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Home My WebLink About15- Development Services ORIGINAL CITY OF SAN BERNARDINO REQUEST FOR COUNCIL ACTION From: Valerie C. Ross, Director Subject: Authorize the Director of Development Services to reimburse GFC Enterprises, LLC for the Dept: Development Services installation of the traffic signal at the intersection of Valaria Drive and Pacific Street. Date: January 20, 2010 MCC Date: February 16, 2010 Synopsis of Previous Council Action: 12/18/2006 The Mayor and Common Council adopted the Negative Declaration and the Mitigation Monitoring/Reporting Program, related to Tract No. 17793. Recommended Motion: Authorize the Director of Development Services to reimburse GFC Enterprises, LLC for the installation of the traffic signal at the intersection of Valaria Drive and Pacific Street. b '-?W Valerie C. Ross Contact Person: Valerie Ross Phone: 5357 Supporting data attached: Staff Report Ward(s): 7 FUNDING REQUIREMENTS: Amount: $150,830 Source: (Acct. No.) 263-483-5504-7772 Acct. Description: Local Circulation Fee Finance: Council Notes: Agenda Item No. 15 ;2ep Lace wte wt-Pccyt i 2_� to-lD CITY OF SAN BERNARDINO REQUEST FOR COUNCIL ACTION STAFF REPORT Subiect: Authorize the Director of Development Services to reimburse GFC Enterprises, LLC for the installation of the traffic signal at the intersection of Valaria Drive and Pacific Street. Backeround: GFR Enterprises is a developer and GFC Enterprises is a business entity of GRF Enterprises (GFR). GFR is the developer of Tract No. 17793, which consists of 18 single-family detached homes on 7.7 acres. The property is located on the east side of Lynwood Way between Byron and Amanda Streets. Several area residents attended the September 19, 2006 Planning Commission meeting and expressed concerns about traffic on Pacific Street and the resulting delays on Valaria Drive for current residents of the neighborhood, which consists of approximately 100 single family residences. The Traffic Study for new development identified the need for a new traffic signal at the intersection of Valaria Drive and Pacific Street. The Public Works/Engineering Standard Requirements required the developer to design and construct a traffic signal at the intersection of Valaria Drive and Pacific Street prior to occupancy of the new homes. A new traffic signal was estimated to cost approximately $200,000, and the project's fair share is 18% (or approximately$36,000). The developer was responsible for 100% of the initial cost for installing the new signal, but may be reimbursed for up to 82% (or $164,000)of the total cost for the new signal. The signal has been installed and is operational. There are minor improvements that will be completed through a separate agreement which include removing temporary asphalt and replacing it with permanent concrete. It is estimated that the additional work will cost approximately$10,000. Financial Impact: The total cost of the design and construction of the traffic signal was $183,939.29. Based on GFR's fair share of 18% (or$33,109.07), they are entitled to a reimbursement of$150,830. Staff included this project in the 2006-2007 Capital Improvements Program, using revenue from the Local Circulation Fee Fund. Recommendation: Authorize the Director of Development Services to reimburse GFC Enterprises, LLC for the installation of the traffic signal at the intersection of Valaria Drive and Pacific Street. a 2 02/10/2010 5:32 PM Attachments: Attachment 1 —Location Map Attachment 2 —Traffic Signal cost break down 3 02/10/2010 11:23 AM n ; a n p d. n $ � E!-Ah It D a ! o D 4t l San k3°_frdrd ou A Cammunty E I--In St Cola @r5 $ D 9 'Mestem Avn IAI Paufic St Pudic St Paufic St l.:ur-nLTV "yi'...CII ml brn.: i ' Byron St t Byron St Y nnOmdn Cl m v t7 � y i 9 I+�chor `i n v 33 . Pa't O .`n 4 j K. 4i1hS. n 4 .a Amanda Et 51 ILth St i 9 � 1 P Ii l Ci! r GFC Enterprises, LLC Traffic Signal at Pacific Street and Valaria Drive - San Bernardino, CA Cost Break-Down Paid Paid to: Invoice # How Number Amount Sierra Pacific Electrical 19315 Voucher 8292 $36,128.95 19315 Voucher 8291 29,393.75 19933 Voucher 72423 13,912.63 19939 Voucher 72423 7,325.75 19672 Voucher 72395 58,828.52 19596 Voucher 72395 761.40 TransTech 26050542 Voucher 989126 15,000.00 Southern California Edison 47669 Voucher 8323 6,333.34 City of San Bernardino CR11170801 Check 2131 308.02 E0700286 Check 2111 6,451.50 E0801235 Check 2113 736.42 $175,180.28 Supervision&Overhead 5.00% 8,759.01 Total Cost of Developing/Contracting/Supervising Install of Traffic Light $183,939.29 GFC Enterprise Share Traffic Light 18.00% 33,109.07 Reimbursement of Cost to GFC Enterprises, LLC $150,830.22 [Copies of Invoices and Payments Attached] nQ n n ionno �.on nr,r 19315 ELECTRICAL CONTRACTING 2542 Avalon St.•Riverside, CA 92 09-2057. Phone: (951)784-1410• Fax:(951)784-4489 Incense#264048 A.C-10 Bro GFR ENTERPRISES, INC. JOB GFR ENTERPRISES, INC. 434 N.SECOND AVENUE PACIFIC STREET&VALARIA DRIVE UPLAND, CA 91786 LYNWOOD ESTATES #17793-#81000 T/S SAN BERNARDINO, CA 92222 • • • GFRENT 521-7 Net 30 11/17/08 Subcontract#81000 Prog No. I-to 50%Complete 0.5 Traffic Signal 1^,5606.00 72,803.00* ��)!r � )OE� 111!lIIIIJJJIIIIII i _- � I�d�-il�� BY:-------Tt------------ *means item is non-taxable SALE AMOUNT 6— Retention -7,280.30 j/NT AMERICAN SOLUTIONS FOR BUSINESS 800-325-3120 CE 1013E CA230896 I California Fund C��trol Inc. F -- ---^-- M" / CFC# 11 �GF MAIL VOUCHER AND ATTACHMENTS TO P.O. SOX 940, FULLERTON,CA 92834-3940 _ (714) 634-4878 9AM to 4PM (Closed 12 Noon to PM) Mon thru Fri Voucher# BEFORE presenting documents in person fo)'payment, please confirm availability of funds by phone. 8292 660 South State College Blvd., Fullerton, CA' 92831. Map is on reverse side of this voucher. 11/25/2008 Date Payee's Federal ID#_ q5-,A(oS28-92 : If l,D,Number is not on file at CFC, see PAYMENT REQUIREMENTS beloH ❑ Check box if new address PAY Names) Sierra Pacific Electrical Contracting ` 0 _ Address 2542 Avalon Street 551 84-1410 Phone ( City Zi®9 L , 5ng ❑ Check box if ❑GRE 5 payment OR .-- Check box if FINAL payment Stale ^A THE SUM OF THIRTY-SIX THOI MAN,1 rINF HI INnfl pn II FNTY FIC;HT ANN) For disbursement on the job designated below,: ` *36,128.95 Job Name GFC ENTERPRISES LLC Job Address LOTS 1-18 TENT TRACT117793 Line Item Numbers I�- Kind of Material or Labor_f_Cj - For the purpose of obtaining payment,the undersigned certifies to CFC that tabor and materials referred to herein have been actually furnished by the persons named herein in the amount specified and were used on the job name land ad�ress designated herein and comply with all terms and conditions of the Fund Control Agreement. Contractor and/or Owner GFR ENTERPRISES ZNC Authorized Signature �ISES LI, Signature(s) T.Q�/(�(,� 1 SIGNATURE FELIZARDO ROBLESI7R CHARLES H CROWELL CHECK US Mail (Standard deliv+y me hod, if no other delivery option is selected.) DELIVERY Another delivery service may be sed by submiin g prepaid shipping document or account number. OPTIONS: ❑ Trans Box ❑CA Ovgrnightf Fed Ex Your Delivery Account# ❑ UPS Other (if no shipping document submitted) ❑ Pickup check ----Call (Contact Name) O '- (Phone) PAYMENT REQUIREMENTS: Submit to C C completed documents listed below by mail or in person. For Services, Labor or Materials: I. Voucher . . . . . . . . . . . . . . . . . . . . . . . . . .Original cornplated and signed by authorized individual(s). 2.. Federal Tax ID No. of Payee . . . . . . . . . s Insert Above, If PAYEE TAX INFORMATION is not on file at CFC, complete W-9 on reverse side of this voucher OR Submit separate W-9 form. 3. Invoice(s) from Vendor . . . . . . . W of bi g ver , ma?e!i is and Services supplied for this job. 4. Release from payee eted Of this voucher. S. Material Supplier Releases . . . . . . . , ubmit ononal release form. O ihai Document. �R cnpy faxed *,c CFC directly from supplier. For Reimbursements: 1, 2,3 & 4 above and proof that expenses do not meet requirements. have;actually been paid by Payee Cancelled Checks or Receipts from Credit Including: Cards/Casa Registers/uoverrirnent Agencies. Copies of issued checks alone g: nconditional Releases, , OETAdH HERE-KEEP THIS STUB FOR YOUR RECORDS California Fund Control, l4c. ("CFC") CFC# 11038 GF Company ! 11/25/2008 Job Name GFR ENTERPRISES INC 'GFC Job Address LOTSENTERRPRISESTRACT 17793 Date '36128.95 Voucher# 8292 Amount Terra as Ic ec Ica ontracting Pavee Name 1 VOUCHER D5 _„l California Funidi Control, Ince ("CFC") CFC # 1103( 8 GF MAIL VOUCHER AND ATTACHMENTS TO P.O. BOX 39¢0 FULLERTON.CA 92834-3940 114) 634-4878 9AM to 4PM (Closed 12 Noon to 1 PM) 'ton thna Fri veuc!�ea# 3291 BEFORE presenting documents in person for paymont, please confirm availability of funds by phone. 360 South State College Blvd., Fullerton, CA 92831;Map is on reverse side of this vouches Date 11/2512008 Payee's Federal ID# Q5 —e1(o$78Da— If I.D.Number is not on file at CFC, see PAYMENT REQUIREMENTS below. ❑ Check box if new address PAY Name(s) Sierra Pacific Electrical Corptracting And McCain Inc. TO Address 2542 Avalon Street ty Phone ( 951784-1410 Ci Riverside State CA _ZigpSg n ❑ Check box ii PROGRESS payment OR ❑' 1 Check box If FINAL payment THE SUM OF—_SwFNTY-NINF THOI ICANn THRF 1-f i jNnRItQ-HlbIEIY-THRFF AND 75/100 001 I ARS $ 2.9 39 .75 For disbursement on the job designated below:! Job Name GFC ENTERPRISES LLC Job Address LOTS 1-18 TENT TRACT 17793 Line Item Numbers Kind of Material or Labor I Q 3I S For the purpose of obtaining payment,the undersigned certifies to CFClthat labor and materials referred to herein have been actually furnished by the persons named herein in the amount specified and were used on the job name and address designated herein and comply with all terms and conditiol s of the Fund Control Agreement. Contractor and/or Owner 02R ENTERPRISES INC GLC Authorized Signature(s) r' I SIGNATURE FELIZARDO R BLES JR OTC CHARLES H CROWELL CHECK 1 /1 US Mail (Standard delivery method, if no other itiflIVOry option is selected.) DELIVERY nother delivery service may be used by;,submitting prepaid shipping document or accouni :umber. OPTIONS: ❑ Trans L30x ❑'CA Ove(night Fed Ex ❑UPS ❑Other _ Your Delivery Account# __ —(it no shipping document submitted) ❑ Pickup check ---- Call ( ) ;(Contact Named (Phone) PAYMENT RE— UIREMENTS' Submit to CFC c0?nplated dOcurnents listed below by mail or in person. For Services, Labor or Materials- 1. Voucher . . . . . . . . . . . . . . . . . .Origina! Cornpletea and signed by authorized individual(s). 