor and �, sTA'F C, Project Name County Project or Contract# A.... r.::., Prime Contractor ❑ Industries .»:> f, o Duvall Avenue NE King CAG-20-065 PrevailingWage Program a::.:.. :: i�x 9 9 _;;,.; :: Subcontractor El PO Box 44540 ,�•:•,� o Project Address Olympia WA 98504-4540 H` `"ay 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 W. E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 11/12/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date I Deductions p Thu Fri Sat Work Classification Name C9 ~ Sun Mon Tue Wed Total ct o m 11/1 11/1 11/1 Gross Amount and And a) E 11/6 11/7 11/8 11/9 1 2 Total Rate Earned/Gross Hourly Net Wages E i= 0 Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address > - y Benefits" Tax CD i 0 o Hours Worked Each Day a No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date Jasmine Neafus Office Administrator 11/30/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W. E.Coates Surveying, LLC employed by: Project Name: For the week starting: For the week ending: n.'vall Avenue NE 11/6/2022 11/12/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. 'F`• 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 Jasmine Neafus Office Administrator Jasmine Neafus MB 12/1/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and F,5,^ATF Project Name County Project or Contract# ?=e+= __�? Prime Contractor ❑ Industries I;=; `:' =iir Duvall Avenue NE King CAG-20-065 Prevailing Wage Program izti +£`• i l l- Subcontractor ❑x PO Box 44540 " ' y Project Address Olympia WA 98504-4540 H` '""�` Final Week of (360)902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W.E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 11/5/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions Work Classification Name H o Sun Mon Tue Wed Thu Fri Sat Total c[ 2. a 10/3 10/3 Gross Amount and And Ea E 11/1 11/2 11/3 11/4 11/5 Total Rate Hourly `m E 0 1 Hours of Pay Earned/Gross "Usual FICA Withholding Other Net Wages Soc Sec#of Employee Address a) - Payroll Benefits" Tax O 0 Hours Worked Each Day a No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date Jasmine Neafus Office Administrator 11/11/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W. E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 10/30/2022 11/5/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. ,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 Jasmine.Neafus Office Administrator Jasmine Neafus • • 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 STATE. Project Name County Project or Contract# A+ °. Prime Contractor ❑ Industries > ,iIil .x Duvall Avenue NE King CAG-20-065 Prevailing Wage Program 4 ii. =i is .i;: Subcontractor Z PO Box 44540 "; v° Project Address Olympia WA 98504-4540 y� `�By 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 W. E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 10/29/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions Work Classification Name a � o Sun Mon Tue Wed Thu Fri Sat Total r o a> 10/2 10/2 10/2 10/2 10/2 10/2 10/2 Gross Amount a> E Total Rate Hourly and And `m E i.-. 3 4 5 6 7 8 9 Hours of PayEarned/Gross °Usual Withholding Net Wages 'E a, Payroll FICA Other Soc Sec#of Employee Address c > Benefits" Tax 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 Jasmine Neafus Office Administrator 11/7/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W.E.Coates Surveying, LLC employed by: Project Name: For the week starting: For the week ending: ',all Avenue NE 10/23/2022 10/29/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual-work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. '5\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 Jasmine Neafus Office Administrator Jasmine Neafus MB 11/8/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side ..wr . Certified Payroll Report Department of Labor and CAT o Project Name County Project or Contract# Industries Prime Contractor ❑ PrevailingWage Program Duvall Avenue NE King CAG 20 065 g g Subcontractor PO Box 44540 ;",r y Project Address Olympia WA 98504-4540 �8°"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 W. E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 10/22/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 IDDay and Date Deductions Work Classification Name c� p 0 Sun Mon'Tue Wed Thu Fri Sat Total PC 2 a) 10/1 10/1 10/1 10/1 10/2 10/2 10/2 Gross Amount E Total Rate Hourly and And = E i= 6 7 8 9 0 1 2 Hours of Pay Earned/Gross °Usual FICA Withholding Other Net Wages Soc Sec#of Employee Address a�'i > a Payroll Benefits" Tax o_ O o Hours Worked Each Day 0 1. Surveyors RG 0.00 0.00 0.00 0.00 0.00 3.00 0.00 3.00 $68.09 $204.27 Dental:$10.69, Construction Site Surveyor ZACHARY MALLOY ( Health:$126.85, (King) 12922 Rocky Creek $102 1 �/ WA Workers: Rd NW OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 $204.27/ $5.40/hr $192.56 $417.01 $5.49, DUES: $1,754.20 " Gig Harbor,WA- $2,517.17 $7.97, UNION: 98329 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1 $2.40 $6.1 $0.00 0 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 Jasmine Neafus Office Administrator 10/28/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W.E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: Duvall vall Avenue NE 10/16/2022 10/22/2022 • "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.ZACHARY MALLOY Surveyors Construction Site Surveyor $5.40 $0.00 $3.94 $0.61 $0.85 $0.00 (King) S F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have-been made by any person either directly or indirectly from the full wages earned. ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ring Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature Jasmine Neafus Office Administrator Jasmine Neafus MB; 11/1/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �,�rf Project Name County Project or Contract# >_ Prime Contractor ❑ Industries ==i'' =jFf. ai3 Duvall Avenue NE King CAG-20-065 Prevailing Wage Program +s=1jj 91j' Subcontractor PO Box 44540 ';y=� �`;„: Project Address Olympia WA 98504-4540 '""" Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W.E.Coates Surveying, LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 10/15/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions Work Classification Name c ~ o Sun Mon Tue Wed Thu Fri Sat Total a� 10/1 10/1 10/1 10/1 10/1 10/1 Gross Amount m E 10/9 Total Rate Hourly and And Earned/Gross Net Wages m` E i- 0 1 2 3 4 5 Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address 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 Jasmine Neafus Office Administrator 10/24/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W. E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: wall Avenue NE 10/9/2022 10/15/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which,are legally permissible, have been made by any person either directly or indirectly from the full wages earned. .1ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and !ping Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature Jasmine Neafus Office Administrator Jasmine Neafus 'M B 10/25/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �� '"T�o Prime Contractor ❑ Project Name County Project or Contract# Industries .�: ii,.1 Duvall Avenue NE King CAG-20-065 Prevailing Wage Program $ Subcontractor PO Box 44540 y� Project Address Olympia WA 98504-4540 yy �e�°ao Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W.E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 10/8/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions Work Classification Name (-3- F' o Sun Mon Tue Wed Thu Fri Sat Total cC O a) Gross Amount and And a) E 10/2 10/3 10/4 10/5 10/6 10/7 10/8 Total Rate Earned/Gross Hourly Net Wages E i= Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address m a ,a y 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 Jasmine Neafus Office Administrator 10/12/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W.E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 10/2/2022 10/8/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing.below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete: (2)The wage rates for workers,'laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker,.laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefitof such employees. (4)-All persons employed on the above-referenced project(s)have been paid the_full weekly wages earned, and no rebates,have been:or will be'made either directly or indirectly-to or on behalf of the above-named contractor or subcontractor from the weekly wages'earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. 7(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 Jasmine Neafus Office Administrator Jasmine Neafus M i:or17t22: • F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and srers n� Project Name County Project or Contract# .e,' Prime Contractor ❑ Industries w::: �.,: ii � Duvall Avenue NE King CAG-20-065 Prevailing Wage Program ; "'r� Subcontractor 0 PO Box 44540 4.� is ,!so s. Project Address Olympia WA 98504-4540 y� ao Final Week of (360)902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W.E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 10/1/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions F= Work Classification Name C9 lao Sun Mon Tue Wed Thu Fri Sat Total tr a� Gross Amount and And - E 9/25 9/26 9/27 9/28 9/29 9/30 10/1 Total Rate Earned/Gross Hourly Net Wages f Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address m a - Benefits" Tax O o Hours Worked Each Day ci 1. Surveyors `r Dental:$10.69, RG 0.00 0.00 0.00 6.00 0.00 0.00 0.00 6.00 $68.09 $408.54 f Health:$126.85 Construction Site Surveyor ZACHARY MALLOY J (King) 12922 Rocky Creek $102.1 WA Workers: , Rd NW OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 $408.54/ $5.40/hr $189.01 $405.66 $6.09,DUES: $1,722.05 Gig Harbor,WA- $2,470.72 $7.97,UNION: 98329 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1$36'1 $2.40 $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 Jasmine Neafus Office Administrator 10/12/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W.E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 9/25/2022 10/1/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.ZACHARY MALLOY Surveyors Construction Site Surveyor $5.40 $0.00 $3.94 $0.61 $0.85 $0.00 (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any.addenda, is correct and.complete: (2)The wage rates for workers, laborers or mechanics as reported'above are not less than the applicable wage rates contained in any wage determination,related to the contract; and the classifications as reported above foreachworker, laborer or mechanic_confbrm.