Okaloosa County BOCC — 2013 meeting #1141 (date undetermined) — CW Roberts DTS Rehab RW 14_32 Final Certified Payroll — reading text

566373 { ae STATEMENT Cr COMPLIANCE Date - 3/04/13 uve I, SHARON MACKEY “ »EEO OFFICER do hereby state: (1) That I pay or supervise the payment of the persons employed by C. W. (building or work} Destin Aiport Rehabilitate Runway 14-32 that during the payroll period 02/16/13 - 02/24/13 ; all persons employed on said project have been paid the full weekly wages earned, that no rebates have been or will be made either directly or indirectly to or on behalf of said (Contractor or Subcontractor} C. W. Roberts Contracting, Inc from the full weekly wages earned hy any person, and that no deductions have been made either directly or indirectly from the full wages earned by person, other than permissible deductions as defined in Regulations Part 3(29 CFR Subtitle A), issued by Secretary of Labor under the Copeland Ack, as amended (48 Stat. 948:63 Stat. 108:72 Stat. 967:76 Stat. 357:40 U.S.C 3145), Roberts Contracting, Ine en che and described below: Loan #1 » Life - AFLAC , Child Supp#1 » Uniforms , Overpayment , AFLAC-Cancer » Fortis-Dentl . AFLAC-Dental , Advance , AFLAC-Hosp ,» AFLAC-STD « APLAC » HIth-E-CWR » Hlth-F-CWR . Hith-EC-CWR + Hith-ES-CWR » 401K CWR 1 Loan #1 ,» Misc ' (2) That any payrolls otherwise under this contract required to be submitted for the above period are correct and complete; That the wage races far laborers and mechanics contained therein are not less than the applicable wage rates contained in any wage determination incorporated into the contract; that the classification set forth for each labarer ar mechanic confarm with the work performed {3) That any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with a State apprenticeship agency recognized by the Bureau of Apprenticeship and Training, United States Department of Labor, or if no such recognized agency exists in a State, are registered with the Bureau of Apprenticeship and Training, United States Department of Labor. {4) That: {a} WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, FUNDS, OR PROGRAMS n addition toa the basic hourly wage rates paid to each laborer or mechanic listed in the above referenced payroll, payments of fringe benefits as listed in the contract have been or will he made to appropriate programs for the benefit of such employees, except as noted in Section 4{c} below ** SEE ATTACHED BENEFIT SHEET ** (b) WHERE FRINGE BENEFITS ARE PAID IN CASH {| | Each laborer or mechanic listed in the above referenced payroll has been paid, as indicated on the payroll an amount not less than the sum o£ che applicahle basic hourly rate plus the amount of the required except as noted in Section4{c) below. fringe benefits as listed in the contract, (ce) EXCEPTIONS {CRAFT) EXCEPTION EXPLANATION Remarks: NAME AND TITLE SIGNATURE horn VEE SHARON MACKEY ,EEO OFFICER THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEMENTS MAY SUBJECT THE CONTRACT! de OR SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION. SEE SECTION 1001 OF TITLE 18 AND SECTION 231 OF TITLE 31 OF THE UNITED STATES CODE. $6372 Cc. W. Roberts Construction Certified Payroll Report w/Fringe Info C.W. Roberts Contracting, Inc. 3372 Capital Circle NE TallahasseFL 32308 Soc.Sec.No FMS Dep S Cac Mn Name/Address XXX-XX-3217 M1 M003 a2 Christopher 5S. Davis Male White (Not of Hispanic Davis, XXX-XX-8809 M 3M OOB Ot Phillip G. Faircioth Male White (Nat of Hispanic Faircloth, Phillip G. XKX-XX-8192 § 3M 008 O01 Steven W. Stanley Male White (Not of Hispanic Stanley, Steven W. XXK-XX-2590 4 M 006 O1 Thomas D, Stanley christopher 5. Job No. : 1511078 Destin Aiport Rehabilitate Runway 14-32 Okaloosa County Craft step Regular. Overtime rk Date Hours Rate Hours = Rate 3010 02/28/13 8.00 92/19/13 8.00 02/20/23 8.00 02/21/13 8.00 02/22/43 8.00 Superintendent 40,00 40,00 1270 02/18/13 12.00 15.250 02/19/23 8.00 15,250 02/21/13 11.50 25.250 