2. Federal Tax ID No.of Payee . . . . . . . . . .;Insert Above. If PAYEE TAX INFORMATION is not on file at CFC, complete W-9 on reverse side of this voucher OR submit separate W-9 form. 3. Invoice(s) from Vendor . . . . . . . . . . . . . .Copy'; of b 14ng for work, materials and services supplied for this job. 4. Release from Payee . . . . . . . . . . . . . . . .Completed conditional release on reverse side of this voucher. OR ubmit a completed separate conditional release form. 5. Material Supplier Release(s) . . . . . . . . Origirial Document. OR copy taxed to CFC directly from supplier. For Fleimbursements: I 1, 2, 3 & 4 above and proof that expenses;have actually been paid by Payee including: Unconditional Releases, Cancelled Checks ur Receipts from Credit Carjis/Cash Registers/Government Agencies. do not meet requirements. Copies of issued checks alone DETAGH HERE-kEEP 7H6 S JE;,ij.ypui,RECORDS California Fund Cc mltr0l, Inc- ("CFC") CFC# i1o3e GF 11/25/2008 Company GFR ENTERPRISES INC Voucher# 8291 Job Name GFC ENTERPRISES LLC Date_ '29 393.75 Job Address LOTS 1-18 TENT TRACT 17793 NmOU^.' McCain Inc.And —S-emz act iC—EF0—CFn-ca7Con tracting ?avee Name y 19933 ELEFTRICAL CONTRACTING 2542 Avalon St.•Riverside, CA 92509-21x:7>i'nur.•::1951)%84-1 10•Fax:(951)784.4"' License#264048 A.C-10 BILL TO GFR ENTERPRISES, INC. JOB ro 434 N.SECOND AVENUE GFR ENTERPRISES, INC. UPLAND, CA 91786 PACIFIC STREET&VALARIA DRIVE LYNWOOD ESTATES #17793-#81000 T/S j SAN BERNARDINO,CA 92222 GFR ENT twc;9ti 6/30/09 I I Retention from previous invoices 19315, 19596, 19672 Our Job#5247 13912.63 13,91263* GIL#23—S° Cog 9 Code I�LI jUN 200 U BY:._._ ----------- Nolte' / _(Date /y�� *means item is non-taxable SALE AMOUNT I lltrG 19939 ELECTRICAL.CONTRACTING 2542 Avalon St.•Riverside, CA 32509-2057•Phone:(951)784-1410•Fax:(951)784-4489 Lieenstr 3264048 A.C-10 BILL GFR ENTERPRISES, INC. �� GFR ENTERPRISES, INC. 434 N.SECOND AVENUE PACIFIC STREET&VALARIA DRIVE UPLAND, CA 91786 LYNWOOD ESTATES#17793-#81000 TS SAN BERNARDINO, CA 92222 GFR ENT 5217 Net 30 6/30/09 1 Contract#81000 Prog Complete I Traffic Signals-5%Balance of contract 7325.75 7,325.75* lot 0 GIL i35a 1 BY:.....__ :�.__ 4ppfowd r� Dote SALE AMOUNT *means item is non-taxable I AMERICAN SOLUTIONS FOR BVBINESS 600J25.3120 CE1013L CA224994 Firs ts'-nerican Fund Control,In "FAFC") use only (666)536-0178 OPEN:gam-4pm Mon-Fri F`, # 11038 GF US Mail with attachmenfls to P.O. BOX 25679, Santa Ana, CA 92799 or Overnigh delivery with attachments to 200 Commerce, Irvine, CA 92602 72423 Check(s)will be distributed after completed documems are approved and funds are available. Voucher# VOUCHER See instructions on reverse side. Date n71nw9nig _ P Payee's Federal ID# 95-2687802 If I.D.# is not on file at FAFC, see requirements on. reverse side. A P91_'-M Name(s) Sierra Pacific Electrical Cpniracting Y New ❑ Address 2542 Avalon Street _ _ Phone (_ 95� 784-1410 Address O City Riverside State CA zip 92509 R THE SUM OF TWENTY-ONE THOUSANOTWd HUNDRED THIRTY—EIGHT AND 381100 DOLLP$RS `21,238.38 C Contractor GFR ENTERPRISES INC j. Owner GFC ENTERPRISES LLC 0 Job Name GFC ENTERPRISES LLC Job Address LOTS 1-18 TENT TRACT 17793 M Line Item Numbers 28' P L Kind of Material/Labor E In order to obtain payment,the undersigned certifies that labor an pp materials referred to herein have been actually furnished by the persons named herein in T the amount specified and were used on the job name and addregstdesignated herein and comply with all terms and conditions of the Fund Control Agreement. E Authorized Signat_ ure(s) 1 SIGNATURE FELIZARDO ROBLES 7R: OR CRARI,ES i_i CROMTSLI.: CHECK _19 ❑ Payee Qg ❑ C/O_.. DELIVERY Address for C/O OPTIONS (Address)— --- — (City) — - (State) (Zip) -- If other than U.S. Mail service is selected,a prepaid shipping document, account#or payment must be provided. ❑ U.S. Mail--standard ❑ CA Overnight !=ad Ex i❑UPS If no shipping document supplied: Your Deliveary acct# _ QB❑ Decoct$20.00 from PAYEE'S Funds. 49 ®Pickup Check---Call_ /YI/C,u,�tj! /¢/,/G/G(✓O.-,___,--____ _ ( �0� ) (See Reverse Side) (Con:ac;t.a�'e' tPhone Number) ¢} Conditional Waiver And Release upon either PRQQRESS oR FINAL. payment Upon receipt by the undersigned of a check from FAFC ip the sum A Payable tc (Amount of Voucher Check s been paid by the bank uool (Payee) and when the check has been properly endorsed and ha E which it is drawn,this document shall become effective.to re. ,. :>r : ;nechallic., ir; siop nv 'CE r.n:i right the undersigned has E the job of GFC ENTERPRISES LLC located at LOTS 1-18 TEN? TRACT 17793 Before any recipient of this document relies on it,said pa4 shcu d veiiy evidence of payment to the undersigned.This form complies with IN C civil codes 3262(d)(1)and 3262(d)(3). It is not effeetive until the check re:!resenting payrnient he s been rr'OpCdy<!nd,,, sad and has cleared the bank MIf PROGRES�4 payment,this release covers labor, services. f FIN I_ A payment,this release covers final payment for labor,service! P equipment or materials furnished through_ : _ to equipment or materials furnished ri the job, except for disputed claim L (Date) (Your Customer) Only and fol a3ditonal work in the amount of$ E does not cover any retention or items furnished-after;sd'id date. T (Da-- (Company Name) _ (Signature) OhETACH :ERit K o 1. ,4 First American FundControl,l C t r>;rte Fe # 111038 cF Company P Y GFR ENTERPRISES INC 07105120v^s �/ouche. A Job Name GFC ENTERPRISES LLC r 72423 Job Address LOTS 1-18 'PENT TRACT 17793 '21.238.38 A!i!ClNSt_ Payee Name _ Sierra Pacific Electrical Contracting ,,. o N A PACT CONTRACTING 2542 Avalon St.•Riverside,CA 9409-'1'0Z-.' :';Icu 1o: (951) 784-14 10• Fax:(951)784-4489 License#264048 A.C-10 BILL TO GFR ENTERPRISES, INC. JOB GFR ENTERPRISES, INC. 434 N. SECOND AVENUE PACIFIC STREET &VALARIA DRIVE UPLAND, CA 91786 LYNWOOD ESTATES #17793-#81000 T/S SAN BERNARDINO, CA 92222 • OUR • : NO. • � , _ GFR ENT 5717 Net 30 3/18/09 1 DESCRIPTION Contract# 81000 Prog No. 2-to 95% -1 Over billing on Inv# 19315,wrong contract amount entered 101.00 -101.00* 0.45 Traffic Signals 145505.00 65,477.25* VQy�CLk)i wit old Dakc. uP01/e6 �047te S ;bc i3d: Pik4WAe , 4u ach,:�t� MAk 2 4 2019 D * means item is non-taxable SALE AMOUNT Retention -6,547.73 $58 A28 57 AMFRICAN MI I TONS FOR RI ISINFSS Wq 42481211 CE 1013E CA224994 '. rgCl�� 1959. _ _- e ELECTRICAL CONTRACTING 2542 Avalon St.•Rlverside, CA 9 509-20u1=Phone: (951) 784-1410• Fax:(951)784-4489 !License#264048 A,C-10 BILL GFR ENTERPRISES, INC. TO JOB GFR ENTERPRISES, INC. 434 N.SECOND AVENUE PACIFIC STREET&VALARIA DRIVE UPLAND, CA 91786 LYNWOOD ESTATES #17793-#81000 GFC �urF?��SF� T/S SAN BERNARDINO, CA 92222 CUSTOMER OUR • • • „ • GFR ENT 5217 Net 30 2/24/09 I Contract# 81000 Change Order # 1 I Provide and Install two (2) straight internally illuminated street name sign arms 846.00 846.00* _...Gee Y•J _'��_ CoSt Cmde__&O „ia9®-- ---.� pate 2 6 201jq DR BY: --- jV.......... e N� * means item is non-taxable SALE AMOUNT Retention -84.60 AMERICAN SOLUTIONS FOR BUSINESS 800-325-3120 CE 1013L CA224994' rnru Pirsto nerican Fund Control,Inc,, '"FAFC") use Only (a66y 536.0178 OPEN:gam-4pm Mon-Fri US Mail with attachments to P.O. BOX 25679, Santa Ana, CA 92799 FC # 11038 GF or Qyernight delivery with attachments to 200 Commerce, Irvine, CA 92602 Check(s)will be distributed a er completed documents are approved and funds are available. Voucher# 72395 VOUCHER see InstrL'to _on reverse side. Date n619919nno P Payee's Federal ID# 95-2681602 If I.D'i If Is not on file at FAFC, see requirements on reverse side. A _PAY T Name(s) Sierra Pacific Electrical Contracting Y New Address 2542 Avalon Street -- O Address❑ -_ Phone ( 951784-1410 City Riverside R State CA Zip 92509 THE SUM OF FIFTY-NINE THOUSAND FIVE HUNDRED EIGHTY-NINE AND 92/100 DOLLARS $ "59,589.92 C Contractor GFR ENTERPRISES INC, 1 OWner GFC ENTERPRISES C Job Name GFC ENTERPRISES LLC - Job AddreSS LOTS 1-18 TENT TRACT 17793 M Line Item Numbers_ `L$ P i L Kind of Material/Labor E In order to obtain payment,the undersigned certifies that labor and materials referred to herein have been actually furnished by the persons named herein in T the amount specified and were used on the job name and addr4s designated herein and comply with all terms and conditions of the Fund Control Agreement. E 8ulhorized 5ignalure(s) 1 SIGDII.TDRH FELIZARDO ROBLES JR OR CHARLES H CROWSLL CHECK Lo ❑ Payee Qg ❑ C/o DELIVERY Address for C/O (Name) OPTIONS If other than U.S. Mail service is selected,a pr aid Shipping ddress) 0iN) ❑ (State) (Zip) 9P Aping document,account#or payment must be provided. U.S. Mail--standard ❑ CA Overnight ❑ Fed Ex ❑UPS If no shipping document supplied: Your Delivery Acct# 413 ®Pickup Check--Call_LYJIGf/,41r �¢ 4H❑ Deduct$20.00 from PAYEE'S Funds. (See Reverse Side) �. (Contact Name) IP (Phone Number) Conditional Waiver And Release upon either OGRES gR FlNAL payment A gned of a check from