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.benefitlof 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 indirectlyto 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 subjectto prosecution, sanctions,and penalties; Printed name of party sighing this report Title Signature Jasmine Neafus Office Administrator Jasmine Neafus M B,1'071 f22 • F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and.Signature Certification-on Reverse Side Certified Payroll Report Department of Labor and ,,ATE. Project Name County Project or Contract# Industries .0'i "aio,, Prime Contractor ❑ " '��` _� Duvall Avenue NE King CAG-20-065 Prevailing Wage Program ijjjLs=€"1 Subcontractor PO Box 44540 �';}���/` i`,;. Project Address Olympia WA 98504-4540 y` �eR" Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W.E.Coates Surveying, LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 9/24/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions Work Classification Name c7 ~ ' Sun Mon Tue Wed Thu Fri Sat Total CC O a> Gross Amount and And E 9/18 9/19 9/20 9/21 9/22 9/23 9/24 Total Rate Earned/Gross Hourly Net Wages `m E i= Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address c •> - Payroll Benefits" Tax f O o Hours Worked Each Day a 1. Surveyors `I " WA Workers: RG 0.00 6.00 0.00 0.00 0.00 0.00 0.00 6.00 $66.93 $401.58 $4.63, DUES: Construction Site Surveyor TRENT COATES (King) 1625 7TH AVE SW $100.4 $401.58/ $23.92,UNION: PUYALLUP,WA- OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0 $0.00 $1,754.06 $6.56/hr $134.19 $220.28 $7.20 $1,363.84 98371 - $133.8 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 6 $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 Jasmine Neafus Office Administrator 9/28/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W. E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 9/18/2022 9/24/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.TRENT COATES Surveyors Construction Site Surveyor $6.56 Ni $0.00 $3.94 $1.54 $1.08 $0.00 (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. ,,Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and 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 Jasmine Neafus Office Administrator Jasmine Neafus MB 10/4/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and a�51�r�:�� Project Name County Project or Contract# Industries ti;: ;,, Prime Contractor ❑ �_: Duvall Avenue NE King CAG-20-065 Prevailing Wage Program liiiiii. ':"= Subcontractor PO Box 44540 .,;,,:4,, yn Project Address Olympia WA 98504-4540 y` '"""ao Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W.E.Coates Surveying, LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 9/17/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions H Work Classification Name c3 ~O o Sun Mon'Tue Wed Thu Fri Sat Total a> Gross Amount and And a> E 9/11 9/12 9/13 9/14 9/15 9/16 9/17 Total Rate Hourly Earned/GrossNet 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 Jasmine Neafus Office Administrator 9/28/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W. E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 9/11/2022 9/17/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. 'Cs ;,ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ling Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature Jasmine Neafus Office Administrator Jasmine Neafus MB 10/4/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and rnrf,` Project Name County Project or Contract# ��`'`•.'.�.. i°F Prime Contractor ❑ Industries - iv ',i f. � :; �s,�:Y Duvall Avenue NE King CAG-20-065 Prevailing Wage Program <ja3 +_" = Subcontractor s,'lll IEi ' Project Address NI PO Box 44540 d' , , ,y° Olympia WA 98504-4540 yy ' "� Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W.E.Coates Surveying, LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 9/10/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions IL- Work Classification Name C7 I- 9- Sun Mon Tue Wed Thu Fri Sat Total cC O a) GrossRate Gross Amount Hourly E 9/4 9/5 9/6 9/7 9/8 9/9 9/10 y and And Earned/Gross Net Wages ct E i Hours of Pay Net FICA Withholding Other Soc Sec#of Employee Address a m - Payroll Benefits" Tax f O o Hours Worked Each Day a No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date Jasmine Neafus Office Administrator 9/17/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W. E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: •vall Avenue NE 9/4/2022 9/10/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side M 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. ( ' kAny 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 Jasmine Neafus Office Administrator Jasmine Neafus 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 ��sTars•6 Project Name County Project or Contract# �isri " �:.irc Prime Contractor ❑ Industries ==k i+==�s a.::-` "! Duvall Avenue NE King CAG-20-065 Prevailing Wage Program �<; t. ,; :x Subcontractor ❑x `isth `� Project Address PO Box 44540 °,y=•'' y�. 1 yyi, dog 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 W.E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 9/3/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 p Day and Date Deductions Work Classification Name c7 ~o o Sun Mon Tue Wed Thu Fri Sat Total a) Gross Amount and And a) E 8/28 8/29 8/30 8/31 9/1 9/2 9/3 Total Rate Earned/Gross Hourly Net Wages `m E i= Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address a > - Payroll Benefits" Tax O o Hours Worked Each Day ❑ J J 1. Surveyors 0.00 .00 $68.09 $408.54Dental:$10.69, RG 0.00 0.00 0.00 4.00 2.00 0.00 6 Construction Site Surveyor ZACHARY MALLOYJ J Health:$126.85, (King) 12922 Rocky Creek $102.1 $408.54/ WA Workers: Rd NW OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 $2423.49 $5.40/hr $185.40 $394.11 $5.22 $1,701.22 ** **_ ** Gig Harbor,WA- 98329 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $18 36"1 $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 Jasmine Neafus Office Administrator 9/7/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W.E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 8/28/2022 9/3/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.ZACHARY MALLOY Surveyors Construction Site Surveyor $5.40 J $0.00 $3.94 $0.61 $0.85 $0.00 (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. -?1ny 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 Jasmine Neafus Office Administrator Jasmine Neafus MB 9/8/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and 5:.,;F Prime Contractor ❑ Project Name County Project or Contract# Industries ;_; -• ,':. `,,, Duvall Avenue NE King CAG-20-065 PrevailingWage Program <;":, ,ari 9 9 WIN III Subcontractor IX PO Box 44540 °; �• : Jy" 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 W.E.Coates Surveying, LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 8/27/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions E= Work Classification Name c9 ~ Sun Mon Tue Wed Thu' Fri Sat Total cG O a> Gross Amount and And 92 E 8/21 8/22 8/23 8/24 8/25 8/26 8/27 Total Rate Earned/Gross Hourly Net Wages 7 1— Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address c > - y Benefits" Tax tY 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 Jasmine Neafus Office Administrator 9/7/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W. E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: wall Avenue NE 8/21/2022 8/27/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. ' Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and 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 Jasmine Neafus Office Administrator Jasmine Neafus MB 9/8/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �a�,`T"r;_o� Prime Contractor ❑ Project Name County Project or Contract# Industries �.!: 90 .... �`::r„ Duvall Avenue NE King CAG-20-065 Prevailing Wage Program iii, i`'x Subcontractor [54 PO Box 44540 4 yy� l v a°y�• Project Address Olympia WA 98504-4540 e" Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W.E. Coates Surveying, LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 8/20/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions p Work Classification Name c9 ~O o Sun Mon Tue Wed.Thu Fri Sat Total c m Gross Amount and And m E 8/14 8/15 8/16 8/17 8/18 8/19 8/20 Total Rate Earned/Gross Hourly Net Wages E i Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address > - y Benefits" Tax 1 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 Jasmine Neafus Office Administrator 8/26/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W. E. Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 8/14/2022 8/20/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side 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 Jasmine Neafus Office Administrator Jasmine Neafus 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 a�S,�TF F Project Name County Project or Contract# . ...i Prime Contractor ❑ Industries § ii `,;Y Duvall Avenue NE King CAG-20-065 Prevailing Wage Program t=,;:• +:=li€= Subcontractor LX7 PO Box 44540 IV �y`� N`y� Project Address Olympia WA 98504-4540 `'—"" Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W.E. Coates Surveying, LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 8/13/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions F= Work Classification Name c7 ~O o Sun Mon Tue Wed Thu Fri Sat Total a) Gross Amount and And @0 E 8/7 8/8 8/9 8/10 8/11 8/12 8/13 Total Rate Earned/Gross Hourly Net Wages E i= _ Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address f o o Hours Worked Each Day PayrollBenefits" 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 Jasmine Neafus Office Administrator 8/16/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W. E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: nuvall Avenue NE 8/7/2022 8/13/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work 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. !�v Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and lining Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature Jasmine Neafus Office Administrator Jasmine Neafus MB 8/17/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and ��rF; Project Name County Project or Contract# ��. ,,__F Prime Contractor ❑ Industries ti "' f. Duvall Avenue NE King CAG-20-065 PrevailingWage Program Iiii� , 9 g �,i�ii; �r Subcontractor Fl Project Address PO Box 44540 kcyy� "i°a�iy 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 W.E.Coates Surveying, LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 8/6/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions p Work Classification Name C7 ~O o Sun Mon Tue Wed Thu Fri Sat Total a� Gross Amount and And m E 7/31 8/1 8/2 8/3 8/4 8/5 8/6 Total Rate Earned/Gross Hourly Net Wages E Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address m 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 Jasmine Neafus Office Administrator 8/16/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W. E.Coates Surveying, LLC employed by: Project Name: For the week starting: For the week ending: n,.vall Avenue NE 7/31/2022 8/6/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. <c\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 Jasmine Neafus Office Administrator Jasmine Neafus MB 8/17/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �:5 �.F�,� Project Name County Project or Contract# �� Industries y Prime Contractor El;;. r Duvall Avenue NE King CAG-20-065 Prevailing Wage Program �_ PO Box 44540 a: g;�r „`ly Subcontractor R j Pro ect Address Olympia WA 98504-4540 y` '�a" Final'''S' Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W.E.Coates Surveying, LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 7/30/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions Work Classification Name C9 ~O o Sun Mon Tue Wed Thu Fri Sat Total Gross Amount and And E 7/24 7/25 7/26 7/27 7/28 7/29 7/30 Total Rate Earned!Gross Hourly Net Wages .- a Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address O o Hours Worked Each Day Benefits" Tax a No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date Jasmine Neafus Office Administrator 8/3/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W. E.Coates Surveying, LLC employed by: Project Name: For the week starting: For the week ending: wall Avenue NE 7/24/2022 7/30/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. ! `<Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and 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 Jasmine Neafus Office Administrator Jasmine Neafus • • MB 8/4/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and ,- ,TArf. Project Name County Project or Contract# :����r. ,i_ , Prime Contractor ❑ Industries e, o:.: - : •�'.;; Duvall Avenue NE King CAG-20-065 Prevailing Wage Program it ciiii: 4,,.:i. ��;- Subcontractor X PO Box 44540 "k,; a( y Project Address Olympia WA 98504-4540 y` !ON Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W.E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 7/23/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions p Work Classification Name CO ~O o Sun Mon Tue Wed Thu Fri Sat Total a) Gross Amount and And E 7/17 7/18 7/19 7/20 7/21 7/22 7/23 Total Rate Earned/Gross Hourly Net Wages E IL- Hours of Pay "Usual FICA Withholding Other rn E 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 Jasmine Neafus Office Administrator 7/29/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W. E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: vall Avenue NE 7/17/2022 7/23/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. !c',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 Jasmine Neafus Office Administrator Jasmine Neafus MB 8/2/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ning Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature Jasmine Neafus Office Administrator Jasmine Neafus MB 7/25/22 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,STAi, Project Name County Project or Contract# ,s?. il ., Prime Contractor ❑ Industries 4. i!t l��• :.�;. °qh.,,, Duvall Avenue NE King CAG-20-065 Prevailing Wage Program -Milli; +�;il!.- Subcontractor IZI PO Box 44540 °; "',�' °v° Project Address Olympia WA 98504-4540 y� 'ady° Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W. E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 7/9/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions Work Classification Name c9 ~O o Sun Mon Tue Wed Thu Fri Sat Total Gross Amount and And m E 7/3 7/4 7/5 7/6 7/7 7/8 7/9 Total Rate Earned/Gross Hourly Net Wages E m Hours of Pay Payroll "Usual FICA Withholding holding Other Soc Sec#of Employee Address > Benefits" Tax O o Hours Worked Each Day a 1. Surveyors `1 J Dental:$10.69, RG 0.00' 0.00 6.00 0.00 0.00 0.00 0.00 6.00 $68.09 $408.54 Health:$126.85, Construction Site Surveyor ZACHARY MALLOY (King) 12922 Rocky Creek $102.1 .1J WA Workers: Rd NW OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 $408.54/ $5.40/hr $162.15 $319.84 $4.63,DUES: $1,540.36 Gig Harbor,WA- $2,169.55 $3.83, UNION: 98329 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $18•1 $0.00 $1.20 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side • Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date Jasmine Neafus Office Administrator 7/14/2022 The party signing this report pays or _ (Name of contractor or subcontractor) supervises the payment of the persons W.E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: C'vall Avenue NE 7/3/2022 7/9/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms). Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.ZACHARY MALLOY Surveyors Construction Site Surveyor $5.40 J $0.00 $3.94 $0.61 $0.85 $0.00 (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. ,Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and '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 Jasmine Neafus Office Administrator Jasmine Neafus MB 7/21/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and rt..,�',", „ Project Name County Projector Contract# Industries ,1t< Prime Contractor ❑ '`��r.}•i,,,•u Duvall Avenue NE King CAG-20-065 Prevailing Wage Program t II1h,, ii - ,� : �{ = Subcontractor fRl PO Box 44540 °'..: or oy Project Address Olympia WA 98504-4540 4 A"°P Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W.E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 7/2/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date 1 Deductions H Work Classification Name c9 8o Sun Mon Tue Wed Thu Fri Sat Total m Gross Amount and And a) E 6/26 6/27 6/28 6/29 6/30 7/1 7/2 Total Rate Hourly Earned/Gross WithholdingNet Wages 03 E i= Hours of Pay pa roll "Usual FICA Other rnf a) y Soc Sec#of Employee Address O Benefits" Tax Et o Hours Worked Each Day 1. Surveyors `, " Dental:$10.69, RG 0.00 0.00 6.00 0.00 0.00 0.00 0.00 6.00 $68.09 $408.54 Health:$126.85, Construction Site Surveyor ZACHARY MALLOY (King) 12922 Rocky Creek $102.1 �/ WA Workers: Rd NW OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 $408.54/ $5.40/hr $143.05 $262.32 $3.47,DUES: $1,313.43 Gig Harbor,WA- $1,869.87 $7.66, UNION: 98329 $2.40 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $136.1 $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 Jasmine Neafus Office Administrator 7/8/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W. E.Coates Surveying, LLC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 6/26/2022 7/2/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.ZACHARY MALLOY Surveyors Construction Site Surveyor $5.40 $0.00 $3.94 $0.61 $0.85 $0.00 (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages.earned. 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 Jasmine Neafus Office Administrator Jasmine Neafus MB 7/11/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and ��;��!���s°� Project Name County Project or Contract# Industries Prime Contractor ❑ ,i �,,,;- ti„:=:,:r Duvall Avenue NE King CAG-20-065 Prevailing Wage Program <t+i;. +;"_` ��j!:;," : tll.�� Subcontractor M PO Box 44540 ° '�►` w y Project Address Olympia WA 98504-4540 H """ Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W.E.Coates Surveying, LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 6/25/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions p Work Classification Name c7 ~O o Sun Mon Tue Wed Thu Fri Sat Total a� Gross Amount and And a E 6/19 6/20 6/21 6/22 6/23 6/24 6/25 Total Rate Earned/Gross Hourly Net Wages E i= Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address 17 O o Hours Worked Each Day PayrollBenefits" 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 Jasmine Neafus Office Administrator 7/1/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W. E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: niivall Avenue NE 6/19/2022 6/25/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. " Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and lining Council. Falsification of any of the above statements is a violation of-RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature Jasmine Neafus Office Administrator Jasmine Neafus MB 7/5/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and i,,'T"''E Prime Contractor ❑ Project Name County Project or Contract# ��.,i: :.. ,-. Industries _ ��4• -wsi: `:_;i„ Duvall Avenue NE King CAG-20-065 Prevailing Wage Program <°;ii. "Ii== Subcontractor ❑x li` Project Address PO Box 44540 °;�y"i a,,y Olympia WA 98504-4540 4 '""o • Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W.E.Coates Surveying, LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 6/18/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions H= Work Classification Name C7 F2- Sun Mon Tue Wed Thu Fri Sat Total a� Gross Amount and And a� 6/12 6/13 6/14 6/15 6/16 6/17 6/18 Total Rate Earned/Gross Hourly Net Wages E i= Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address C > - Payroll Benefits" Tax 12 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 Jasmine Neafus Office Administrator 6/23/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W. E.Coates Surveying, LLC employed by: Project Name: For the week starting: For the week ending: fall Avenue NE 6/12/2022 6/18/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. 