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

1001 OF TITLE 18 AND SECTION 231 OF TITLE 31 OF THE UNITED STATES CODE. Remarks: ff NAME AND TITLE nouns ff i) , EEO OFFICER , LIND i lichen, SUSCONTRACTOR TO CIVIL OR page - a7 563720” Cc. W. Roberts Construction Dare - 3/11/13 Period End - 03/03/13 Certified Payroll Report w/fringe Info C.W. Roberts Contracting, Inc. Period No. - 0s 4372 Capital Circle NE TallahassefL 32308 Job No.: 1511078 Destin Aiport Rehabilitate Runway 24-32 Okaloosa County Soc.Sec.Na FMS Dep S Cat Ma Craft Step Regular. . .. . Overtime . . Other Total Job » oo +» Cheek Detail Name/Address wrk Date Hours Rate Hours Rate Hrs. Hours Amount Description Amount XXX-XX-B657 S 1M 008 03 50 Felito &. Altamirano 02/25/13 2.00 3.500 2.00 29.00 308231 eeeeee tee - Gross Pay 458.38 Unskilled Laborer (General) 2.00 2.00 19.00 FED Income T 42.568 FED FICA w/h 28.42 FED Medicare 6.64 Life - Cinn 2.62 Male Hispanic or Latino Nek Pay 378.12 2.00 Altamirano, Felite L. 2.00 2.00 XXX-XX-1821 0M M 00a 02 1030 Adam R. Clift 03/02/13 20.00 27,385 10.00 173.85 86473 seeeeee - -- Gross Pay 629.62 Asphalt Screed Operator 10.00 10.00 173.85 FED Income T 81.99 PED FICA w/h 46.75 FED Medicare 10.93 H1th-ES-CHR 70.00 AmDental EH 5.66 Life - AFLAC 5.12 Uniforms 4.00 Male white {Nor of Hispanic Net. Pay 605.15 Clift, Adam R. 10.00 XXX-XX-3217 M 2M 003 01 3010 Christopher Ss. Davis 02/25/13 8.00 22,500 8.00 180.00 86376 02/26/13 4,00 22,500 4.00 90.00 Gross Pay 1,075.00 . aeeeee we tteee - ~- FED Income T 94.64 Superintendent 12.00 22.00 270.00 FED FECA w/h 60.76 FED Medicare 14.22 H1th-F-cwR 95.00 AFLAC-STD 7.34 401K CWR RTH 36.00 CHR 401KR 0% 18.00 Net Pay 743.05 Male White (Not of Hispanic Bavis, Christopher s. MXX-EX-d809 M 3M 008 01 1170 Page - 438 86372 ¢. W, Roberts Construction Date - 3/1/13 Certified Payroll Report w/Fringe Info Period End - 03/03/13 C.W. Roberts Contracting, Inc. Period No. - 0s 3372 Capital Circle NE TallabasseFL 32306 vob No.: 1511078 pestin Aiport Rehabilitate Runway 14-32 Okaloosa county Soc.Sec.No EMS Dep § Cat Mn Craft Step Regular. Overtime . . Other Total Sob . Check Detail. Name/Address Wrk Date Hours Rate Bours Rate Hrs. Hours Amount: Description Amount Fringe Benefits-- Phillip G. Faircloth 02/26/13 - 7.50 15.250 114.38 3 -- ee woe -- Gross Pay “Meror Gradex{ Operator 7.50 114.3a FED Income T & FED FICA w/h 50 FED Medicare 02/25/13 HAth-F-CWR corners Loan #1 Unskilled Laborer {General) 2.00 Wet Pay Male White {Not of Hispanic 9.50 Faircloth, Phillip G. 9.50 XXX-XX-8022 § M 008 B 50 Devin R, Gibson 03/02/13 #.00 13.500 4.00 54.00 46383 weer wee Gross Pay 603.00 Unskilled Laborer {General} 4.00 4.00 54.00 FED Income T 71.96 FED FICA w/h 37.04 PED Medicare 8.67 AmDental EH 5.66 Life - AFLAC 3.67 403K CMR RTH 24.12 40ik CWR 18,09 Male Black Net Pay 433.79 Gibson, Devin R. 4.00 4,00 54.00 XXX-KX-2324 M M 008 03 50 Matilde 8, Palacios 02/28/13 2.00 9.500 2.00 19.00 86408 - Gross Pay 458.38 Unskilled Laborer (General) 2.00 2.00 19.00 FED Income T 29.32 FED