Upon receipt by the undersigned FAFC;n the sum a Y (Amount of Voucher Cl'ac81 payable to (Payee) antl when the check has been properly endorsed and nas been paid by the bank upor E which it f drawn,this document shall become effective tq release pro tnte any mechanics lien,Stop notice or bond right the undersigned has o E the job Of GFC ENTERPRISES LLC Before any recipient of this document relies on it, Said located at L,OmS :1 -18 TENT "i'RACT 17793 MC civil codes 3262(d)(1)and 3262(d)(3). It is not effective unq the check representing payment hasnbeenhProperly endorsed and hseared the ibank. �If PROGRESS --_�payment,this release covers labor,SeP rice;, if F NAL payment,this release covers final payment for labor,services P equipment or materials furnished through to L (caret equipment or materials furnisher cr lire job,except for disputed claim: (Your Customer) only and for additional work in the amount of$ E does not cover any retention or items furnished after said data. T -- E (oa— ta�) -- (Company)Verne) DETACH HERF4' KEEP THIS STUB FOR YOUR RECORDS is,gnaturel First American Fund Control,Inc. , FC# 11o3a cF Company GFR ENTERPRISES INC Job Name GFC ENTERPRISES LLC Date 06/22/2009 Job Address LOTS 1-18 TENT TRACT 1770; —�'— Voucher# 72395 Arncwlt "59.589.92 Payee Name Sierra Pacific Electrical Contracting Certified Payroll Re.gi5ter Page' 1 y- Contractor Customer P.ENTERPR15E5,IF1C- SIERRA PACIFIC ELECTRICAL CONT 45M ENTERR!ISE5,INC. Jab Number! 5217 CInC STREET it VALARIA UkIVE 2542 AVALON STREET 434 W.SECONO AVENUE Week Fndirg: SO/ts12008 NWOOb ESTATES#17793-#8YJ00 RIVERSIDE,CA 92509-2057 UPLAIJO,CA 91766 S /c/ ` IN 85"A?bINO,CA 92222 �.5� 1�ez ...bedudioes--- Fed. La l $ac Sec W. ------------•- Hours Worked This Sob------------ Gross Pay Fca ot.1w Check# Class 10113 10114 10/15 10/16 10/17 10/18 10112 Pay Thia Jab Med 1ms old Addresr Mar Ewemp. Mon Tue Wed Thu Fri Sat Sun Tut Rate All Jobs Stale TOW Net Pay icHAE16EHL -" -_8338 R: 800 8-0D 80D 6,00 8,00 400 GM 40-70 38,000 1520.00 167.74 0.00 75153 633 8URW00D AVE, FORE ELEC +16.702FR. 93-39 91,62 -CTORVIILE,CA 92392 5inyle 2 O: ODD 0.00 0.00 000 0.00 0.00 0-00 0.00 1540Fu's 56.12 430.72 . 1089.28 WHILE Male :E ANDREW JOh1E5III ""`-""-1844 R: 8-00 B.00 8.00 8.00 8,00 000 0,00 40.OD 34,140 1365-60 126-43 OAO 75158 185 ALMAI45A WAY JOUR ELEC •16255WR- 84,66 70,28 1?P15,CA 92571 Single 4 0: D-00 0.00 0.00 0.00 000 000 0,00 0,00 0.000 1365.60 19.60 1021.63 BLACX Male, +0.000FR 40hrs 42.80 343.97 L416 R MARSHALL ""*-&708 Its 8,00 0,00 0.00 OAO 0.00 0.00 0.00 5.00 20.480 163.64 74,76 0,00 75167 43 STLNEPINE LN#b (,qyo AP ELEC .12,458FR. 50.79 42.96 )ROW,CA 92879 Married 10: 0.00 0.00 0.00 MOO +0.00 0.00 0:00 0.00 0.000 . 919,20 S!.tL8 619.08 WHITE Mole •O.OWFR. 4ahrs 19.73 200.12 4RRY b PATTON "'*"•6665 R: 800 800 8.00 8-00 8-00 0.00 0.00 40.00 27.980 111920 109.66 0.00 75171 .a 6LP�FAIR Lobarer Sro%1 •5,920FR. 69.39 66M AN 8EPHAROTNO,CA 92410 Married 2 0: 0.00 0.00 0-00 0.0 O,OD 0,00 0,00 0,00 O.00D 1119,20 16.23 828.27 WHITE Male .0,000114t, 40hrs 29.65 29D.93 RktSTOPHER ADEN WANSTREET *' -7494 R: 0.00 0.00 0.00 0.00 8.00 0.00 0.00 8.00 30.00D 240.00 134.22 0,00 75188 438 LUCR.FTIA AVE laborer Group I +5,92DFR, 75,37 81.60 LMA LOM4,CA 91752 Monied 1 0: 0.00 0.00 0.00 0.00 0.00 0.00 Gino 0-00 0.000 1215.60 17.62 8647] WHITE Mole •0.000FR. 40hrs 42,08 350,69 Hours P1m Regular 136,00 4,408.64 Overtime 0-00 0,00 1- - Certified Payroll Register Page' 2 Can}MLTef Custom¢!' FR ENTERPRISES,INC. SIERRA PACIFIC ELECTRICAL CON7 &FR ENTERPRISES.INC. Jab Nmeber: 5217 aCIFIC STREET d VALARFA DRIVE 2542 AVAL.ON STREET 434N.SECOND AVENVE Week Ending: 10118/2008 JNWOOD E6TATE5#ll793-f18IWO RIVERSIDE,CA 92509.2057 UPLAND,CA 91786 /5 AN RMNARDINO.CA 92222 iTATEMENT OF COMPLIANCE: )ATE !/-i d BERNICE WAGNER, PAYROLL/PERSONNEL MGR- do hereby certify under penalty of .erjury. 1)That I pay or supervise the payment of persons employed by SIERRA PACIFIC ELECTRICAL CONTRACTING, INC. on the ri PROJECT NAMED AND SVUM8E1ze0 ON THE UPPER .EFT CORNER--- and that during the payroll commencing on ha /:'l day of D E, 2009 and ending on the /8 day of 0L r 2008 all persons on said project have been paid their full weekly wages earned,that a rebates have been or will be made either directly or indirectiy to or on ,ehalf of said SIERRA PACSFIC ELECTRICAL CONTRACTING, INC_ from the 'ull weekly wages earned by any person and that no deductions have ,eon made elther directly or indirectly from the full wages earned by any -arson, other than permissible deductions,as defined in lcyulations, Part 3(29 CFR Subtitle A), issued by the Secretary �f Labor under the Copeland Act,as amended (45 Stat. 948,63 5tat. 08, 72 5tat. 357= 40 U_S_C275c),and described below' 'IT, FICA, SST, SDI,UNION DEDVCTIONS, AND ANY COURT ORDERED WAGE- 2) That any payrolls otherwise under contract required to be submitted for he above period are correct and complete,: that the wage rates for laborers r mechanics contained therein are not Seas then the applicable wage rates ontalned in any wages determination Incorporated into the contract; that he clossif ication set forth therein for each laborer or mechanic conform Ath the work he or she performed_ IlMat any apprentices employed in the above period are duly registered in : bona fide apprenticeship program registered with a state apprenticeship gency recognized by the Bureau of Apprenticeship and Training, United ,rates Depaertment of Labor,or if no such recognized agency exlsis in a Tate, are registered with the Bureau of Apprenticeship and Training, Jnited States Deportment of Labor. 4)That; (A) WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, FUNDS, OR 'R06RAMS: (X)In addition to the basic hourly wage rates paid to each Laborer or Mechanic listed in the above rsfarenced payroll, payments of fringe Benefits as listed in the contract have been or will be made to the :ppropriote programs for the benefits of such employees, except where noted 1 section 4c below. (8) WHERE F{tLNGE BENEFITS AAE PAID IN CA5H; ( )Each laborer or mechanic listed in the above payroll has been paid s indicated on the poyroil,an amount not less than the sum of the .pplicable basic hourly wage rate plus the amount of the required fringe �enefIts as listed in the contract, except as noted in section 4c below. (C) EXCEPTIONS: EXCEPTION(CRAFT) EXPLANATION EMARKS: Jame and Title Signature l 1 ;ernice Wagner. Payroll/Personnel Mgr_ pax Numboe(951) 784-3558 -he wilful falsification of any of the above statements may subject the ontractor to civil or criminal prosecution. 5ea section 1001 of title 18 ectian 2331 of Title 31 of the United States Code. The employer has omplied with the requirements of section 1771. 1811 and 1815 for any work erform,td by his Employees on the public works project. - GerT'rfied Pay tall Register Page: I b CaMm Guatomcr SIQRRA PACITIC ELECTRICAL CONT w ENTERPRISES,INC. lab Numha': 5217 R ENTERPRISES,INC. 434 N.5ECOND AVENUE Weak Ending' IW2512008 1CIFIC STREET d YALARIA DRIVE 2542 AVALON STREET UPLAND.CA 91786 Payroll# 2 (MWOOD ESTATES#hT2934"1000 RIVER5IDE,CA 92509-2057 'S AN 9ERNARDINO,CA 52222 -Deductions- Fed. Local See Sec No. _-------------___Haun Worked This Job-------------------- Gross Pay F3co Other Check# Class 10/20 10/21 10!22 !0/23 10/24 10/25 10/19 Pay Thlsdah '� ama and Address Mir E>remp_ Men T, Wed Thu Fri Sat Sun Tot Rate Al I Sets Stare Total Net Pay iaRK DAVID LAMARENA "'".`*3422 R: 0.00 8.00 0.00 0.000.00 DAD 0,00 5.00 27_98oFR 223.84 594.63 119.17 15196 3535 Yakima Rd. Labarar Group 1 597.84 PPLE VALLEY,CA 92308 Married 3 On 0.00 0.00 0.00 000 OM OX O,OD 0,00 � FR 910.96 12.62 36,00 313.12 HISPANIC Mate DAVID SEAN FOLLMAN -°"--9065 R! 0.00 0.00 6.00 0,00 000 000 0.00 8.00 20.450 163.84 54.56 0.00 75210 .12.56FR. 50.79 42.96 48 5,BRAWrON AVE (7P9P ELEC 3ALTO,CA 92376 Married 3 0: D= 0.00 000 0.00 0-00 0.00 0.00 000 .0.000 R 6140hrs 1341 MAO 645.60 WHITE Male AICHAEL6EHL -"-8398 R� 8.00 5.00 8.00 MOO OAO 0.00 0.00 24,00 386,000 912,00 144.94 83.00 75212 2633 RURWOOD AVE. FORE ELEC 1360.:X1 19.63 96999 lIC7ORV1iLE,CA 92392 Singis 2 0: .QA0 0.0. 0.00 0.00 0.00 Oi00 0,00 0.00 0.000 . 36hrs 45.65 378.01 WHITE Male .EE ANDREW JONES III --"-1644 R: 8,00 0.00 0.00 0.00 0.00 0,00 0.00 8,00 34,140 273.12 141.79 0-00 75217 3785 ALAIANSA WAY JOUR ELEC *16.255FR. 9102 75.50 rERRI5.CA 42571 single i 0: D 0.00 000 0.00 0.00 0.00 0-00 0.00 40-OOOFR.i44 30613.47 BLACK Male 2hrs 49-75 379.35 'Jd+RY DPATTYIN •""-•" 885 R: 8A0 8.00 B.DO 0.00 0.00 0.00 0.00 24-00 27.980.90FR, 67152 63.2 7500 75230 169 GIENFAIR Laharar 6mup l SAN MRNARDINO,CA 92410 Married 2 01 0.00 0.00 0.00 0,00 0.00 0.00 0-00 0.00 .0-000M.1022.88 2499 273,45 749.43 WHITE Male CHRI5TOPHER ALEN WANStREET '.W`"-7494 R: 000 8-00 0.00 ODD ODD 0.00 0.00 8-00 30.000 240,00 134,22 0.00 75241 54M LUORETTA AVE Laba'er bmup£ ♦5.920FR. 7$.36 81.60 MIRA LOMA,CA 91752 M:amiod 1 0: 0.00 0.00 0-00 0.00 0.00 0.00 0.00 0-CO 0.000 12�h 0 42,67 350-88 864-72 WHITE Male urs Paw Regular 6000 2,454.32 Pertime 000 0.00 SSOII 254:#2 Certified Payroll Register Page: 2 Job 4ros}or LLSiomel' GFR ENTERPRISES.INC. SIERRA PACIFEC ELECTRICAL CONT GFR ENTERPRISES.INC Job Number: 5217 PACSFIC STREETA VALARIA DRIVE 2542 AVALON STREET 434 N.SECOND AVENUE Week Epciiag: 10/25/2009 LYNWOOD ESTATES#17793-#81000 RIVERSIDE,CA 925N-20S UPLAND,CA%786 Payroll 0 2 T/S SAN 9ERNMZi NO,CA 92222 .5TATEMENT OF COMPLIANCE bATF � ' /10 d I BERNICE WAGNER,PAYROLL/PERSONNEL MGk, do hereby certify under penalty of perjury_ (1)That I pay or supervise the payment of persons employed by SIERRA PACIFIC ELECTRICAL CONTRACTTN6, TNC.on the ""`PROJECT NAMED AND NUMBERED ON THE UPPER LEFT CQANER""-and that during the payroll commencing on the 7 day of�_200p and