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 Jasmine Neafus Office Administrator Jasmine Neafus MB 6/24/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and rnre Project Name County Project or Contract# -sliDnt a ", Prime Contractor E Industries di! ,. f. �a!11' ' .!!!y? Duvall Avenue NE King CAG-20-065 Prevailing Wage Program IiiiiiF' /411Er Subcontractor PO Box 44540 °'.',II „µ a�,y". Project Address Olympia WA 98504-4540 Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W.E.Coates Surveying, LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 6/11/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions IL- Work Classification Name C7 ~O o Sun Mon Tue Wed Thu Fri Sat Total E 6/5 6/6 6/7 6/8 6/9 6/10 6/11 Total Rate Gross Amount Hourly and And E 0 Earned/Gross Hours of Pay Payroll "Usual FICA WithholdingNet Wages Tax Other Soc Sec#of Employee Address > - 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 Jasmine Neafus Office Administrator 6/17/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W. E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 6/5/2022 6/11/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side - The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ling Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature Jasmine Neafus Office Administrator Jasmine Neafus MB 6/17/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and ��,caAr(: Project Name County Project or Contract# Industries Prime Contractor ❑ p!a , __ Duvall Avenue NE King CAG-20-065 Prevailing Wage Program ill ii ;; _�;;(_ {fir Subcontractor n PO Box 44540 `;ty`.�` S' 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 W.E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 6/4/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions F= Work Classification Name (. ~O - Sun Mon Tue Wed Thu Fri Sat Total a> Gross Amount and And t.. a) E 5/29 5/30 5/31 6/1 6/2 6/3 6/4 Total Rate Earned/Gross Hourly Net Wages E i Hours of Pay Payroll Usual FICA Withholding Other Soc Sec#of Employee Address aO1i > - y Benefits" Tax n O o Hours Worked Each Day 0 1. Surveyors 4 J Dental:$10.69, Construction Site Surveyor ZACHARY MALLOY RG 0.00 0.00 0.00 0.00 0.00 4.00 0.00 4.00 $68.09 $272.36 Health:$126.85, (King) 12922 Rocky Creek $102.1 $272.36/ Workers' Rd NW OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 $2 017.57 $5.40/hr $154.34 $295.47 Compensation: $1,425.88 ********* Gig Harbor,WA- $4.34 98329 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1$36.1 $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 Jasmine Neafus Office Administrator 6/8/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W. E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: n""vall Avenue NE 5/29/2022 6/4/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.ZACHARY MALLOY Surveyors Construction Site Surveyor $5.40 $0.00 $3.94 $0.61 $0.85 $0.00 (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to'or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. ,\ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and 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 Jasmine Neafus Office Administrator Jasmine Neafus • MB 6/8/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and r..kr, Project Name County Project or Contract# , tiot '', Prime Contractor ❑ Industries in;ura,u; Duvall Avenue NE King GAG-20-065 Prevailing Wage Program -;'ll tills,, Subcontractor Fi PO Box 44540 '.y"; Project Address Olympia WA 98504-4540 ""' Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W.E.Coates Surveying, LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 5/28/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions Work Classification Name ~O o Sun Mon Tue Wed Thu Fri Sat Total a) Gross Amount and And m E 5/22 5/23 5/24 5/25 5/26 5/27 5/28 Total Rate Earned/Gross Hourly Net Wages .E 7 Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address c > - y Benefits" Tax ellf O o Hours Worked Each Day a 1. Surveyors J J WA Workers: RG 0.00 0.00 6.00 0.00 0.00 6.00 0.00 12.00 $66.93 $803.16 $4.06, DUES: Construction Site Surveyor TRENT COATES J (King) 1625 7TH AVE SW $100.4 $803.16/ `� $7.66, UNION: PUYALLUP,WA- OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0 $0.00 $1,530.36 $6.56/hr $117.07 $192.46 $2.40 $1,206.71 98371 $133.8 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 6 $0.00 2. Surveyors Dental:$10.69, RG 0.00 0.00 0.00 0.00 3.00 0.00 0.00 3.00 $68.09 $204.27 Health: $126.85, Construction Site Surveyor ZACHARY MALLOY _- (King) 12922 Rocky Creek $102.1 WA Workers: Rd NW OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 $204.27/ $5.40/hr $179.02 $373.76 $5.76, DUES: $1,633.99 - '* Gig Harbor,WA- $2,340.13 $7.66,UNION: 98329 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1 8 36"1 $2.40 $0.00 I 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 Jasmine Neafus Office Administrator 6/2/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W. E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 5/22/2022 5/28/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.TRENT COATES Surveyors Construction Site Surveyor $6.56 $0.00 $3.94 $1.54 S1.08 $0.00 (King) 2.ZACHARY MALLOY Surveyors instruction Site Surveyor $5.40 $0.00 $3.94 $0.61 $0.85 $0.00 (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. ,—',any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and _ ,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 Jasmine Neafus Office Administrator Jasmine Neafus MB 6/4/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and Y.j,i Project Name County Project or Contract# ,afti. C: ''{ Prime Contractor ❑ Industries _ l°'y Duvall Avenue NE King CAG-20-065 Prevailing Wage Program ;rill� 111< Subcontractor PO Box 44540 '.r''' > Project Address Olympia WA 98504-4540 Final Week of (360) 902-5335 Payroll ❑ Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W.E.Coates Surveying, LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 5/21/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions H Work Classification Name c7 ~O o Sun Mon Tue Wed Thu Fri Sat Total Gross Amount and And j E 5/15 5/16 5/17 5/18 5/19 5/20 5/21 Total Rate Hourly E i= Hours of Pay Earned/Gross "Usual Withholding Net Wages o 'ESoc Sec#of Employee Address O o Hours Worked Each Day Benefits" Tax 0 J J 1. Surveyors RG 0.00 0.00 0.00 0.00 0.00 6.00 0.00 6.00 $66.93 $401.58 WA Workers: Construction Site Surveyor TRENT COATES Ni `/ $4.06, DUES: (King) 1625 7TH AVE SW $100.4 $401.58/ $7.66, UNION: PUYALLUP,WA- OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0 $0.00 $1,584.30 $6.56/hr $121.20 $199.17 $2.40 $1,249.81 98371 $133.8 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 6 $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 Jasmine Neafus Office Administrator 5/27/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W.E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: n.all Avenue NE 5/15/2022 5/21/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.TRENT COATES Surveyors Construction Site Surveyor $6.56 J $0.00 $3.94 $1.54 $1.08 $0.00 (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. " ,ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ling Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature Jasmine Neafus Office Administrator Jasmine Neafus MB 5/31/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �,5rarr Project Name County Project or Contract# a,1 _ °,, Prime Contractor ❑ Industries _ f. �::'.;� - i!!.*, Duvall Avenue NE King CAG 20 065 Prevailing Wage Program W;,,t=, ,tl.