FICA w/h 28.07 FED Medicare 6.56 AmDental £ H 5.66 Uni Eorms 3.00 Male Hispanic or Latino Net Pay 385.78 Palacios, Matilde s, 2,00 2.00 19.00 XXX-KX-3600 5 1M 008 03 50 Gregorio A. Rodriguez 02/28/13 2,00 10,000 2.00 20.00 86423 errors ++ Gross Pay 482.50 86372” Page : 49 Cc. W, Roberts Construction Date - af/li/l3 Period End - 03/03/23 Certified Payroll Report w/Fringe Info C.W. Roberts Coneracting, Ine. Period No. - os 3372 Capical Circle NE TallahasseFL 32308 Job No.: 1511078 Destin Aiport Rehabilitate Runway 14-32 Okaloosa County Soc.Sec.No FMS Dep § Cat Mn Craft step Regular. . .. . Overtime . . Other Total Job .e Amount: Description Hours Rate Hours Rate Hrs. Name/Address wrk Date Unskilled taborer (General) 2,00 2.00 20.09 FED Income T FED FICA w/h FED Medicare H1th-5-CHR Net Pay Male Hispanic or Latino Rodriguez, Gregorio A. XXX-XX-3084 S F 907 01 2042 Velma L. Sasnett 02/28/13 2.09 11.900 2.00 11.00 03/01/13 5.50 16.500 5 90.75 Gross Pay eee eee nee -- ++ FED Income T Dump Truck Driver 2.00 5.50 6.50 202.75 FED FICA w/h FED Medicare HLth-EC-CWR aAmPental gcH hife - Cinn Female White {Not of Hispanic Net Pay Sasnett, Velma L, 1.00 XXX-XX-4403 M M 006 01 S50 Donald E, Tate 02/25/13 8.00 25.000 - Gross Pay Unskilled Laborer (General) 3.00 8.00 200.00 FED Income T FED FICA w/h FED Medicare Hlth-F-CWR ARLAC-SPEVNT AFLAC-Dental AFLAC-Acc hife - Cinn AFLAC-STD 401K CHR Male White (Not of Hispanic Nat Pay Tate, Donald £. Destin Aiport . 1,002.48 Check Detail. Amount 86426 638.00 68.19 34.36 a.03 70,80 13.89 2,24 441.29 Davis Bacon Employee Wage Rate and Fringe Benefits Statement Certified Payroll End Date: 3/3/2013 Project: Destin Airport Rehabilitate Runway 14-12 FPN # County: Okaloosa Employee Name: Adam Clift Hire Date: 11/14/2014 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 Screed Operator $10.75 | $11.59} $0.00 | $5.70 $0.00 $0.04 $5.74 $0.00 Overtime Hourly Rate $11.59 Overtime Hourly Rate X 1.5 $17.39 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 [ ES $1,290.87 $987.54 2080 173.33 $5.70 Life Ins. (# 2) 2080 173.33 $0.00 401K Pian (# 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 $10.75 $0.00 $0.00 Paid Personal (# 5) 1 $10.75 $86.00 $0.04 Davis Bacon Employee Wage Rate and Fringe Benefits Statement Certified Payroll End Date: 3/3/2013 Project: Destin Airport Rehabilitate Runway 14-12 FPN # County: Okaloosa Employee Name: Phillip Faircioth Hire Date: 2/24/2003 Employee Rate & Fringe Calculations Employee Fringe Benefit Calculations Emp. Additional Hourly | Wage Table | Medicai| 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 $15.41 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 [ FAM $1,514.87 $1,103.20 2080 173.33 $6.36 Life Ins. (# 2) 2080 173.33 50.00 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 366372 ) Ho) STATEMENT OF COMPLIANCE Date - 3/19/13 sgeall I, SHARON MACKEY ras) »EEO OFFICER do hereby state: (i) That I pay or supervise the payment of the persons employed hy C. W. Roberts Contracting, Inc on the {building or