ending on the 5 day of !9�W20Q9 all persons on said project have been paid their full weekly wages earned, that no rebates have been or will be made either directly or indir" ly to or on behalf of said SIERRA PACIFIC ELECTRICAL CONTRACTIN6,INC, from the full weekly wages earned by any parson and that no deductions have been made either directly or indirectly from the full wages earned by any person,other than permissible deductions,as defined in Regulations,Part 3(29 GFR Subtitle A), issued by the Secretary of Labor under The Copeland Act,as amended (48 Stat. 948.63 Stut. 108,72 Stat_ 357: 40 U.S.C-276c), and described below: Fi i". FICA, SIT, SDI, UNTON DEDUCTIONS_ AND ANY COURT ORDERED WAGE DEDUCTIONS. (2)That any payrolls otharwisa under contract required to be submitted for the above period are correct and earnpl eta; that the wage rates for laborers or mechanics contained therein are not less then the applicable wage rates contained in any wages determination incorporated into the contract; that the classification set forth therein for each laborer or mechonia conform with the work he or she 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 Depoetmment 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 FRIN6E BENEFITS Ake PAID TO APPROVED PLAN-5, FUNDS, Ok PROGRAMS: (X)In addition to the basic hourly wage rates paid to eoch Laborer or mechanic listed in the above referenced payroll, payments of fringe benefits as listed in the contract have been or will be made to the nppropriata progr R.for the benefits of such employees. except where noted in section 4c below, (B) WHERE FRINGE BENEFITS ARE PAM IN CASH: ()Each laborer or mechanic listed in the above payroll has been paid as indicated on the payroll, an amount not less than the sum of the applicable basic hourly wage rate plus the amount of The required fringe benefits as listed in the contract, except as noted in section 4c below. (C) EXCEPTZONS: eXCEPTTON (CRAFT) EXPLANATION REMARKS: Name and Title signature 6ernice Wagner,Payroll/Personnel Mgr. Fox Number (951)784-3558 The wilful falsification of any of the above statements may subject the Contractor to civil or criminal prosecution. See section 1.001 of title 18 section"St of Title 31 of The United States Code, The employer has complied with the requirements of section 1771, 1811 and 1815 for any work performed by his employers on the public works project. Certified Payroll Register Pagel 1 Job Contractor a er ;FR ENTFO(tiSE5,INC. SIERRA PACIFIC ELECTRICAL CONT OFR ENTERPkrSE5,IW. Jab Naobcr. 5217 PAC",''STREET6 VALARIA DRIVE 2542 AVALON STREET ' 434 N.SECOND AVENUE Week Ending: W1/2008 LYNWOOD ESTATES RIVERSIDE,CA 92509-2057 UPLAND,CA 91766 Payroll# 3 T/5 SAN SERNARDINO,CA 92222 --Deductions--- Fad. Local Soc Sec Na. -----------Hors Worked This Job-------------------- Gross Pay Fm Othrr Check# Chss 10/27 10128 10129 10/30 IW31 11101 10/26 Pay This Job Mod Nana and Address Mar Emmp. Mon TVe Wad Thu Fri Sat Sun Tot Rate All Jobs State Total filet Pay MICHAEL GEHL '^"M4-8338 R: 8.00 WDO 0.00 0.0) 8.00 0,00 0.00 16.00 38,000 608.00 167.74 - 0,07 75262 12633 9URW000 AVE, FORE ELEC •16.703FR. 93.40 91.62 VIL-T-ORVILLE,CA 92392 Single 2 O: 0,00 0,00 0.00 0.00 000 0.00 0.00 0.00 0,000' 1520.00 21.85 1059.27 WHITE Male +O-WO R. 40hn 56-12 430.7$ LARRY D PATTON *•"-""-8685 R: 8.00 0.00 0.00 0,00 8.00 0.00 0.00 16.00 27.980 447,68 80.76 0.00 75280 1696LENFA2R Laborer Group 1 -5.9201-R. 57.44 84.00 SAN RERNARDINO,CA 92410 Married 2 O: 0.00 0.00 0,00 0.00 0.00 OM OpD 0.00 0.000 926,56 13.43 670.55 WHITE Male •0.000FR. 32hre 2038 256.01 CHRESTOP14ER ALLEN WANSTREET *"» 2-7494 R: 0.00 0.00 0.00 0.00 8.00 0,00 0.00 8.00 3D,0W 240DO 131,89 0.00 75296 5438 LUCRETIA AVE Laborer Group I *5.920Fk, 74.40 66.00 MIRA LOMA,CA 91782 Married 1 0; 0.00 OAo ODD COD 0.00 0,00 0,00 0-00 O,ODO 1200.00 77.40 869-31 WHITE Mole -0000FR. 40hrs 41.01 330.69 Hcura pav Regubr 40.00 1,295-68 overtime 0.00 0.00 Cortifiad Payroll Register Page: 2 " racror Customer 6M EN7EU%5ES,INC. SIERRA PACIFIC ELECTRICAL CONT C+A ENTERPRISES,rNC, Job Number: 5217 PACIFIC STREET 8 VALAPIA DRIVE 2542 AVALON STREET 434 N.SECOND AVENVE Waa Eiditg: 11;1/2008 LYNWOOD ESTATE5*117793-#81000 DIVEDSME,CA 92509-2057 UPLAND,CA 91786 "ll* 3 T/S SAN 6ERNARDINO,CA 92222 STATEMENT OF COMPLIANCE DATE !/•"/?'�f 168RNICE WAGNER,PAYROLLIPERSONNEL MGR,do hereby certify under penalty of perjury. (1)That I pay or supervise the payment of persons employed by SIERRA PACIFIC ELECTRICAL CONTRACTING, INC_on the ---PROJECT NAMED AND NUMBERED ON THE UPPER LeFT CQRNER" and that during the payroll commencing on the �Xe day of Or-7- 2009 and ending on the---L-:--day of ti id V 2008 all persons on said project have been paid their full weekly wages earned, that no rebates have been or will be made either directly or indirectly to or on beholf of said SIERRA PACIFIC ELECTRICAL CONTRACTING,INC, from the full weekly wages earned by any person and that no deductions hove been made either directly or indirectly from the full wages earned by any person,other than permissible deductions,as defined in Regulations, Pars 3(29 CFR Subtitle A), issued by the Secretpry of Labor under the Copeland Act-as amended (48 Star. 948,63 Stat, 108, 72 STat_ 357: 40 U,S.C_276c),and described below= FIT, FICA, SIT, SOT, UNION DEDUCTIONS. AND ANY COURT ORDERED WAGE DEDUCTIONS. (2)That any payrolls otherwise under contract required to be submitted for the above period are correct and complete; That the wage rates for laborers or mechanics contained therein are not less then the applicable wage rates contained in any wages deferminntion incorporated into the contract; that the classification set forth therein for each laborer or mcchonic conform with the work he or she performed. (3)That any apprentices employed in the above period are duly registered in a bona fido apprenticeship program registered with a state apprenticeship agency recognized by the Bureau of Apprenticeship and Training, United States Depoertment of Labor,or if no such recognized agency exists in a stator are registered with the Bureau of Apprenticeship and Training, United States Department of Labor, (4)T haT; (A) WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, FUNDS, OR PROGRAMS: (X)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 or will be made to the appropriate programs for The.benefits of such employees,except where noted in section 4c bale., (8) WHERE FRINGE BENEFITS ARE PAID IN CASH: C)Each laborer ar mechanic listed in the above payrolf has been paid as indicated on the payroll, on amount not less than the sum of the applicable Logic hourly wage rate plus the amount of the required fringe benefits as listed in the contract,except as noted in section 4c below, (C) EXCEPTIONS: EXCEPTION (CRAFT) EXPLANATION REMARKS: Name and Title Signature Bernice Wagner, Payroll/PCr5annal Mgr. ,Fax Number(951) 784-3398 The wilful falsification of any of the above statements may subject The Contractor to civil or criminal prosecution. See section 2001 of title 18 section 2331 of Title 31 of the United 5",re Code, The employer has complied with the requirements of section 1771, 1811 and 1815 for any work performed by his employees an the public works project, Certified Payroll Register Page; 1 � �� CoMraetor Customer 6FR-E4)-ERFRI5E5,INC. SIERRA PACIFIC ELECTRICAL CONT 6fR ENTERP14.I5E5.INC Job Number: 5217 PACIFIC5TREET&MALARIA DRIVE 2542 AVALON STREET 434 N.SECOND AVENVE Week Ending: 11!8/2008 LYNWOOO ESTATE5#17793-#81000 RIVERSIDE,CA 92509.2057 UPLAND,CA 91786 Payroll# 4 T15 SAN 6ERNARDINO,CA 92222 --•beductions--- . Fad. local Sot Sac No- ----------Hoare W4rked This Sob•-•-••-•------------ Grow Pay Fra4 Other Check# Clow 11/03 11/04 il/05 11/06 11107 11108 31102 Pay This Jab Mad Name and Adclress Mar hemp" Mon Tus Wed Thu Fri Sot Sm Tot Rate AIIJebc 5tote Total Net Pay MICHAEL&EHL '"-"4-ans R: 8.00 8.00 3.00 0,00 0,00 0.00 D-OD 19.00 38.000 722,00 167.74 O.DO 75317 12633 RVRWOOD AVE- FORE Me +16.702FR. 93,39 97.62 VIC1-011VILLE,CA 92392 Sln41e 2 0: 0,00 0.(* 0.00 0.00 0"00 0.00 0.00 000 0.000 1520.00 21.84 1)89.29 WHITE MaIe .O,OODFR, 40rs 56.12 430.71 LARRY 0"PATTON • '"-8885 R= 8,00 8,00 3.00 0.00 0.00 0.00 0.00 19,00 27,980 531.62 1I3,46 0.00 75335 1686LENFAM barer CxoaP 1 .5.920FR. 70,96 91-35 SAN RMARDIND,CA 92410 Marled 2 O: O,OD 0.00 D.00 0"00 0.00 0.00 0.0) 0.00 0.000 1144.55 L6.60 820.61 WHITE Molt .O.ODOFR. 