` Subcontractor PO Box 44540 '; ', y° Project Address Olympia WA 98504-4540 y� 'a ac Final Week of (360) 902-5335 Payroll ❑ 1 Awarding Agency Name Phone Company Name Phone For the week ending: RENTON,CITY OF (425)430-7303 W.E.Coates Surveying, LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 5/14/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions Work Classification Name 5 ~O o Sun Mon Tue Wed Thu Fri Sat Total m Gross Amount and And E 5/8 5/9 5/10 5/11 5/12 5/13 5/14 Total Rate Earned/Gross Hourly Net Wages E Hours of Pay Payroll "Usual FICA Withholding Other Soc Sec#of Employee Address c > -, Benefits" Tax 1/ O o Hours Worked Each Day a 1. Surveyors 4 `' WA Workers: RG 0.00 0.00 6.00 0.00 0.00 0.00 0.00 6.00 $66.93 $401.58 $4.34, DUES: Construction Site Surveyor TRENT COATES J (King) 1625 7TH AVE SW $100.4 $401.58/ J $15.31,UNION: PUYALLUP,WA- OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0 $0.00 $1,535.98 $6.56/hr $117.50 $193.16 $4.80 $1,200.87 98371 $133.8 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 6 $0.00 2. Surveyors Dental:$10.69, RG 0.00 0.00 0.00 0.00 6.00 0.00 0.00 6.00 $68.09 $408.54 Health:$126.85, Construction Site Surveyor ZACHARY MALLOY (King) 12922 Rocky Creek $102.1 WA Workers: Rd NW OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 $408.54/ $5.40/hr $173.88 $357.32 $5.79, DUES: $1,588.36 Gig Harbor,WA- $2,272.95 $7.66, UNION: 98329 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $136.1 $2.40 $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 Jasmine Neafus Office Administrator 5/24/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W.E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: +vall Avenue NE 5/8/2022 5/14/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F)Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.TRENT COATES Surveyors Construction Site Surveyor $6.56 J $0.00 $3.94 $1.54 $1.08 $0.00 (King) • 2.ZACHARY MALLOY ,irveyors Instruction Site Surveyor $5.40 $0.00 $3.94 $0.61 $0.85 $0.00 (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. '°any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ,`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 Jasmine Neafus Office Administrator Jasmine Neafus MB 5/24/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Department of Labor and Industries CERTIFIED PAYROLL REPORT Prevailing Wage Program PO Box 44540 Prime Contractor LI Project Name County r Project or Contract# Olympia,WA 98504-4540 (360)902-5335 21-16-Duvall Avenue NE KING Subcontractor 1X Project Address City State ZIP+4 Duvall Ave NE Renton WA Awarding Agency Name Phone Company Name Phone For the week ending: Renton,City of W E Coates Surveying LLC (360)413-0510 Month Day Year Address City State ZIP+4 Address City State ZIP+4 05 / 07 / 2022 9825 Glory Dr SE Olympia WA 98513 Deductions DAY AND DATE Work Classification Name Total and and Earn SUN MON TUE WED THU FRI I SAT Total Rate Hourly Withhold- Soc Sec#of Employee Address Code Hours of Gross Amount "Usual FICA ing Tax Other NET 05/01 05/02 05/03 05/04 05/05 05/06105/07 Pay Earned Benefits" WAGES HOURS WORKED EACH DAY No Work Performed I F700-065-000 certified payroll report 05-09 Page 1 OF 1 Department of Labor and Industries Prevailing Wage Program AFFIRMATION PO Box 44540 Olympia WA 98504-4540 Page 1 of 1 Today's Date Printed name of party signing this report Title 05/12/22 Jasmine Neafus Office Administrator The party signing this report pays or supervises the (Name of contractor or subcontractor) payment of the persons employed by: W E Coates Surveying LLC Project Name: For the week starting: For the week ending: 21-16-Duvall Avenue NE 05/01/22 05/07/22 "USUAL BENEFITS"DISTRIBUTION (Please report in"per hour"terms) Total Hourly (E)Approved Work Classification "Usual Benefits" (A)Hourly Pension (B)Hourly Medical (C)Hourly Vacation (D)Hourly Holiday Apprentice Program (A+B+C+D+E) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. The party signing below AFFIRMS the following: (I) 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. Print or type name of party signing this report Title Signature tt Jasmine Neafus Office Administrator `SIM l r1(� Ne F700-065-000 certified payroll report backer 05-09 MB 5/17/22 Certified Payroll Report Department of Labor and �, r�rE: Project Name County Project or Contract# Industries •s0.:1 6`f Prime Contractor ❑ '::::' r, Duvall Avenue NE King CAG-20-065 Prevailing Wage Program <::::. z XI PO Box 44540 -- l Subcontractor .k `� Project Address Olympia WA 98504-4540 may"1 18Ad"(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 W.E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 4/30/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions P Work Classification Name cc& ~O o Sun Mon Tue Wed Thu Fri Sat Total Gross Amount and And E 4/24 4/25 4/26 4/27 4/28 4/29 4/30 Total Rate Hourly Hours of PayEarned/Gross °Usual WithholdingNet Wages r a> Payroll FICAOther Soc Sec#of Employee Address rn > Benefits" Tax O o Hours Worked Each Day a J NI 1. Surveyors RG 0.00 0.00 0.00 0.00 2.00 0.00 0.00 2.00 $68.09 $136.18 Dental:$10.69, Construction Site Surveyor ZACHARY MALLOY / Health:rkers:$126.85, (King) 12922 Rocky Creek $102.1 V WA Workers: Rd NW OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 $136.18/ $5.40/hr $133.77 $235.11 $4.63,DUES: $1,227.53 Gig Harbor,WA- $1,748.64 $7.66, UNION: 98329 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $186'1 $0.00 $2.40 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date Jasmine Neafus Office Administrator 5/5/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W. E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: vall Avenue NE 4/24/2022 4/30/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.ZACHARY MALLOY Surveyors Construction Site Surveyor $5.40 J $0.00 $3.94 $0.61 $0.85 $0.00 (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. -' Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ,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 Jasmine Neafus Office Administrator Jasmine Neafus MB 5/9/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �,STAif: Project Name County Project or Contract# Industries Prevailing Wage Program i .�:.. Prime Contractor ❑ _A l i£, ii_=r ii Subcontractor X Duvall Avenue NE King CAG-20-065 PO Box 44540 `;MI� 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 W.E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 4/23/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions H Work Classification Name 3 ~O o Sun Mon Tue Wed Thu Fri Sat Total Gross Amount m E 4/17 4/18 4/19 4/20 4/21 4/22 4/23 Total Rate Hourly and And Earned/Gross Net Wages d Hours of Pay Payroll Net FICA Withholdingf Other Soc Sec#of Employee Address cC O o Hours Worked Each Day Benefits" Tax 0 No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date Jasmine Neafus Office Administrator 4/28/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W. E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: /all Avenue NE 4/17/2022 4/23/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E) Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F No Employees performed work on this project during this reporting period. F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker,laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. !g'4ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ining Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature Jasmine Neafus Office Administrator Jasmine Neafus MB 5/2/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and Project Name County Project or Contract# Industries fir-,,!l ";Y Prime Contractor CI::1.f+ :ls Duvall Avenue NE King CAG-20-065 Prevailing Wage Program =glib'' uE ; Subcontractor PO Box 44540 ,y,ts. 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 W.E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 4/16/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions IL- Work Classification Name (- ~ 9- Sun Mon Tue Wed Thu Fri Sat Total ce O d Gross Amount and And cu E 4/10 4/11 4/12 4/13 4/14 4/15 4/16 Total Rate Hourly cu E H Hours of PayEarned/Gross "Usual Withholding Net Wages rn f m Payroll Benefits" FICA Tax Other Soc Sec#of Employee Address CD O in o Hours Worked Each Day 0 / 1. Surveyors `� `/ Dental:$10.69, RG 0.00 0.00 0.00 0.00 2.00 0.00 0.00 2.00 $68.09 $136.18 Health:$126.85, Construction Site Surveyor ZACHARY MALLOY . (King) 12922 Rocky Creek $102 1 WA Workers: OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $0.00 $136.18/ $5.78,DUES: Rd NW q $5.40/hr $169.42 $343.08 $1,531.18 Gig Harbor,WA- $2,214.65 $21.05,UNION: 98329 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $18'1 $0.00 $6.60 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Affirmation Department of Labor and Industries Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Today's Printed name of party signing this report Title Date Jasmine Neafus Office Administrator 4/21/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W.E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 4/10/2022 4/16/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour"terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.ZACHARY MALLOY Surveyors / Construction Site Surveyor $5.40 V/ $0.00 $3.94 $0.61 $0.85 $0.00 (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans,funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. (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 Jasmine Neafus Office Administrator Jasmine Neafus M B 4/22/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and Project Project Name County Project or Contract# Industries ;.;.;'•' 'i"•°`� Prime Contractor ❑ Prevailing Wage Program -•-° ii,,, Duvall Avenue NE King CAG-20-065 171 PO Box 44540 ,, ;,, , `€L:: Subcontractor 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 W.E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 4/9/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions p Work Classification Name c7 ~O o Sun Mon Tue Wed Thu Fri Sat Total a) Gross Amount and And a� E 4/3 4/4 4/5 4/6 4/7 4/8 4/9 Total Rate Earned/Gross Hourly Net Wages E Hours of Pay "Usual FICA Withholding Other Soc Sec#of Employee Address ct o 13 o Hours Worked Each Day Payroll Benefits" Tax 0 J J 1. Surveyors RG 0.00 0.00 6.00 6.00 0.00 0.00 0.00 12.00 $68.09 $817.08 Dental:$10.69, V Construction Site Surveyor ZACHARY MALLOY ' J Health:$126.85, (King) 12922 Rocky Creek $102.1 J WA Workers: Rd NW OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 $817.08/ $5.40/hr $176.63 $366.12 $5.79, DUES: $1,662.81 "-""`k Gig Harbor,WA- $2,358.95 $7.66, UNION: 98329 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $1 8 36'1 $2.40 $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 Jasmine Neafus Office Administrator 4/13/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W. E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 4/3/2022 4/9/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.ZACHARY MALLOY Surveyors Construction Site Surveyor $5.40 v $0.00 $3.94 $0.61 $0.85 $0.00 (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. 