work) Destin Aiport Rehabilitate Runway 14-32 that during the payroll period 03/04/13 - 03/10/13 ; 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, Ine 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 Copeland Act, as amended (48 Stat, 948:63 Stat. 108:72 Stat. 967:76 Stat. 357:40 U.S.C 3145), by Secretary of Labor under the Fortis-Dentl ‘ and described below: Loan #1 » Life - APLAC » Child Supp#1 . Uniforms . Overpayment , AFLAC-Cancer A AFLAC-Dental . Advance . AFLAC-Hosp » AFLAC-STD » AFLAC » Hlth-B-CWR » Hith-F-CWR ’ Hith-EC-CwR » Hith-ES-CWR » 401K CWR , Doan #2 » 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, FUNDS, OR PROGRAMS wae | vi In addition ta 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 conrract have been or will be made to appropriate programs for the benefit of such employees, except as noted in Section 4(c) below. ** SEE ATTACHED BENEFET SHEET ** (bo) WHERE FRINGE BENEFITS ARE PAID IN CASH | |. Each laborer or mechanic listed in the above referenced payroll has bean 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 fringe benefits as listed in the contract, except as noted in Section4(c) below. {a} EXCEPTIONS (CRAFT) EXCEPTION EXPLANATION fralel Remarks: NAME AND TITLE saan {i ,EEO OFFICER \ ibys Uacdeeg SHARON MACKEY THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEMENTS MAY SUBJECT THE CONTRACTOR OR“SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION. SEE SECTION 1001 OF TITLE 18 AND SECTION 231 OF TITLE 31 OF THE UNITED STATES CODE. ©.W. Roberts Contracting, Inc. 3372 Capital Circle NE TallahasseFL 32308 Soc.Sec.No FMS Dep § Cat wn Name/Address XXK-XX-J084 S F007 02 Velma L, Sasnett Female White (Not of Hispanic Sasnett, Velma L. Destin Aiport C. W, Roberts Construction Certified Payroll Report w/Fringe Info Job Now: 1511978 Destin Aiport Rehabilitate Runway 14-32 Okaloosa County . Regular. Craft Step Hours Rate Hou: ‘wrk Date 2042 03/04/13 4.00 11.000 03/06/13 4.00 12.000 03/08/13 4 pump Truck Driver 4.00 8.00 4 39 Page - Date ~ 3/19/23 Period End - 03/10/13 Period No. - 06 . Overtime . . Other Total Job a Check irs Rate Hrs. Hours Description 4.00 4.00 Gross Pay -00 16.500 4,00 FED Income T PED FICA w/h FED Medicare H1th-BC-CWR AmDental ECH Life - Cinn Net Pay Detail. Amount STATEMENT OF COMPLIANCE Date - 3/25/13 Raat *9 I, SHARON MACKEY ,EEO OFFICER do hereby state: (i) That I pay or supervise the payment of the persons employed by C. W. Roberts Contracting, Ine on che {building or work) Destin Aiport Rehabilitate Runway 14-32 that during the payroll period 03/11/13 - 03/17/13 ; all persons employed on said project have been paid the full weekly wages earned, that na 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 by Secretary of Labor under the Copeland Act, as amended (48 Stat. 948:63 Stat, 108:72 Stat. 9367:76 Stat. 357:40 u.s.c 3145), and described belaw: Loan $1 » Life - AFLAC , Child Supp#1 » Uniforms , Overpayment , APLAC-Cancer . Fortis-Dentl , AFLAC~-Dental , Advance , AFLAC-Hosp » AFPLAC-STD » AFLAC »