40hrs 3137 32474 CHRISTOPHER ALIEN WANSTREET ""�-7494 R: 8,00 0.00 000 OAO 0.00 0.00 0.00 8.0D 30.000 240,0 13656 0.0D 75351 5438 LUCRETIA AVE Laborer 6rcup1 +59201`k 76,34 97-20 MIRA LOMA,CA 91752 Married 1 O: 0-00 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0-000 1231.20 17.85 560.12 WHITE Mate +O.00DF, 40hrs 43.13 371,05 Hoare pay Regulor 46.00 1,493,82 Wvtimc O.00 COO X00 1,4$3, Certified Payroll Register Page: 2 .7igp, Contractor &FR ENnWn5E5,INC. SIERRA PACIFIC ELECTRICAL CONT GFR ENTEPSISE5,INC. Job P.Amber 52f7 PAC>FTC STREETA MALARIA bll VE 2542 AVALAN5TREET 434 N.5ECOND AVENUE Week Endings 1118/2008 LVNW00D E5TAIES M7793-P64= RIVRSTI)E,CA 92509-L%M7 UPLAND,CA 917Si, Paymli# 4 TJ5 5AN SEWARDMO,CA 92222 5TATEMENT OF�rOMPLSANCE DATE (/•11 `49 I aekNICE WA6NER. PAYROLL/PERSONNEL MGR, do hereby certify under penalty of perjury, (1)That I pay or supervise the payment of persons employed by SIERRA PACIFIC ELECTRICAL CONTRACTIN&. INC_on the ^-"PROJECT NAMED AND NUMBERED ON THE UPPER LEFT CORNER""" and t at during the payroll commencing on the_ day of !V o� z0W and ending on the day of Nd� 20QP al] persons on said project have been paid Their full weekly wager earned,that no rebates have been or will be made either directly or Indirectly to or on behalf of said SIERRA PACIFIC ELECTRICAL CONTRACTING, INC. from the full weekly wages earned by any person and t'xnt nn deductions have been made either directly or indirectly from The full wages earned by any person,ather than permissible deductions, no defined in Regulations,Part 3(29 CFR Subtitle A), issued by the Secretary of Labor under the Copeland Act,as amended (46 Stat. 946,63 5tat. 108,72 Stot. 357: 40 U,S,C.276c),and described below: FIT, FICA, SIT,5bT. UNION DEDUCTIONS, AND ANY COURT ORDERED WAGE DEDUCTIONS. (2)'rhot any payrolls otherwise under contract required to be submitted for The above period are correct and complete; that the wage rates for laborers or mechanics contained therein are not less then the applicable wage rates contained in any wages determination incorporated into the contract; that the classification set forth therein for each laborer or mechanic conform with the work he ar she performed- (3)'rbot any apprentices employed in the above period are duly registered in a bans fide apprenticeship program registered with a state apprenticeship agency recognized by the Bureau of Apprenticeship and Training, United States Depaertment 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: (X)In addition to the basic hourly wage rates paid to each Laborer ar mechanic listed in the above referenced payroll, payments of fringe benefits as listed in the contract have been or will be mode to the appropriate pragrems far the benefits of such employees, except where noted in section 4c below- (B) WHERE FRINGE BENEFITS ARE PAID IN CASH: ()Each laborer or meahonle listed in the above payrail has been paid as indicated on the payroll,an amount net less than the sum of the applicable basic hourly wage rate plus the amount of the required fringe benefits as listed in the contract,exrept as noted in section 4c below. (C) EXCEPTIONS= EXCEPTION (CRAFT) EXPLANATION FtEMARKS: Name and Title Signature Rarnice Wagner. Payroll/Personnel Mgr- Fax Number(951) 784-3558 The wilful falsification of any of the above statements may subject the Contractor to civil or criminal prosecution. see section 3001 of title 16 section 2331 of Title 31 of the United STaTes Code, The employer has complied with the requirements of section 1771, 1811 and 1615 for any work performed by his employees on the public works project. certified Payroll Register Pko9e:: 1 C9rrtra4tor Custamrs E1�7ERPRISE5,INC. SIERRA PACIFIC ELECTRICAL CONT 6FR ENTERPRISE5.INC. Job Nwber! 5217 IFTC STREET d MALARIA DRIVE 2542 AVALON 5-MEET 434 M.SECOND AVENUE Week Endng: 71/22/2008 [WOOD E5TATE5#1T793-8781000 RIVERSIDE,CA 92509-2057 UMAND,CA 91786 Payroll# 6 4 BERNARDINO,CA 92222 -._Oeduciior6___ Fed. Wcal Sat Sec Na. - Hours Worlsod TTtis Jab-----------^•• Gross Pay Fca Other Check# More 1V17 11/19 11119 11120 11/21 11/22 11/16 Pay This Jab Mad m and Address NAr Examp, Mon Tus Wed Thu Fri Sal 5un Tot Rate All Jobs State Total Net Pay :HAE6 GEH6 •"-"-6336 R= 8.00 8.00 8.00 0.00 3.00 0.00 0.00 27,00 35,000 I026,DO 167.62 000 75428 33 BURW000 AVE, FORE ELEC +16.702PR. 93,35 91,58 I-MVILLE,CA 92392 Single 2 0; 0.00 0.00 0.00 0.00 000 0.00 0,00 0,00 0.000 1519.20 21.83 108677 WH1TEMale 40..OMPA. 40hrs 56,05 43043 VID A,GONZALES --" 9794 R: 0.00 000 8JM 0.00 3,00 0,00 0.00 11.00 22.710 249.61 132,60 0.0D 75430 3 Acacid Aux [zborrr Group 1 •5.920F31. 56.98 66.00 O RIVERA,CA 90660 Marred 1 0: 0.00 0.00 0.00 000 000 0.00 0.00 0.00 0.000 915,93 13.32 607.38 HISPANICMae *O.ODOM. 40hrs 42.65 311.55 :LETS V.MAV '"•2254 R: 0.00 0.00 8.00 000 300 0.00 0,00 MOO 22,710 249.81 63.76 0.00 73443 -51 aYDESDALE AVE. Loborer Group +6.92DFR. 58.76 7390 IERSIOE,CA 925D9 Married 4 0. 0.00 0.00 000 0.00 0,00 0.00 0.00 0.00 0.000 94791 13,74 719.97 PACIFIC We -0.000FR 40hr4 17.78 227,84 M D PATTON 's""-""-8885 R: 8.00 8,00 B4OD 0.00 3.00 0.00 0.00 2700 27,980 755.46 111,12 0.00 75447 1 GLENFAIR Laborer Eroup I +5.920FR. 6999 75.75 N BERNAROINO,CA 92410 Married 2 0= 000 0,00 0.00 0.00 000 000 OOD O.DO 0.000 I128.95 16.37 825.41 WHITE Male �0000FR 4045 30.31 303.54 Hare to Rngukr 76.00 2,281.06 Oaertime 0.00 0,00 7CM Tura Certified Payroll Register Page; 2 Job.' CORTrOCtd' Cist0mgr GFR ENTERPRISE5,IIJC SIERRA PACIFIC ELEC kV:AL CONT 6FR ENTERPRISES,INC. 3ab Number: 5217 PACIFIC STREE74 VALAP3A bRIVE 2542 AVALON 571ZEET 434 N.SECOND AVENUE Week Ending: 11122/2000 LYNW001)ESTATES#17793-#01000 RTYERSIDE,CA 92509.2057 UPLAND,CA 91786 Payrull# 6 T/5 $AN BERNARDINO,CA 92222 STATEMENT OF COMPLIANCE DATE I BERNICE WAGNER, PAYROLL/PERSONNEL MGR. do hereby certify under penalty of perjury, (1) That I pay or supervise the payment of persons employed by SIERRA PACIFIC ELECTRICAL CONTRACTINS,INC, on the "--PROJECT NAMED AND NUMBERED ON THE UPPER LEFT C ANER• and Jhat during the payroll commencing on the_1Lday of )U ev �ZDOQ and ending on the day of 20gg all Person*an said project have been paid their ful! weekly wages earned, that no rebates have been or will be mode either directly or indirectly to oe on behalf of sold SIERRA PACIFYC ELECTRICAL CONTRACTING,YNC, from The full weekly wages earned by any person and that na deductions have been made either directly or indirectly from the full wages earned by any person,other than permissible deductions,as defined in Regulations.Part 3(29 CM Subtitle A), issued by the Secretary of Lobar under the Copeland Act,as amended (46 Stat. 948.63 Stat, 108, 72 5-tat, 357: 40 U.S_C.276c), and described below: FIT, FICA, SIT,$DI,UNION DEDUCTIONS, AND ANY COURT ORDERED WAGE DEDUCTION5, (z)That any payrolls otherwise under contract required to be submitted for the above period are correct and complete: that the wage rates for laborers or mechanics contained therein are not less then the applicable wage rotes eon Mined in any wages determination incorporated into the contract; that the classification set forth therein for each laborer or mechanic conform with the work he or she performed- (3)That any apprentices emproyed 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 Depaertment 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: (X)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 or will be made to the appropriate programs for the benefits of such employees, except where noted in section 4c below. (8) WHERE FRINGE BENEFITS ARE PAID IN CASH= ()Each laborer or mechanic fisted in the above payroll has been paid as indicated on the payroll I. an amount not less than the sum of the applicable basic hourly wage rate plus the amount of the required fringe benefits as listed In the contract, except os noted in section 4c below, (C) EXCEPTION5: FXCEPTION (CRAFT) EXPLANATION REMARKS: Name and Title Slgnn+ure Bernice Wagner. Poyrall/Personnel Mgr_ Fax Number(9g1) 784-3558 The wilful falsification of any of the above statements may subject the Contractor to civil or criminal prosecution_ see section 1Do1 of title 18 section 2331 of Title 31 of the United States Code. The employer has complied with the requirements of section 1772. 1831 and 1615 for any work Performed by his employees on the public works project. .. car-riT ied Payroll Register page: I � ontraelar Cuetomrr 6FR EwwftISES,INC. SIERRA PACIFIC ELEC7RICAL CANT GFR ENTERPRISES,INC. Job Number; 5217 PACIFIC STREET d VALARIA DRIVE 2542 AVALON STREET 434 N-SECOND AVENUE Weak Ending= 1)24/2009 LYNWOOD ESTA7E.5#17793-#81000 RIVERSIDE,CA 92509-Z057 UPLAND,CA 91786 Payroll# 15 T/$ SAN BERNARDINO,CA 92222 --- Fed. Local Sac See No. -------------------Hours Worked This job------ Grose Pay Fco OMer Check A Class 01/19 01/20 01/21 01/22 01/23 01124 01/16 Pay This job Med N=a and Address Mar E;ammp, Mon Tue Wed Thu Fri Sol Sun Tot Rah AII.Tobd State Total Net Pay -------------- _______......._._._________.. _._-__-______ ......_... MICHAEL GEHL """«-8338 R: 0.00 OAO OAO OAO 8-00 0.00 0.0D 8.00 38960 311.68 77.06 0.00 76020 12633 RURWOOD AVE. FORE 81Ec +I6-735PR. 56.44 61,0i VTCTORVILLE.CA 92392 Single 2 0: 000 O.DO 000 0.00 0-00 0,00 O,OD 0,00 O,ODO 923.84 13.20 695.03 WHITE Mak w.000FR, 24hm 2110 22851 LARRY D PATTON ...- -8885 R: 0.00 0.00 0-00 0-00 SAO 0.00 0,00 8A0 27,980 223.94 66.99 0.00 76034 168&LENFAIR Lobar"OruW 1 •5.920FR- 0.3.57 70-80 SAN RFRNARDINO,CA 92410 Married 0 0: 0.00 000 0.00 D.00 0.00 0.00 0,00 0,00 4),0DD 702.72 10.19 493,56 WHITE mole .O,000PR, 24hrs 17.61 209.16 Hours NY Regular 16.00 535.52 Owcrtlme 0.00 0,00 IM 55M Certified Payroll Register page: 2 Sob Conn for Customer OFF.ENTERM15E5.INC. 5IERRA PACIFIC ELECTRICAL CONT GFR ENTBMMES,INC. Jab Number: 5217 PAa-KC S{REETA VALARIA ORnT 2542 AVALON 57REET JIM N.5ECOND AVENUE Week Eadag: 1/24/2009 LYNWOOD ESTATE5#17793-981000 RIVERSIDE,CA 92509-2047 UPLAND,CA 91786 Payroll# 13 T/5 5AN REWAROINO,CA 92222 STATEM T OF OMPLIANCE BATE, /L -!f I BERNICE WAGNER,PAYROLL/PERSONNEL MGR.do hereby certify under penalty of perjury. (1) That I pay or supervise the payment of persons employed by 51ERRA PACIFIC ELECTRICAL CONTRACTING, INC.on the "-^PROTECT NAMEb ANb NUMBEREb ON THE UPPER LEFT CO NER^w" d that during The pay e n roll commonr on theday of2009 and ending on the day of 2009 al l persons on said project have been paid their full weekly wages earnacr that no rebates have been or will be made either directly or Indirectly to or on behalf of said SZERRA PACIFIC ELECTRICAL CONTRACTING,INC, from the full weekly wages earned by any person and that no deductions have been mode either directly or indirectly from the full wages earned by any person,other than permissible deductions,as defined in Regulatlons,Part 3(29 CFR Subtitle A). issued_by the Secretary of Labor under the Copeland Act,as amended (4$ Slat. 948,63 5TaT. 108, 72 Staf. 557-.40 U.S.C_276c),and described below: FIT, FICA, SIT, SOT,UNION bEOUCTIONS, AND ANY COURT ORb FRED WAGE DEp�cTIONS. (2) That any payrolls otherwise under contract required to be submitted for the above period are correct and complete; that the wage rates for laborers or mechanics contained therein are not less then the applicable wage rates contained in any wages determination incorporated Into The contract; that The classification set forth therein for each laborer or mechanic conform with the work he or she 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 wining, United States bepaertmenT 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 PAIID 7.0 APPROI/EO PLANS, FUNDS,OR PROGRAMS: (X)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 or will be made to the appropriate programs for the benefits of such employees, axcept where noted in section 41; below, (B) WHERE FRINGE BENEFITS ARE PAID IN CASH: ()Each laborer or m.hartic listed in the above payroll has bean paid as indicated on the payroll.an amount not less than the sum of the applicable basic hourly wage rate plus The amount of the required fringe benefits as listed in the contract, except as noted In section 4. below, (C)EXCEPTIONS: EXCEPTION (CRAFT) EXPLANATION REMARKS: Name and Title Signature Bernice Wagner, Payrotl/Personnel Mgr_ �G�-✓JILI Fax Number(951) 784-3558 The wilful falsification of any of the above statements may subject the Contractor to civil or criminal prosecution. See section 1001 of title 38 section 2331 of Title 31 of The United states Code. The employer has complied with The requirements of section 1771. 