1-:'_Any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and ning Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature Jasmine Neafus Office Administrator Jasmine Neafus MB 4/18/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Certified Payroll Report Department of Labor and �,s,�r�, Project Name County Project or Contract# Industries ; V;77 ° Prime Contractor ❑ Prevailing Wage Program .i. _=x� Duvall Avenue NE King CAG-20-065 �._:, �l� Subcontractor PO Box 44540 "'' , 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 W.E.Coates Surveying,LLC (360)413-0510 Month Day Year Awarding Agency Address Address City State Zip+4 4/2/2022 1055 S GRADY WAY RENTON,WA-98055 9825 Glory Drive SE Olympia WA 98513 Day and Date Deductions H Work Classification Name 6 ~O o Sun Mon Tue Wed Thu Fri Sat Total ce „ Gross Amount and And a� E 3/27 3/28 3/29 3/30 3/31 4/1 4/2 Total Rate Earned/Gross Hourly Net Wages E i Hours of Pay "Usual FICA Withholding Other rn r a) Payroll Benefits" Tax Soc Sec#of Employee Address cc O o Hours Worked Each Day 0 J J 1. Surveyors RG 0.00 3.00 0.00 0.00 0.00 0.00 0.00 3.00 $68.09 $204.27 / Dental:$10.69, Construction Site Surveyor ZACHARY MALLOY J f Health:$126.85, (King) 12922 Rocky Creek $102.1 $204.27/ v WA Workers: Rd NW OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4 $0.00 $2 844.97 $5.40/hr $217.64 $497.13 $6.49 $1,986.17 * _ ***** Gig Harbor,WA- 98329 DT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $18 36.1 $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 Jasmine Neafus Office Administrator 4/8/2022 The party signing this report pays or (Name of contractor or subcontractor) supervises the payment of the persons W.E.Coates Surveying,LLC employed by: Project Name: For the week starting: For the week ending: Duvall Avenue NE 3/27/2022 4/2/2022 "USUAL BENEFITS" DISTRIBUTION (Please report in "per hour" terms) Work Classification Total Hourly (A) Hourly (B) Hourly (C) Hourly (D) Hourly (E)Approved (F) Other "Usual Pension Medical Vacation Holiday Apprentice Benefits Benefits" Program (A+B+C+D+E+F 1.ZACHARY MALLOY Surveyors Construction Site Surveyor $5.40 J $0.00 $3.94 $0.61 $0.85 $0.00 (King) F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side The party signing below AFFIRMS the following: (1)All information contained in this Certified Payroll Report, including any addenda, is correct and complete. (2)The wage rates for workers, laborers or mechanics as reported above are not less than the applicable wage rates contained in any wage determination related to the contract; and the classifications as reported above for each worker, laborer or mechanic conform with the actual work performed by such worker, laborer or mechanic. (3)The payments of usual benefits as listed above have been or will be made to appropriate approved plans, funds or programs for the benefit of such employees. (4)All persons employed on the above-referenced project(s) have been paid the full weekly wages earned, and no rebates have been or will be made either directly or indirectly to or on behalf of the above-named contractor or subcontractor from the weekly wages earned by any person. No deductions, other than those which are legally permissible, have been made by any person either directly or indirectly from the full wages earned. .'=',/i\ny apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with the Washington State Apprenticeship and lining Council. Falsification of any of the above statements is a violation of RCW 39.12.050 subject to prosecution, sanctions, and penalties. Printed name of party signing this report Title Signature Jasmine Neafus Office Administrator Jasmine Neafus MB 4/18/22 F700-065-000 certified payroll report 05-09 Employee Benefits Distribution and Signature Certification on Reverse Side Department of Labor and Industries CERTIFIED PAYROLL REPORT Prevailing Wage Program PO Box 44540 Prime Contractor E Project Name County Project or Contract# Olympia,WA 98504-4540 21-16-Duvall Avenue NE KING (360)902-5335 Subcontractor LX Project Address City State ZIP+4 Duvall Ave NE Renton WA Awarding Agency Name Phone Company Name Phone For the week ending: Renton,City of W E Coates Surveying LLC (360)413-0510 Month Day Year Address City State ZIP+4 Address City State ZIP+4 • 03 / 26 / 2022 9825 Glory Dr SE Olympia WA 98513 Deductions DAY AND DATE Work Classification Name Total and and Earn SUN MON TUE WED THU FRI I SAT Total Rate Hourly Withhold- Soc Sec#of Employee Address Code - Hours of Gross Amount "Usual FICA ing Tax Other NET 03/20 03/21 03/22 03/23 03/24 03/25103/26 Pay Earned Benefits" WAGES HOURS WORKED EACH DAY ` No Work Performed F700-065-000 certified payroll report 05-09 Page 1 OF 1 . Department of Labor and Industries Prevailing Wage Program AFFIRMATION PO Box 44540 Olympia WA 98504-4540 Page 1 of 1 Today's Dale Printed name of party signing this report Title 04/02/22 Jasmine Neafus Office Administrator The party signing this report pays or supervises the (Name of contractor or subcontractor) payment of the persons employed by: W E Coates Surveying LLC Project Name: For the week starting: For the week ending: 21-16-Duvall Avenue NE 03/20/22 03/26/22 "USUAL BENEFITS"DISTRIBUTION (Please report in"per hour"terms) Total Hourly Work Classification "Usual Benefits" (A)Hourly Pension (B)Hourly Medical (C)Hourly Vacation (D)Hourly Holiday (E)Approved (A+B+C+D+ Apprentice Program 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. The party signing below AFFIRMS the following: (I) 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. Print or type name of party signing this report Title Signature Jasmine Neafus Office Administrator /�'�Sm f,Vt& F700-065-000 certified payroll report backer 05-09 �J MB 4/5/22 Department of Labor and Industries CERTIFIED PAYROLL REPORT Prevailing Wage Program • PO-Box 44540 Prime Contractor E Project Name County Project or Contract# Olympia,WA 98504-4540 (360)902-5335 21-16-Duvall Avenue NE KING • Subcontractor IX Project Address City State ZIP+4 Duvall Ave NE Renton WA Awarding Agency Name Phone Company Name Phone For the week ending: Renton,City of W E Coates Surveying LLC (360)413-0510 Month Day Year Address City State ZIP+4 Address City State ZIP+4 03 / 19 / 2022 9825 Glory Dr SE Olympia WA 98513 Deductions DAY AND DATE Work Classification Name Total and and Earn SUN MON TUE WED THU FRI I SAT Total Rate Hourly Withhold- Soc Sec#of Employee Address Code Hours of Gross Amount "Usual FICA ing Tax Other NET 03/13 03/14 03/15 03/16 03/17 03/18I03/19 Pay Earned Benefits" WAGES HOURS WORKED EACH DAY Instruction Site MALLOY,ZACHARY M REG 2.00 2.00168.090,. 1136.18 136.18 1 5.400 10.42 17.91 0.37 107.48 .,�nreyor 12922 Rocky Creek Rd NW OTHER DETAIL: Ded. Amt. ***-**-0134 Gig Harbor,WA 98329 WC 0.37 F700-065-000 certified payroll report 05-09 Page 1 OF 1 Department ent Labor and Industries AFFIRMATION Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Page 1 of 1 Today's Date Printed name of party signing this report Title 03/24/22 Jasmine Neafus Office Administrator The party signing this report pays or supervises the (Name of contractor or subcontractor) payment of the persons employed by: W E Coates Surveying LLC Project Name: For the week starting: For the week ending: 21-16-Duvall Avenue NE 03/13/22 03/19/22 "USUAL BENEFITS"DISTRIBUTION (Please report in"per hour"terms) Total Hourly Work Classification "Usual Benefits" (A)Hourly Pension (B)Hourly Medical (C)Hourly Vacation (D)Hourly Holiday (E)Approved (A+B+C+n+E) Apprentice,Program 1. Construction Site Surveyor 15.400 3.940 0.610 0.850 2. 3. 4. 5. 6. 7. 8. 9. 10. The party signing below AFFIRMS the following: (I) 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. Print or type name of party signing this report Title Signature Jasmine Neafus Office Administrator F700-065-000 certified payroll report backer 05-09 M B 3/24/22 03/24/2022 02:22:31 PM W E Coates Surveying LLC Page 1 of 1 Payroll Certification Report 21-16-Duvall Avenue NE 03/13/22 To 03/19/22 Employee Trade jl Pension I Medical I Vacation I Holiday I Apprentice I I Total I 7-MALLOY,ZACHARY M Construction Site Surveyc 3.940 0.610 0.850 5.400 Department of Labor and Industries CERTIFIED PAYROLL REPORT Prevailing Wage Program PO Box 44540 Prime Contractor E Project Name County Project or Contract# Olympia,WA 98504-4540 (360)902-5335 21-16-Duvall Avenue NE KING Subcontractor LX Project Address City State ZIP+4 Duvall Ave NE Renton WA Awarding Agency Name Phone Company Name Phone For the week ending: Renton,City of W E Coates Surveying LLC (360)413-0510 Month Day Year Address City State ZIP+4 Address City State ZIP+4 03 / 12 / 2022 9825 Glory Dr SE Olympia WA 98513 Deductions DAY AND DATE Work Classification Name Total and and Earn SUN MON TUE WED THU FRI I SAT Total Rate Hourly Withhold- Soc Sec#of Employee Address Code Hours of Gross Amount "Usual FICA ing Tax Other NET 03/06 03/07 03/08 03/09 03/10 03/11103/12 Pay Earned Benefits" WAGES HOURS WORKED EACH DAY Dnstruction Site MALLOY,ZACHARY M REG _ 6.00 6.00 2.00 14.00468.090 953.26 953.26 5.400 72.93 142.33 2.52 735.48 .,urveyor -12922 Rocky Creek Rd NW OTHER DETAIL: Ded. Amt. ***-**-0134 Gig Harbor,WA 98329 WC 2.52 F700-065-000 certified payroll report 05-09 Page 1 OF 1 Department of Labor and Industries Prevailing Wage Program AFFIRMATION PO Box 44540 Olympia WA 98504-4540 Page 1 of 1 Today's Date Printed name of party signing this report Title 03/18/22 Jasmine Neafus Office Administrator _ The party signing this report pays or supervises the (Name of contractor or subcontractor) payment of the persons employed by: W E Coates Surveying LLC Project Name: For the week starting: For the week ending: 21-16-Duvall Avenue NE 03/06/22 03/12/22 "USUAL BENEFITS"DISTRIBUTION (Please report in"per hour"terms) Total Hourly (E)Approved Work Classification "Usual Benefits" (A)Hourly Pension (B)Hourly Medical (C)Hourly Vacation (D)Hourly Holiday (A+s+c+n+/E) Apprentice Program 1.Construction Site Surveyor 5.400 3.940 0.610 0.850 2. 