02/22/13 co 7.00 18.250 SN tte Mater Grader|operacar Place 47.50 1980 02/18/13 9.50 14.620 Bulldozer Operator 9.50 9.50 1080 02/18/13 9.50 13.500 Other Total Hxs. Hours a. a. 8B. 8. a. 4a 900.00 900.90 14.00 167.75 B.00 122,00 11.80 175.38 7.90 106.75 47 3/04/13 as Check Detail. Amount Description Gross Pay FED Income T FED FICA w/b FED Medicare Hith-P-CuR AFLAC- STO 401K CHR RTH CWR 401KR 0% Net Pay Page - Date - Period End - 02/24/13 Period No. - Job Amount 20 180.00 00 180.00 oo 180.00 oo 180.00 ao 180.00 00 900.00 Gross Pay FED Income T FED FICA w/b FED Medicare H1th-F-~CHR Loan 82 Net Pay Gross Pay FED Income T FED FICA w/h FED Medicare Hlth-E£-CwR AFLAC-Ace Net Pay 86059 266.88 42.23 47.99 12.22 95.00 50.00 623.44 308099 375.14 6.47 20,58 4.81 38,00 S.16 300.12 308100 -Fringe Benefits- Page - 48 56372 Cc. W. Roberts Construction Date - 3/04/13 Certified Payroll Report w/Fringe info Period End - 02/24/13 Period No. - 05 c.W. Roberts Contracting, Inc. 3372 Capital Circle NE TallahasseFi 32308 Job No.: 1531078 Destin Aiport Rehabilitate Runway 14-32 Okaloosa County Check Detail. Soc.Sec.No FMS Dep S Cat Mn Craft Step . Regular. . .. . Overtime . , Other Total Name/Address frk Date Hours Race Hours Rate Hrs, Hours Description Amount ---Fringe Benefits- Gross Pay Bulldozer Operator 9.50 FED income T FED FICA w/h 21.39 FED Medicare 4.96 Hlth-BS-CWR 70.00 Net Pay 297.39 Male White (Not of Hispanic Stanley, Thomas D. Destin Aiport Davis Bacon Employee Wage Rate and Fringe Benefits Statement Certified Payroll End Date: 2/24/2013 Project: Destin Airport Rehabilitate Runway 14-12 FPN # County: Okaloosa Employee Name: Phillip Faircloth Hire Date: 2124/2003 Employee Rate & Fringe Calculations Employee Fringe Benefit Calculations Emp. Additional Hourly | Wage Table Medical| Life 401K Paid Paid Total Cash Payment Job Pay Ins. Ins. Plan |Vacation| Holiday | Paid For Classif. Rate Rate |Fringe| See #1 | See #2 | See #3 See #4 | See #5 | Fringe Fringe Grader! Blade Op. | $15.25 |$15.41| $3.60 | $6.36 $0.88 $0.59 $7.83 $0.00 Overtime Hourly Rate $15.44 Overtime Hourly Rate X 1.5 $23.12 Monthly Portion of Annual Monthly Funded Fringe Total Monthly] Premium Paid by Standard Standard Hourly Fringe Benefit Calculations | Premium Company Hours Hours Benefit Amout Medical ins. (# 1) Coverage [ FAN $1,514.87 $1,103.20 2080 173.33 $6.36 Life Ins. (# 2) 2080 173.33 $0.00 401K Plan (#3) Unfunded Fringe Benefit Calculations for Hourly Pay Employee Paid Hours times | Annual Value (Annual Value / Rate Paid Days Hourly Rate Hourly Rate Annual Standard Hours) Paid Vacation (# 4) 15 $15.25 $1,830.00 $0.88 Paid Personal (# 5) 10 $15.25 $1,220.00 $0.59 Davis Bacon Employee Wage Rate and Fringe Benefits Statement Certified Payroll End Date: 2/24/2013 Project: Destin Airport Rehabilitate Runway 14-12 FPN # County: Okaloosa Employee Name: Steven Stanley Hire Date: 3/19/2012 Employee Rate & Fringe Calculations Employee Fringe Benefit Calculations Emp. Additional Hourly | Wage Table | Medical| Life 401K Paid Paid Total Cash Payment Job Pay Ins. Ins. Plan |Vacation| Holiday} Paid For Classif, Rate Rate |Fringe| See #1| See #2 | See#3 | See #4 | See #5 | Fringe Fringe Bulldozer Operator $11.25 1$14.18} $2.56 | $2.12 $0.00 $0.00 $2.12 $3.37 Overtime Hourly Rate $14.18 Overtirne Hourly Rate X 1.5 $21.27 Monthly Portion of| Annual Monthly Funded Fringe Total Monthly! Premium Paid by Standard Standard Hourly Fringe Benefit Calculations | Premium Company Hours Hours Benefit Amout Medical Ins. (# 1) Coverage [E $532.32 $367.65 2080 173.33 $2.12 Life Ins. (# 2) 2080 173.33 $0.00 401K Plan (# 3) Unfunded Fringe Benefit ‘Calculations for Hourly Pay Employee Paid Hours times | Annual Value (Annual Value / Rate Paid Days Hourly Rate Hourly Rate Annual Standard Hours) Paid Vacation (# 4) 0 $11.25 $0.00 $0.00 Paid Personal (# 5) 0 $11.25 $0.00 $0.00 Davis Bacon Employee Wage Rate and Fringe Benefits Statement Certified Payroll End Date: 2/24/2013 Project: Destin Airport Rehabilitate Runway 14-12 FPN # Gounty: Okaloosa Employee Name: Thomas Stanley Hire Date: 7/8/2002 Employee Rate & Fringe Calculations Employee Fringe Benefit Calculations Emp. Additional Hourly | Wage Table | Medical Life 401K Paid Paid Total Cash Payment Job Pay Ins. Ins. Pian | Vacation} Holiday | Paid For Classif. Rate Rate |Fringe| See #1| See #2 | See #3 | See #4 | See #5 Fringe Fringe Bulldozer Operator $13.50 |$14.18] $2.56 | $5.70 $0.78 $0.52 $7.00 $0.00 Overtime Hourly Rate $14.18 Overtime Hourly Rate X 1.5 $21.27 Monthly Portion of Annual Vionthly Funded Fringe Total Monthly) Premium Paid by Standard Standard Hourly Fringe Benefit Calculations | Premium Company Hours Hours Benefit Amout Medical Ins. (# 1) Coverage ES $1,290.87 $987.54 2080 173,33 $5.70 Life Ins. (# 2) 2080 173.33 $0.00 401K Plan (# 3) Unfunded Fringe Benefit ; Calculations for Hourly Pay Employee Paid Hours times | Annual Value (Annual Value / Rate Paid Days Hourly Rate Hourly Rate Annual Standard Hours) Paid Vacation (# 4) 15 $13.50 $1,620.00 $0.78 Paid Personal (# 5} 10 $13.50 $1,080.00 $0.52 Date - 3/11/13 "5366373 STATEMENT OF COMPLIANCE ae ral" S I, SHARON MACKEY » EEO OFFICER do hereby state: (1) That I pay or supervise the payment of the persons employed by C. W. Roberts Contracting, Inc on the (building or work} Destin Aiport Rehabilitate Runway 14-32 that during the payroll period 02/25/13 - 03/03/13 ; all persons employed on said project have been paid the full weekly wages earned, that no rebates have been or will be made either directly or indirectly to or on behalf of said (Contractor or Subcontractor) C. W, Roberts Contracting, Inc from the full weekly wages earned by any person, and that no deductions have been made either directly or indirectly from the full wages earned by person, other than permissible deductions as defined in Regulations Part 3(29 CFR Subtitle A), issued 967:76 Stat. 357:40 U.S.C 3145), by Secretary of Labor under the Copeland Act, as amended (48 Stat, 948:63 Stat. 108:72 Stat. and described belo Loan #1 . Lite - AFLAC » Child Supp#1 , Uniforms , Overpayment . AFLAC-Cancer + Fortis-Dentl ’ AFLAC- Dental » Advance . APLAC-Hosp 1 AFLAC-STD » AFLAC Hith-E-CWR » Hlth-F-CWR ’ H1th-EC-CWR , H1lth-ES-CWR + 401K CHR » Loan #1 » Mise ’ (2) That any payrolls otherwise under this contract required to be submitted for the above period are correct and complete; That the wage rates for laborers and mechanics contained therein are not less than the applicable wage rates contained in any wage determination incorporated into the contract; that the classification set forth for each laborer or mechanic conform with the work performed (3) That any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with a State apprenticeship agency recognized by the Bureau of Apprenticeship and Training, United States Department of Labor, or if no such recognized agency exists in a State, are registered with the Bureau of Apprenticeship and Training, United States Department of Labor. (4) That: (a) WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, eval In addition to the basic hourly wage rates paid to each laborer or mechanic listed in the above referenced ---- payroll, payments of fringe benefits as listed in the contract have been ar will he made to appropriate programs for the benefit of such employees, except as noted in Section 4(c) below. ** SEE ATTACHED BENEFIT SHEET ** FUNDS, OR PROGRAMS (b) WHERE FRINGE BENEFITS ARE PAID IN CASH { | Bach laborer or mechanic listed in the above referenced payroll has been paid, as indicated on the payroll, an amount not less than the sum of the applicable basic hourly rate plus the amount of the required except as noted in Section4(c) below. Ecinge benefits as listed in the contract, {c}) EXCEPTIONS (CRAFT) EXCEPTION EXPLANATION SHARON MACKEY THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEMENTS MAY SUBJECT THE conzeactor OR CRIMINAL PROSECUTION. SEE SECTION