1811 and 1815 for any work performed by his employees on the public works project. Certified Payroll Register page; 1 Sob Con t Cwtomr GFR ENTERPRISES,INC. SIERRA PACIFIC ELECTRICAL CONT 6FR ENTERPRISES,INC. Job Number: 5217 PACIFIC STREET VALARIA DRIVE 2542 AVALON STREET 434 N.SECOND AVENUE Weak Ending: 217/2009 LYNWOOD ESTATES#17 7 9 3 47810 0 0 RIVERSIDE,CA 92509-2057 UPLAND,CA 91786 Payroll#7 17 T/5 5AN BERNARDINO.CA 92222 --•Deductimu"- Fed. Local Soo Sea No, ----------------_Haun Waked This Job-------------------- Grads Pay taw Other Check# Class 02/02 02/03 02104 02105 02106 02/07 02/01 Pay This Jab Med Now and Addrass Mw Exemp- Man Tua Wed Thu Fri Sat Sun Tot Rate AIIJobs 51ote Total Nei Pay JEFFREY LCLOPM5 ""*44557 R: 0,00 0.00 0.00 8.00 om 000 0.00 8.00 33,960 311-68 138,07 0-00 76101 66935 FLORA AVE. FORE ELEC .16,764FR. 77-29 63.94 DESERT HOT SPRINGS,CA 9224 Morcied 1 0: 0.00 0.00 0,00 0.D0 0.00 0,00 0.00 0.00 0.000 1246.72 iBA7 90346 WHITE Male :0.01DOFR. 32hra 45-89 34326 JOHNM RUIZ *'-7846 R: 0.00 0110 0.00 8-00 0.00 0,00 0,00 8-00 24.000 MOO 34-67 0.00 76130 1150 RIMPAU AVE,7747 jJfAP ELFC .12.670FR. 47,62 190.48 CORONA.CA 92881 Single 40: 000 0,00 OX 0-00 0-00 0,00 0.00 0.00 0.000 768.00 11.14 473.50 HISPANIC Male -0-000FR. 32hn 10.59 294.60 JAMES E WILLIAM$JR "-4443 R: 000 OM 0.00 8,00 0,00 0-00 0.00 8.00 29930 23944 13832 0,00 76139 12641 MORNIN6 STAR RD. LABORER CP I PREV .10.49CF1, 59.38 115.20 APPLE VALLEY,CA 92309 Single 1 0; 0.00 0.00 ODD 0,00 0.00 OM 0,00 0.00 0.000 957,76 13-89 683,55 WHITE Malt i0000FR- 32hrg 47A2 37421 Hours pay Regular 24.00 743.12 OY¢rtime ODD 0-00 24.0 Certified Payroll Register Page: 2 lob odor Cwsf nFT &FR ENTERPRISES,INC, SIERRA PACIM ELECTRICAL(ANT GFR ENTERPRISES,INC. lob l Wber. 5217 PACIFIC 57REET&VALARIA DRIVE 2542 AVALON STREET 434 N.SECOND AVENUE Weak Ending: 2/712009 LYNW04M ESTATES#17793-#81000 RIVER SIDE,CA 92509-2057 UPLAND,CA 91786 Payroll# 17 T/5 5AN RERNARDIND,CA 92222 STAYEME 7 C(/)rPLIANCE I BERNICE//W'AGJNER, PAYROLL/PERSONNEL MGR, do hereby certify under penalty of perjury. (1) That I pay or supervise the payment of persons employed by SIERRA PACIFIC ELECTRICAL CONTRACTING,INC. on the ' PROJECT NAMED AND NUMBERED ON THE UPPER LEFT CORNER" grld hat during The payroll commencing on The1Iday of -h 2009 w d ending on the—_2day of 2009 all persons on said project have been paid their full weekly wages earned, that no rebates have been or will be made either directly or indirectly to ar on behalf of said SIERRA PACIFIC ELECTRICAL 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 any person,other than permissible deductions,as defined in Regulations,Part 3(29 CFR Subtitle A), issued by the Secretary of Labor under the Copeland Act, as amended(46 Stat. 948.63 Stat. 109,72 Stot. 357: 40 U.S.C.276c),and described below: FIT, FICA, SIT, SDI, UNION DEDUCTIONS, AND ANY COURT ORDERED WAGE DE=DUCTIONS. (2) That any payrolls otherwise under contract required to be submitted for the above period are correct and complete; that the wage rates for laborers or mechanics contained therein are not less then the applicable wage rates contained in any wages determination incorporated into the contract; that the classification set forth therein for each laborer or mechanic conform with the work he or she performed. (S)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 Depae%tmcnt 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) WHERI: FRINGE BENEFITS ARE PAID TO APPROVE=D PLANS, FUNDS, OR PROGRAMS: (X) In addition to the basic hourly wage rates paid to each Laborer or mechanic listed in the above referenced payroll, poyments of fringe benefits as listed in The contract have been or will be made To the appropriate programs for the benefits of such employees,except where noted in 9cctian 4. below. (B)WHERE FRINGE BENEFITS ARE PAID IN CASH: ()Each laborer or mechanic listed in the above payroll has been paid as indicated an the payroll, an amount not less than the sum of the applicable basic hourly wage rate plus the amount of the required fringe benefits as listed in the contract, except as noted in section 4c below. (C) EXCEPTIONS= EXCEPTION (CRAFT) EXPLANATION REMARKS: Name and Title Signatures Bernice Wagner,Payroll/Personnel Mgr. Fax Number (951) 784-3558 The wilful falsification of any of The above statements may subject the Contractor to civil or criminal prosacution. See section 1001 of title 19 section 2331 of Title 31 of the United States Code. The employer has complied with the requirements of section 1771, 1811 and 1815 far any work performed by his employees on the public works project, Certified Payroll Register Page: I Job ConTmctar Custarrer CPR Er'oWl?ISES,II.1c_ 5IERRA PACIFIC ELECTRICAL CONT 6FR ENTERPRI5E5,INC. Job Number: 5217 PACIFIC STREET VALARIA DRIVE 2542 AVALON STREET 434 N.SECOND AVENUE Wed;Endivg: 2/14/2009 LYNWOOD ES7ATE5917793-i IOM RIVERSIDE,CA 92509.2057 UPLAND,CA 91786 "all 18 T/5 SAN PERNARDINO,CA 92222 Deductions___ Fed. Loral Sac Set No. ...................Hours WorY,ed This Job-------------------- Eros Pay Eta Other Check# Class 02/09 OZ/I0 02111 02/12 02/13 02/14 0210$ Pay This Jab MW Name and Address Mar Facernp, Mon Tue Wed Thu Fri Sal' Sun Tot Rate Alf Jobs 5taie Total Net Pay JEFFREY L CURTrS - "-8557 R: 000 8A0 8A0 0,00 0,00 0.00 0.00 16.00 98960 623.36 226.38 0.013 76147 66935 FLORA AVE, FORE ELEC +16.763FR, 72.47 59.94 DESERT HOT SPRIN65,CA 9224 Married 10: 0,00 0,00 0.00 D.00 0.00 0.00 0.0D UO 0000 1166.80 16,95 852.70 WHITE Mak -0.OWFR, 30hrs 40.36 316,!0 MICHAEL 6214E = -8938 9: 0,00 $.00 8,00 $DO OJW 0100 0.00 24.00 38-MO 935,04 125,49 000 76155 12633 BURWOOD AVE. FORE ELEC .16,735FR 76.45 77,56 VICTORVILLE,CA 92392 Singk 2 O: GM 0,00 0.00 0.00 0,00 000 0.00 0.00 0.600 124672 17.88 910,58 WHITE Male +0.00018 32hn 3576 336.14 LARRY 0 PATTON `-e"4885 R! 000 8.00 6,00 8,00 0.00 0110 0.00 24,00 27.980 67152 96,23 0-00 76168 168 EL.ENFAM laborer Group +5920FR. 56.48 68.40 SAN eERNAR0INO,CA 92410 Married 0 O: 0.00 0.00 0,00 0,00 0.00 0.00 000 0,00 0.000 910.96 I321 6 6.85 WFRTE Mak 400OFR, 32hrr 27.79 264.11 TAMES WILLIAMSJR ^'"°+'"-9443 R: 0.00 8,00 8.00 0,00 0,00 0,00 0.00 16.00 29.930 478.88 123.75 0,00 76184 12641 MORN;M STAR RD. LA9ORER 6P 1 PREY +10,490FR 55.67 108.00 APPLE VALLEV,CA 9Z308 Single 1 0: 0.00 0,00 0.00 0.00 0.00 0,00 0.00 0.00 0.000 897,90 13.01 55529 WHITE wk 10.000FR. 30hrs 41,58 342.01 bs-urs Ea Regular . 80.00 2,708.60 overtime 0.00 0.00 86iFd 2,7 Certified Payroll Register Page: 2 Zak Contractor 0a tomer 5FR CNN-EUPRISES,TNC. SIERPA PACIFIC ELECTRICAL CONT &FR ENTERPRI5E5,INC. Job Number: 5217 PACIFIC STREETA VALARIA 0RIYE 2542 AVALON 5iMEET 439 N.5fCON0 AVENVE Week Eediig; 2/14!2009 LYNWOOb ESTATES#17 79 3 4 910W RrVERSIDE,CA 92509-2057 UPLAND,CA 91786 Payroll# 18 T/5 SAN eERNARDINO,CA 92222 STATEME - reMPLIANCE DATE I /f//7 I BERNICE WAGNER, PAYROLL/PEI2SONNEL MGR. do hereby certify under penalty of Perjury. (1) That I pay or supervise The payment of persons employed by SIERRA PACIFIC ELECTRICAL CONTRACTING, INC. an the **wPROTECT NAMED AND NUMBEREb ON THE UPPER LEFT CQR d NOZ**" hat during the payroll commen t.n on the Y day of _2009 and ending on the day of 2009011 persons on said project have been paid their full weekly wages earned. That no rebates have been or will be made either directly or Indirectly to or on behalf of said SIERRA PACIFIC ELECTRICAL CONTRACTING,INC. from the full weekly wages earned by,ony person and that no deductions have been made either directly or indirectly from the full wages earned by any person,other than permissible deductions,as defined in Regulations. Part 3(29 CFA Subtitle A), issued by the Secretary of Labor under the Copeland Act,as amended (48 Stat, 948,63 5TaT. 108, 72 Slat_ 357: 40 U,S.C,276c),and described below: FIT, FICA, SIT, 5bi. UNION bEDUCTiON.S, AND ANY COURT oRDEREb WAGE DEOUCTION5. (2)That any payrolls otherwise under contract required to be submitted for the above period are correct and complete: that the wage rates for laborers or mechanics contained Therein are not less then the applicable wage rates contained in any wages determination incorporated into the contract; That the classification set forth therein for edch laborer or mechanic conform with the work he or she performed. (3)That any apprentices employed in the above period are duly registered In a bona fide apprenTiceshlp program registered with a state apprenticeship agency recognized by the Bureau of Apprenticeship and Training, United States Deparrtment 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. C4) That; (A) WHERE FRINGE RC-MeFIT'5 ARE PAID TO APPROVEb PLANS, FUND5, OR PROGRAM5+ (X)In addition to the basic hourly wage rates paid to each Laborer or mechanic listed in the above referenced payroll, payments of fringc benefits as listed in the contract have been or will be made to the appropriats programs for the benefits of such employees, except where noted in section 4c below, (B) WHERE; FRINGE BENEFITS ARE PAID IN CASH: ( ) Each laborer or mechanic listed in the above payroll has been paid as indicated an the payroll, an amount not less than the sum of the applicable basic hourly wage rate plus the amount of the required fringe benefits os listed In the contract, except as noted in section 4c below. (C) EXCEPTIONS: EXCEPTION(CRAFT} EXPLANATION REMARKS: Name and T itle 5ignaturs Bernice Wagner, Payroll/Personnel Mgr_ ,.