3. 4. 5. 6. 7. 8. 9. 10. 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. Print or type name of party signing this report Title Signature Jasmine Neafus Office Administrator a/LS*1 VI& Ntte F700-065-000 certified payroll report backer 05-09 MB 3/24/22 03/18/2022 05:28:50 PM W E Coates Surveying LLC Page 1 of 1 Payroll Certification Report 21-16-Duvall Avenue NE 03/06/22 To 03/12/22 Employee Trade Pension Medical I Vacation I Holiday I Apprentice I I Total 7-MALLOY,ZACHARY M Construction Site Survey( 3.940 0.610 0.850 5.400 Department of Labor and Industries CERTIFIED PAYROLL REPORT Prevailing Wage Program PO Box 44540 Prime Contractor E Project Name County Project or Contract# Olympia,WA 98504-4540 (360)902-5335 21-16-Duvall Avenue NE KING Subcontractor X Project Address . City State ZIP+4 Duvall Ave NE Renton WA Awarding Agency Name Phone Company Name Phone For the week ending: Renton,City of W E Coates Surveying LLC • (360)413-0510 Month Day Year Address City State ZIP+4 Address City State ZIP+4 03 / 05 / 2022 9825 Glory Dr SE Olympia WA 98513 Deductions DAY AND DATE Work Classification Name Total ' and and Earn SUN MON TUE WED THU FRI I SAT Total Rate Hourly Withhold- Soc Sec#of Employee Address Code Hours of Gross Amount "Usual FICA ing Tax Other NET 02/27 02/28 03/01 03/02 03/03 03/04 03/05 P7 Earned Benefits" WAGES HOURS WORKED EACH DAY nnstruction Site MALLOY,ZACHARY M REG 6.00 6.00 68.090 408.54 408.54 45.400 31.25 59.29 1.07 316.93 jurveyor 12922 Rocky Creek Rd NW OTHER DETAIL: Ded. Amt. ***-**-0134 Gig Harbor,WA 98329 WC 1.07 F700-065-000 certified payroll report 05-09 - Page 1 OF 1 Department of Labor and Industries - Prevailing Wage Program AFFIRMATION PO Box 44540 Olympia WA 98504-4540 Page 1 of 1 Today's Dale Printed name of party signing this report Title 03/10/22 Jasmine Neafus Office Administrator - The party signing this report pays or supervises the (Name of contractor or subcontractor) payment of the persons employed by: W E Coates Surveying LLC Project Name: For the week starting: For the week ending: 21-16-Duvall Avenue NE 02/27/22 03/05/22 "USUAL BENEFITS"DISTRIBUTION (Please report in"per hour"terms) Total Hourly (E)Approved Work Classification "Usual Benefits" (A)Hourly Pension (B)Hourly Medical (C)Hourly Vacation (D)Hourly Holiday Apprentice Program (A+B+C+D+E) 1. Construction Site Surveyor 5.400 3.940 0.610 0.850 2. 3. 4. 5. 6. 7. 8. 9. 10. 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. Print or type name of party signing this report Title Signature e Jasmine Neafus Office Administrator � d'�.SlN1 t NIG '�40-Q� F700-065-000 certified payroll report backer 05-09 03/10/2022 02:41:18 PM W E Coates Surveying LLC Page 1 of 1 Payroll Certification Report 21-16-Duvall Avenue NE 02/27/22 To 03/05/22 Employee Trade Pension I Medical I Vacation I Holiday I Apprentice I I Total I 7-MALLOY,ZACHARY M Construction Site Surveyc 3.940 0.610 0.850 5.400 " MB 3/14/22 Department of Labor and Industries CERTIFIED PAYROLL REPORT Prevailing Wage Program PO Box 44540 Prime Contractor LI Project Name County Project or Contract# Olympia,WA 98504-4540 (360)902-5335 L/C_ 21-16-Duvall Avenue NE KING Subcontractor � Project Address City State ZIP+4 ' Duvall Ave NE Renton WA Awarding Agency Name Phone Company Name Phone For the week ending: Renton,City of W E Coates Surveying LLC (360)413-0510 Month Day Year Address City State ZIP+4 Address City State ZIP+4 02 / 26 / 2022 9825 Glory Dr SE Olympia WA 98513 Deductions DAY AND DATE Work Classification Name Total and and Earn SUN MON TUE WED THU FRI I SAT Total Rate Hourly Withhold- Soc Sec#of Employee Address Code Hours • of Gross Amount "Usual FICA ing Tax Other NET 02/20 02/21 02/22 02/23 02/24 02/25IO2/26 Pay Earned Benefits" WAGES L- HOURS WORKED EACH DAY I. No Work Performed F700-065-000 certified payroll report 05-09 Page 1 OF 1 Department Labor and Industries AFFIRMATION Prevailing Wage Program AFFIRMATION PO Box 44540 Olympia WA 98504-4540 Page 1 of 1 Today's Dale Printed name of party signing this report Title 03/02/22 Jasmine Neafus Office Administrator The party signing this report pays or supervises the (Name of contractor or subcontractor) payment of the persons employed by: W,E Coates Surveying LLC Project Name: For the week starting: For the week ending: 21-16-Duvall Avenue NE 02/20/22 02/26/22 "USUAL BENEFITS"DISTRIBUTION (Please report in"per hour"terms) Total Hourly (E)Approved Work Classification "Usual Benefits" - (A)Hourly Pension (B)Hourly Medical (C)Hourly Vacation (D)Hourly Holiday Apprentice Program (A+B+C+D+E) 1. • 2. 3. 4: 5. 6. 7. 8. 9. 10. The party signing below AFFIRMS the following: (I) 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. • Print or type name of party signing this report Title Signature Jasmine Neafus Office Administrator F700-065-000 certified payroll report backer 05-09 • MB 3/5/22 Department of Labor and Industries Prevailing Wage Program CERTIFIED PAYROLL REPORT PO Box 44540 Prime Contractor LI Project Name County Project or Contract# Olympia,WA 98504-4540 (360)902-5335 21-16-Duvall Avenue NE KING Subcontractor L Project Address City State ZIP+4 Duvall Ave NE Renton WA Awarding Agency Name Phone Company Name Phone For the week ending: Renton,City of W E Coates Surveying LLC (360)413-0510 Month Day Year Address City State ZIP+4 Address City State ZIP+4 02 / 19 / 2022 9825 Glory Dr SE Olympia WA 98513 Deductions DAY AND DATE Work Classification Name Total and and Earn SUN MON TUE WED THU FRI I SAT Total Rate Hourly Withhold- Soc Sec#of Employee Address Code Hours of Gross Amount "Usual FICA ing Tax Other NET 02/13 02/14 02/15 02/16 02/17 02/18 02/19 Pave \tarned J Benefits" WAGES HOURS WORKED EACH DAY J ,� onstruction Site MALLOY,ZACHARY M REG 6.00 6.00 68.090 408:54 408.54 5.400 31.25 62.61 1.08 313.60 .urveyor 12922 Rocky Creek Rd NW OTHER DETAIL: Ded. Amt. ** **0134 Gig Harbor,WA 98329 WC 1.08 F700 065 000 certified payroll report 05-09 Page 1 OF 1 D ent Labor and Industries AFFIRMATION Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Page 1 of 1 Today's Date Printed name of party signing this report Title 02/23/22 Jasmine Neafus Office Administrator The party signing this report pays or supervises the (Name of contractor or subcontractor) payment of the persons employed by: W E Coates Surveying LLC Project Name: For the week starting: For the week ending: 21-16-Duvall Avenue NE 02/13/22 02/19/22 "USUAL BENEFITS"DISTRIBUTION (Please report in"per hour"terms) Total Hourly (E)Approved Work Classification "Usual Benefits" (A)Hourly Pension (B)Hourly Medical (C)Hourly Vacation (D)Hourly Holiday (A+B+C+n+/k) Apprentice Program 1.Construction Site Surveyor V 5.400 3.940 0.610 0.850 3. 4. 5. 6. • 7. 8. 9. 10. 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. Print or type name of party signing this report Title Signature Jasmine Neafus ' Office Administrator �sM/l itte 11/4.63C1-1-% F700-065-000 certified payroll report backer 05-09 MB 3/1/22 02/23/2022 06:08:46 PM W E Coates Surveying LLC Page 1 of 1 Payroll Certification Report 21-16-Duvall Avenue NE 02/13/22 To 02/19/22 Employee Trade Pension I Medical Vacation I Holiday I Apprentice I I Total 7-MALLOY,ZACHARY M Construction Site Surveyc 3.940 0.610 0.850 5.400 Department of Labor and Industries CERTIFIED PAYROLL REPORT Prevailing Wage Program PO Box 44540 Prime Contractor E Project Name County Project or Contract# Olympia,WA 98504-4540 (360)902-5335 21-16-Duvall Avenue NE KING Subcontractor L Project Address .City State ZIP+4 Duvall Ave NE Renton WA Awarding Agency Name Phone Company Name Phone For the week ending: Renton,City of W E Coates Surveying LLC (360)413-0510 Month Day Year Address City State ZIP+4 Address City State ZIP+4 02 / 12 / 2022 9825 Glory Dr SE Olympia WA 98513 Deductions DAY AND DATE Work Classification Name Total and and Earn SUN MON TUE WED THU FRI I SAT Total Rate Hourly Withhold- Soc Sec#of Employee Address Code 02/06 02/07 02/08 02/09 02/10 02/11 02/12 Hours of Gross Amount "Usual FICA ing Tax Other NET Pay Earned Benefits" WAGES HOURS WORKED EACH DAY No Work Performed I F700-065-000 certified payroll report 05-09 Page 1 OF 1 Department g Labor and industries AFFIRMATION Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Page 1 of 1 Today's Date Printed name of party signing this report Title 02/23/22 Jasmine Neafus Office Administrator The party signing this report pays or supervises the (Name of contractor or subcontractor) payment of the persons employed by: W E Coates Surveying LLC Project Namc: For the week starting: For the week ending: 21-16-Duvall Avenue NE 02/06/22 02/12/22 • "USUAL BENEFITS"DISTRIBUTION (Please report in"per hour"terms) Total Hourly (E)Approved Work Classification "Usual Benefits" (A)Hourly Pension (B)Hourly Medical (C)Hourly Vacation (D)Hourly Holiday Apprentice Program (A+B+C+D+E) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. The party signing below AFFIRMS the following: (l) 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. Print or type name of party signing this report Title Signature �C 'Jasmine Neafus Office Administrator /f�.SMYL t t�IL F700-065-000 certified payroll report backer 05-09 VVV MB 3/1/22 Department of Labor and Industries CERTIFIED PAYROLL REPORT Prevailing Wage Program PO Box 44540 Prime Contractor LI Project Name County Project or Contract# Olympia,WA 98504-4540 (360)902-5335 21-16-Duvall Avenue NE KING Subcontractor L Project Address City State ZIP+4 Duvall Ave NE Renton WA Awarding Agency Name Phone Company Name Phone For the week ending: Renton,City of W E Coates Surveying LLC (360)413-0510 Month Day Year Address City State ZIP+4 Address City State ZIP+4 02 / 05 / 2022 9825 Glory Dr SE Olympia WA 98513 Deductions DAY AND DATE Work Classification Name Total and and Earn SUN MON TUE. WED THU FRI I SAT Total Rate Hourly Withhold- Soc Sec#of Employee Address Code Hours of Gross Amount "Usual FICA ing Tax Other NET 01/30 01/31 02/01 02/02 02/03 02/04 02/05 Pay Earned Benefits" WAGES HOURS WORKED EACH DAY r ' No Work Performed I F700-065-000 certified payroll report 05-09 Page 1 OF 1 Department Labor and Industries AFFIRMATION Prevailing Wage Program PO Box 44540 Olympia\VA 98504-4540 Page 1 of 1 Today's Date Printed name of party signing this report Title 02/11/22 Jasmine Neafus Office Administrator The party signing this report pays or supervises the (Name of contractor or subcontractor) payment of the persons employed by: W E Coates Surveying LLC Project Name: - For the week starting: For the week ending: 21-16-Duvall Avenue NE 01/30/22 02/05/22 "USUAL BENEFITS"DISTRIBUTION (Please report,in"per hour"terms) Total Hourly (E)Approved Work Classification "Usual Benefits" (A)Hourly Pension (B)Hourly Medical (C)Hourly Vacation (D)Hourly Holiday Apprentice Program (A+B+C+D+E) 2. 