( u- Fax Number (951) 784-3556 The wilful falsification of any of the above statements may subJect the Contractor to civf I or criminal prosecution, See section 1001 of title IS section 2331 of Title 31 of the United States Code. The employer has complied with the requirements of section 1771, 1811 and 1818 for any work performed by his employees on the public works project. Certified Payroll Registce Page= 1 Sob Contractor Customer ;FR ENTERPRISES,INC. SIERRA PACIFIC ELECWCAL CONT 6FR ENTERPRISES,INC. Tob Number 6217 PACIFIC STREET A VALARIA DRIVE 2842 AVALON STREET 434 N.SECOND AVENUE Week Ending, 2/21/2009 LYNWOOD ESTATE54MT793-M WW RIVE115IDE,CA 92509.2057 UPLAND,CA 91786 Payroll# 19 T/$ 5AN BERNARDINO,CA 92222 C Deducnan L ca ,1 Fea. Local 5"Sec No. --------------Hours Worked This Job------------- 6rass Pay Fim Othor Check# Cloys 02/16 02/17 02)18 02/19 02120 02/21 02/18 Pay Thls Job Med Name and Address Mar Examp. Mon Tut Wed Thu Fri Sot Sun Tot Rote A3Ta6s Slate Total Net Pay :::::::::::a__________________________n•e:::::::_:::::._.______ -_xa:aveee:::::::::::.___..______:eccee_e:::::::::.____........___—_ve:e:::::__.________ MICHAEL 6EHL •""!" 333 R: 0.00 O.OD 1.00 D,DO 0.00 0.00 OAO 1,00 83,960 38.96 124,18 0.00 76199 12633 BURWOOD AVE. FORE ELEC +16,730P. 75.39 17,11 VICTORVILLE,CA 92392 $iryio 2 0; 0.00 0-00 0,00 0.00 0.00 0.00 0.00 0.00 0.000 1237.76 17-75 900.73 WHITE Male -DAOOFR. 32hrs 38.13 333.03 Hours Pia Regular 1,00 38.96 Ovcrtlmt 0,00 000 700 396 Certified Payroll Register PaQe,; 2 nir=ftr oAfamcr GFR ENTERPRISES,INC, SIERRA PACIFIC ELECTRICAL CONT 6M ENTERPRISES,INC. Job Numlim 5217 PACLf7C STREET a VALARIA DRIVE 2542 AVALON STREET 434 N.SECOND AVENUE Weak Esi rg, 2/2112009 LYNWOOD ESTATES#17793-#81000 RIVERSIDE.CA 92509-2057 UPLANp,CA 91786 Pdrdla 19 T/S SAN BERNARDMO.CA 92222 STATEME T OF MPLIANCE bATE •�7 I BERNICE WAGNER,PAYROLL/PEASONl1JEL MGR-do hereby certify under psnolty of perjury. (1) That I pay or supervise the paylneht of persons employed by SIEkRA PACIFIC ELECTRICAL CONTRACTING,INC. on the "*-PROTECT NAMED AND NUMBEREb ON THE UPPER LEEFT NER&O� t aT during the payroll commencing on the day of�R009 and ending on the__0,A�4day of r 6 2009 all persons on Said project have been paid their full weekly wages earned. that no rebates have been or will be made either directly or indirectly to or on behalf of said SIERRA PACIFIC ELECTRICAL CONTRACTING, INC. from the full weekly wages earned by any person and that no deductions have boon Rude either directly ar indirectly from the full wages earned by any person, other than permissible deductions, as defined in Regulations,Part 3(29 CPR Subtitle A), issued by the Secretary of Labor under the Copeland ACT, as amended (48 Stat. 948,63 Sim. 108,72 Stat, 357: 40 U.5.C.276c), and described below: FIT. FICA, SIT,SbI.UNION bEDUCTIONS, ANb ANY COURT ORDERED WAGE DEDUCTIONS. (2)That any payrolls otherwise under contract required to be submitted for the above period are Correct and complete; that the wage rates for laborers or mechanics contained therein are not less then the applicable wage rates contained in any wages determination Incorporated into The contract- that the elassif icc Lion set forth therein for each laborer or mechanic eenform with the work he or.she 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 Depoertment of Labor,or if no such recognized agency exists in a state,are registered with the Bureau of Apprenticeship and Training, United Stater Department of Labor. (4) That; (A) WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, FUNDS, OR PROCPRAM5: (X)In addition to the basic hourly wage rates paid to each Laborer or mechanic llstsd in the above referenced payroll,payments of fringe benefits as listed in the contract have been or will be made to the appropriate programs for the benefits of such employees, except where noted in section 4c below. (8) WHERE FRINGE BENEFITS ARE PAID IN CASH: () Each laborer or mechanic listed in the above payroll has been paid as indicated on the payroll,an amount not less than the sum of the applicable basic hourly wage rats plus the amount of the required fringe benefits as listed In the contract, except as noted In section 4c below. (C) EXCEPTIONS: EXCEPTION (CAAFi) EXPLANATION REMARKS: Name and Title Signature Bernice Wagner,Payroll/Personnel Mgr- AQ ' Fax Number(951)784-3598 The wilful falsification of any of the above statements may subject the Contractor to civil or criminal prosecution. See section 1002 of title 18 section 2331 of Title 31 of the United States Code. The employer has complied with the requirements of section 1771, 1811 and 1815 for any work Performed by his employees on the public works project. caIns ech 1 6INEERS■PLANNERS■MUNICIPAL CONSULTANTS 624 Brea Canyon Road ■ walnut ■ California 91789172705 a Talephone:(909)595.8599 ■ Fax:(909)595-8863 _ INVOICE TO: wJli� VV�" Invoice No 2w150542 GFRENTERPRISES,INC. , ;-, q_ C ';�� Date: 601: 06 434 N.SECOND AVENUE page: 1 UPLAND,CA 91786 �5 r ATTENTION:MR.CHUCK CROWELL �S "`"REVISED Prood: FINAL ENGINEERING FOR TRACT 17793-LYM\,CXk6 ESTATES TT Job Number: 252311 Contract S: 1 SCOPE OF WORK % AMWNT LESS CURRENT Y VOI FEE INCED INVOICED PRE1/IOUS INVOICE ATE TO DATE INVOICES AMOUNT EXTRA WORK THAT WAS EXCLUDED FROM ORIGINAL SCOPE OF WOF3K PER CHUCK CROWELL.'!?DISCUSSION WITH CITY. THE WORK ITEMS BELOW WERE LATER REQUSTED BY THE qTY AND PER CHUCK'' AUTHORVATION,THEY WERE COMPLETED AND SI.IS;�.tlTTED 1-4 CITY, TRAFFIC STUDY(Was not Included In the orlgin�l sacope.Per Chuck Crowall's discussion YVltti qty ,,�� Cfty would not require a Traffic Study,and treat 512,500 1009c $1'L,500 $0 $12,500 y this proJad ass an tnfill.jTrafflc Study completed � an approved by the Clary. ISaNITIAL ENVIRONMENTAL STUDY(Was not Included In the original sacope, Per Chuck Crowell's discussion with City City would riot $10,r 0, l00% 310,000 �l1 require an IS,and treat this project as an In flllj. $10,000 IS complatad and approved by the qty. Prepare and process a traffic signal plan to City for plan check and approval 415,000 80% I $12,000 9) $12,000 y6� I I AMOUNT FO�TFIIIS IWVOICE - I. $34 600.00 j Remit payment to: - Trarrstech Er 9ea ,Inc.lnc ra ,Inc. /! 1,47 624 Brea Canyon Rosati ------- � Fed Tax ID: P5-4314745 Walnut,CA 91789 Sh4a Tax ID: 3439207-A Sfate Corp.ID: i% 1493938 FOR QUESTIONS, PLEASE COWTACI-DAVE a738410071 t%Tllcher ----0atch 1 .lob # nCIL# e Cost Coda P.O. No. . Conk White-CLIENT Yellow-COPY Pinx ACCOUNTING Goldenrod- �r� ��+' Date �� VII V V U M L -C use Only California Fund Control' Inc. ("CFC") CFC # 1 11038 GF MAIL VOUCHER AND ATTACHMENTS TO P.O._BOX 3940, FULLERTON, CA 92834-3940 (714) 634-4878 9AM to 4PM (Closed 12 Noon to j1 PM) Mon thru Fri Voucher# 989126 BEFORE presenting documents in person for payment, please confirm availability of funds by pRene. 660 South State College Blvd., Fullerton, CA 92831. Mar is on reverse side of this voucher. Date 11/21/2007 Payee's Federal ID# 95-4314745 If ! D.Number is not on file at CFC, see PAYMENT REQUIREMENTS below ❑ Check box'd new address PAY Names) Transtech Erroineers Inc TO Address 624 Brea Can on Road -Y Phone (-909x595-8599 City Walnut State CA ZiP j17 @9 — ❑ Check box"PROGRESS payment OR ❑ Check box if FINAL payment THE SUM OF $ *37 2Q0 00 For disbursement on the job designated below: Job Name GFC ENTERPRISES LLC ! Job Address LOTS 1-18 TENT TRACT, 17793 Line Item Numbers Kind of Material or Labor For the purpose of obtaining payment,the undersigned certifies:o Cl that labor and materials referred to herein have been actually furnished by the persons named herein in the amount specified and were used on the job name and address designated herein and comply with all terms and conditions of the Fund Control Agreement. Contractor and/or Owner GFR ENTERPRISES INC GFC E T RPR3,SES LC Authorized Signatures) 1 SIGNATURE FELI O ROBLES JR CHECK US Mail (Standard delivery method, if no other delivery option is selected.) DELIVERY Another delivery service may be used l submihing prepaid shipping document or account number. OPTIONS: ❑ Trans Box ❑CA Overnight r3 'red Ex ❑ UPS ❑Other _ Your Delivery Account# (if no shipping document submitted) LXI Pickup check---- Call Ll� /�k✓� a T _ _ qpX) _q,5_Aq q q _ {Pnune) ".YMENT _REQUIREMENTS• Submit to CFC completed documents listed below by mail or in person. For Services, Labor or Materials: 1. Voucher . . . . . . . . . . . . . . . . . . . . . . . . . .Original compieted and signed by authorized individual(s). 