3. 4. 5. 6. 7. 8. 9. 10. The party signing below AFFIRMS the following: (I) 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. Print or type name of party signing this report Title Signature aiStni �CJasmine Neafus Office Administrator tali '" F700-065-000 certified payroll report backer 05-09 MB 2/11/22 Department of Labor and Industries CERTIFIED PAYROLL REPORT Prevailing Wage Program PO Box 44540 Prime Contractor E Project Name County Project or Contract# Olympia,WA 98504-4540 (360)902-5335 21-16-Duvall Avenue NE KING Subcontractor L Project Address City State ZIP+4 Duvall Ave NE Renton WA Awarding Agency Name Phone Company Name Phone For the week ending: Renton,City of W E Coates Surveying LLC (360)413-0510 Month Day Year Address City State ZIP+4 Address City State ZIP+4 01 / 29 / 2022 9825 Glory Dr SE Olympia WA 98513 Deductions DAY AND DATE Work Classification Name Total and and Earn SUN MON TUE WED THU FRI I SAT Total Rate Hourly Withhold- Soc Sec#of Employee Address Code - Hours of Gross Amount "Usual FICA ing Tax Other NET 01/23 01/24 01/25 01/26 01/27 01/28 01/29 Pay Earned Benefits" WAGES HOURS WORKED EACH DAY No Work Performed F700-065-000 certified payroll report 05-09 Page 1 OF 1 Department Labor and Industries AFFIRMATION Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Page 1 of 1 Today's Date Printed name of party signing this report Title 02/04/22 Jasmine Neafus Office Administrator The party signing this report pays or supervises the (Name of contractor or subcontractor) payment of the persons employed by: W ECoates Surveying LLC Project Name: - For the week starting: For the week ending: 21-16-Duvall Avenue NE 01/23/22 01/29/22 "USUAL BENEFITS"DISTRIBUTION (Please report in"per hour"terms) Total Hourly (E)Approved Work Classification "Usual Benefits" (A)Hourly Pension (B)Hourly Medical (C)Hourly Vacation (D)Hourly Holiday (A+B+C+D+E) Apprentice Program 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. The party signing below AFFIRMS the following: (I) 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. Print or type name of party signing this report Title Signature �� �? Jasmine Neafus Office Administrator jiSrieli lw F700-065-000 certified payroll report backer 05-09 MB 2/4/22 Department of Labor and Industries CERTIFIED PAYROLL REPORT Prevailing Wage Program PO Box 44540 Prime Contractor E Project Name County Project or Contract# Olympia,WA 98504-4540 (360)902-5335 21-16-Duvall Avenue NE KING Subcontractor IX Project Address City State ZIP+4 Duvall Ave NE Renton WA Awarding Agency Name Phone Company Name Phone For the week ending: Renton,City of W E Coates Surveying LLC (360)413-0510 Month Day Year Address City State ZIP+4 Address City State ZIP+4 01 / 22 / 2022 9825 Glory Dr SE Olympia WA 98513 Deductions DAY AND DATE Work Classification Name Total and and Earn SUN MON TUE WED THU FRI I SAT Total Rate Hourly Withhold- Soc Sec#of Employee Address Code Hours of Gross Amount "Usual FICA ing Tax Other NET 01/16 01/17 01/18 01/19 01/20 01/21 01/22 Pay Earned Benefits" WAGES HOURS WORKED EACH DAY No Work Performed F700-065-000 certified payroll report 05-09 Page 1 OF 1 Department of Labor and Industries AFFIRMATION Prevailing Wage Program PO Box 44540 Olympia WA 98504-4540 Page 1 of 1 Today's Date Printed name of party signing this report Title 01/25/22 Jasmine Neafus Office Administrator The party signing this report pays or supervises the (Name of contractor or subcontractor) payment of the persons employed by: W E Coates Surveying LLC Project Name: For the week starting: For the week ending: 21-16-Duvall Avenue NE 01/16/22 01/22/22 "USUAL BENEFITS"DISTRIBUTION (Please report in"per hour"terms) Total Hourly (E)Approved Work Classification "Usual Benefits" (A)Hourly Pension (B)Hourly Medical (C)Hourly Vacation (D)Hourly Holiday (A+a+C+n+E) Apprentice Program 1. , 2. 3. 4. 5. 6. 7. 8. 9. 10. 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. Print or type name of party signing this report Title Signature I �e '`^�Jasmine Neafus Office Administrator �.SWI,I,VVLi F700-065-000 certified payroll report backer 05-09 VVV MB 2/1/22 Department of Labor and Industries CERTIFIED PAYROLL REPORT Prevailing Wage Program PO Box 44540 Prime Contractor LI Project Name County Project or Contract# Olympia,WA 98504-4540 (360)902-5335 21-16-Duvall Avenue NE KING Subcontractor L Project Address City State ZIP+4 Duvall Ave NE Renton WA Awarding Agency Name Phone Company Name Phone For the week ending: Renton,City of W E Coates Surveying LLC (360)413-0510 Month Day Year Address City State ZIP+4• Address City State ZIP+4 01 / 15 / 2022 9825 Glory Dr SE Olympia WA 98513 Deductions DAY AND DATE Work Classification Name Total and and Earn SUN MON TUE WED THU FRI I SAT Total Rate Hourly Withhold- ' Soc Sec#of Employee Address Code - Hours of Gross Amount "Usual FICA ing Tax Other NET 01/09 01/10 01/11 01/12 01/13 01/14I01/15 Pay Earned Benefits" WAGES /. HOURS WORKED EACH DAY / ( :onstruction Site MALLOY,ZACHARY M OVT 1.00 1.001/ 8.090 /J102.14 1,123.49 J 5.400 85.94 194.12 2.66 840.77 surveyor 12922 Rocky Creek Rd NW REG _ _ 6.00 3.00 6.00 15.00 v 68.090 V 1,021.35 OTHER DETAIL: Ded. Amt. **'-**-0134 Gig Harbor,WA 98329 WC 2.66 F700-065-000 certified payroll report 05-09 Page 1 OF 1 • Department of Labor and Industries Prevailing Wage Program AFFIRMATION PO Box 44540 Olympia WA 98504-4540 Page 1 of 1 Today's Date Printed name of party signing this report Title 01/25/22 Jasmine Neafus Office Administrator The party signing this report pays or supervises the (Name of contractor or subcontractor) payment of the persons employed by: W E Coates Surveying LLC Project Name: For the week starting: For the week ending: 21-16-Duvall Avenue NE 01/09/22 01/15/22 "USUAL BENEFITS"DISTRIBUTION (Please report in"per hour"terms) Total Hourly (E)Approved Work Classification "Usual Benefits" (A)Hourly Pension (13)Hourly Medical (C)Hourly Vacation (D)Hourly Holiday Apprentice Program (A+B+C+D+p 1. Construction Site Surveyor 45.400 3.940 0.610 0.850 2. 3. 4. 5. 6. 7. 8. 9. 10. 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. Print or type name of party signing this report Title Signature Jasmine Neafus Office Administrator dLS1.vfltIt(iF700-065-000 certified payroll report backer 05-09 01/25/2022 01:40:25 PM W E Coates Surveying LLC Page 1 of 1 Payroll Certification Report 21-16-Duvall Avenue NE 01/09/22 To 01/15/22 Employee Trade Pension I Medical ( Vacation I Holiday I Apprentice I I Total I 7-MALLOY,ZACHARY M Construction Site Surveyc 3.940 0.610 0.850 5.400 MB 2/1/22 ' I • Department of Labor and Industries CERTIFIED PAYROLL REPORT Prevailing Wage Program PO Box 44540 Prime Contractor E Project Name County Project or Contract# Olympia,WA 98504-4540 21 16 Duvall Avenue NE KING (360)902-5335 Iv Subcontractor X Project Address City State ZIP+4 Duvall Ave NE Renton WA Awarding Agency Name Phone Company Name Phone For the week ending: Renton,City of W E Coates Surveying LLC (360)413-0510 Month Day Year Address City State ZIP+4 Address City State ZIP+4 01 / 08 / 2022 9825 Glory Dr SE Olympia WA 98513 Deductions DAY AND DATE Work Classification Name Total and and Earn SUN MON TUE WED THU FRI I SAT Total Rate Hourly Withhold- Soc Sec#of Employee Address Code Hours of Gross Amount "Usual FICA ing Tax Other NET 01/02 01/03 01/04 01/05 01/06 01/07 01/08 Pay Earned Benefit' WAGES - HOURS WORKED EACH DAY J J J instruction Site MALLOY,ZACHARY M REG 2.00 2.00 68.090 136.18 136.18 5.400 • 10.42 16.69 0.38 108.69 <urveyor 12922 RockyCreek Rd NW OTHER DETAIL: Ded. Amt. ***-**-0134 Gig Harbor,WA 98329 WC 0.38 F700-065-000 certified payroll report 05-09 Page 1 OF 1 Department Labor and Industries AFFIRMATION PrevailingWage Program PO Box 44540 Olympia WA 98504-4540 Page 1 of 1 Today's Dale Printed name of party signing this report Title 01/13/22 Jasmine Neafus Office Administrator The party signing this report pays or supervises the (Name of contractor or subcontractor) payment of the persons employed by: W E Coates Surveying LLC Project Name: For the week starting: For the week ending: 21-16-Duvall Avenue NE 01/02/22 01/08/22 "USUAL BENEFITS"DISTRIBUTION (Please report in"per hour"terms) Total Hourly (E)Approved Work Classification "Usual Benefits" (A)Hourly Pension (B)Hourly Medical (C)Hourly Vacation (D)Hourly Holiday Apprentice Program (A+B+C+D+E) 1. Construction Site Surveyor 5.400 J 3.940 0.610 0.850 2. 3. 4. 5. 6. 7. 8. 9. 10. 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. Print or type name of party signing this report Title Signature d'ASWYCL Mat/4Jasmine Neafus Office Administrator Vl+fi • F700-065-000 certified payroll report backer 05-09 MB 1/19/22 01/13/2022 03:40:59 PM W E Coates Surveying LLC Page 1 of 1 Payroll Certification Report 21-16-Duvall Avenue NE 01/02/22 To 01/08/22 Employee Trade II Pension I Medical I Vacation I Holiday I Apprentice I I Total 7-MALLOY,ZACHARY M Construction Site Surveyc 3.940 0.610 0.850 5.400