2. Federal Tax ID No, of Payee . . . . . . . . . .Inserl Above. If PAYEE TAX INFORMATION is not on file at CFC, ccrnclete W-9 cn rver<,e side of ;his voucher Oil_submit separate W-9 form. 3. invoices) from Vendor . . . . . . . . . . . . . .C:Dpy: of bi!iim; fef work, ;na?eria.s and services si;pp:.ied for this job. 4. Release from Payee . . . . . . . . . . . . . . . .Completed conditional release on reverse side of this voucher. conditional release fci�T. JR 'submit a completed sepr.rate 5. Material Supplier Release(s) . . . . . . . . .Ovigiis:a' u- • C_?3 co,�y ,f ceu to CSC directly from supplier. For Reimbursements: 1, 2,3 & 4 above and proof that expenses have achraf: ;:, n ilaid ;;y; 'Payee inciuu'sng. Unconditional Releases, Cancelled Checks or Receipts from Credit Cards/Cash Registers/Government Agencies. Copies of issued checks alone rin not moot ronuiromantc Fes\ SOUTHERN CALIFORNIA Invoice#r 47669 EDISON' A.,eurso+INTEaNn WNAI.- Cue,V..', invoice Date: 11%21.2008 Southern California Edison Company 287 TENNESSEE STREET SCE Contact: Ryan Travis Jasso REDLANDS CA 92373 CITY OF SAN BERNARDINO Telephone: (909)-307-6749 300 N D ST SAN BERNARDINO CA 92401 Install - Billing Option: SCE INSTALL-REFUNDABLE Descriotion Amount Service Request Number 1183837 CHANGE E X DUPLEX IN METER AND SERVICE TO TRAFFIC S GNAL PEDESTAL Item# 50064 82370 105715 I $3.995.18 015380 LINE EXTENSION . pk�y��'f�- 1�go '�$"Rri , ,wrt�,p,a.by 50.5 R�°.d-4 .. "n'��f,4i'3 Tl•,, r TJ71110 J.- Previous Pavment $p •Enclosed are 2 copies of our invoice Please return I copy of the invoice with your payment j •Final electrical inspection from the local govemmental buildiog,and safety department must be received before we can energize your service. •If a street light work order is associated with this project,conpacts for that project will be enclosed. •Enclosed are copies of refundable and discount option appendices. Piece e select one option.sign,both copies(one as selected, the other as not selected)and return with your payment •All prices are valid until 1231-08 due to the Income Tax Corr ionent of Contribution NTCC)rate change from 22%to 35% effective 1-1-09. Invoices not paid in full on or before 12-31-08 will be re-priced u: Ina current labor,material,and tax rates. •Please retum all applications and/or contracts fully completed. - •Easement documents will be mailed directly to you from our pight of Way department.Please complete and remm them as soon as possible,es we will not be able to proceed with the project without clearance •An Edison Inspector must approve all underground systems.Please call your designated inspector X18 hours prior to construction to schedule an inspection. •Call the Edison company at 1-800-655-4555 to make application for electrical service. Invoice Total $3.995.18 — — — — — — — — — — — — — — — — — — — — — — Please detach and return payment stub with payment Payment Please pa\total amount now due: $3.995.18 Stub r Invoice#: 47669 Thank you for pa}ing promptl} CITY OF SAN BERNARDINO Make check payable to Southern California Edison 300 N D ST 287"TENNESSEE STREET SAN BERNARDINO CA 92401 REDLANDS CA 92373 ,nnaN cnuFOanu Invoice# 47669 WA EDISON' .tasDWONINr&tnrarltivu-Mmn n. Invoice Date: 11/24;2008 Southern California Edison Company 287 TENNESSEE STREET REDLANDS CA 92373 '��, SCE Contact: Ryan Travis Jasso CITY OF SAN BERNARDINO Telephone: (909)-307-6749 300 N D ST SAN BERNARDINO CA 92401 Install -Billing Option: SCE INSTALL-DISCOUNT J Description amount Service Request Number: 118,837 CHANGEEXIDUPLEX IN METER AND SERVICE TO TRAFFIC SIdNAL PEDESTAL i m> 50064 82375 _ S'-.338.16 315380-Li�,t EX TF_X S I ON L35G._ n o Previous Payment •Enclosed are 2 copies of our invoice.Please return I copy of the invoice with vour payment SO •Final electrical inspection from the local governmental building and safety department must be received before we can energize your service. •If a street light work order is associated with this project,contracts for that project will be enciosed •Enclosed are copies of refundable and discount option appendices{ Please select one option,sign both copies(one as selected. the other as not selected)and return with your payment. •All prices are valid until 12-31-08 due to the Income Tae Component of Contribution(ITCC)rate change from 22%to 35% effective 1-1-09. Invoices not paid in full on or before 12-31.08 will be re-priced using current labor,material,and tae rates. Please return all applications and/or contracts fully completed. •Easement documents will be mailed directly to you from our Right of Way department Please complete and return them as soon as possible,as we will not be able to proceed with the project without clearance "An Edison Inspector must approve all underground systems.Please call your desimated inspector 48 hours prior to construction to schedule an inspection. "Call the Edison company at 1-800-655.4555 to make application for electrical service. Invoice Total $2.338.16 1 Please detach and return payment stub with payment Payment Please pay total amount now due: Stub S'_.338.16 i Invoice 0: 47669 Thank you for paying prompilZ CITY OF SAN BERNARDINO Make check payable to Southern Califomia 300 N D ST Edison SAN BERNARDINO CA 92401 287 TENNESSEE STREET REDLANDS CA 92373 i V Now v0 %0 I I lil� I t Calklornia Fund ControU Inc. ("CFC") CFC # 11036 GF MAIL VOUCHER AND ATTACHMENTS TO P.O. BOX 3IB40,MLLERTON, CA 92834-3940 (714) 634-4878 9AM to 4PM (Closed 12 Noon to IPM) Mon thru Fri Voucher# 8323 BEFORE presenting documents in person for payment, please confirm availability of funds by phone. 660 South State College Blvd., Fullerton, CA 92831. Map is on reverse side of this voucher. Datel2/16/2008 Payee's Federal ID# If I.D.Number is not on file at CFC, see PAYMENT REQUIREMENTS below. ❑ Check box If new address PAY Names) Southern alifornia Edison TO Address 9R7 TannPCCPP SjIaet _ Phone ( 99-307-6749 City State CA —Zi 92573 ❑ Check box if PBOGRESS payment OR ❑ Check box if FINAL payment THE SUM OF For disbursement on the job designated below: Job Name GFC ENTERPRISES LLC Job Address LOTS 1-18 TENT TRACT 17793 Line Item Numbers 28' Kind of Material or Labor 14 -76AP of For the purpose of obtaining payment,the undersigned certifies to CFC that labor and materials referred to herein have been actually furnished by the persons named herein in the amount specified and were used on the job name and address designated herein and comply with all terms and conditions of the Fund Control Agreement. Contractor and/or Owner GFR ENTERPRISES INC GFC E 'RPRISES Authorized Signature(s) 1 SIGNATURE FELIZ O ROBLES .JR 0 CHARLES H CROWELL CH— CK Q US Mail (Standard delivery met hod. if no other delivery option is selected.) DELIVERY Another delivery service may be used by submitting prepaid shipping document or account number. OPTIONS: Trans Box ❑CA Overnight ® Fed Ex UPS ❑Other_ Your Delivery Account# (if no shipping documen! submitted) Pickup check ---- Call Ki C C ngf t A,�,I, c• (Contact Name) (�) q— I Ph (Phone) PAYMENT REQUIREMENTS: Submit to CFC completed documents listed below by mail or in person. For Services, Labor or Materials: 1. Voucher . . . . . . . . . . . . . . . . . . . . . . . . . .Original completed and signed by authorized individual(s). Federal Tax ID No, of Payee . . . . . . . . . .Insert y Above. If PAYEE TAX INFORMATION is not on file at CFC, complete W-9 on reverse side of this voucher Q_Fi submit separate W-9 form. 3. Invoice(s) from Vendor . . . . . . . . . . . . . .Copy of billing for work, materials and services supplied for this job. 4. Release from Payee . . . . . . . . . . . . . . . .Completed conditional release on reverse side of this voucher. s . . . , , • O_R Submit a completed separate conditional release form. 5. Material Supplier Release Original Document. Qg copy faxed to CFC directly from supplier. For Reimbursements: 1, 2, 3 & 4 above and proof that expenses have actually been paid by Payee Including: Unconditional Releases, Cancelled Checks or Receipts from Credit Cards/Cash Registers/Government Agencies. Copies of issued checks alone do not meet requirements.r� California ]'4�Itta11 Control,HERE Inc- ( G FOR ")RECORDS i-• �xrCFC��) CFC# 11038 GF Company 12/1612008 Job Name GFR ENTERPRISES GFC INC Date Voucher# 6323 ENTERPRISES LLC ---;8 313.34 Job Address LOTS 1-18 TENT TRACT 17793 Amount. Pavee Name S'6_lhern California Edison -• i i REQUEST FOR CHECK 0_9 e/i7or-d/ Date: li i� Payable To: ter. soh �- Address: —�'FaP ?75 -- City: l Amount: $ T-- State: Zip Code: 9`y= n� SPecial Instruction ; .. lAia�E? �y —=oS4ieC .Requested By: Approved By: --' _ G Check Issued By: Check No. please bring the receipt for Accountin Check Date: H•' I neck#: 2131 Date: 111,.- 2008 Vendor#: 12 City of San Bernardin . °Invoice# Job/Descri tion P Balance Retain Discount This Check CR111708-01 Traf Sig-Lane Closure 308.02 308.02 i i i GFC`ENTERPRISES, LLC 2 131 , 434 N.2ND AVE. ^� 20E.FOOTHILL BLVD. UPLAND, CA 91786 '�R'33�aAAIi&musr UPLAND,..CA.91788 (909)949-1400.- 90-7049/3222 , 11/17/2008 $ '308.02 THREE HUNDRED EIGHT AND 02/1.00 DOLLARS E PAY j City of San Bernardino DATE AMOUNT TO THE 300 North-"D" Street ORDER San Bernardino CA 92418--001 ,4 OF AUTHORAED SIGNATURE IRl Ill1 I M' 'in 002 L3 Lii° 1: 32224049 C-71' r° 39$ ZBr8466ii" GFC ENTERPRISES,LLC 2131 Check#: 2131 Date: 11/17/2008 Amount: 308.02 Vendor: 12 City of San Bernardino Invoice# JOWDescription Balance Retain Discount This Check CR111708-01 Traf Sig-Lane Closure 308.02 308.02 TO REORDER:CALL YOUR LOCAL SAFEGUARD DISTRIBUTOR AT 80M1427841 NARGUARD. UTROIJ. sru2 cnsaenl 2 - RBBLHJBm Biao YO65F00<]J6 t i 1 L FQEI Fnmar.� .. I RNOW Calculated Fees $121,50 Detak .Pay Fury Balance $sa=Additional Add tional Fees: Fee $aon Here TotalFeex $12,851.50 Details Partial Payment Redis'iibute Back Overpayment. Payments $6.400.0 Details BalanPag,*ipe�tic i.:_ ttam(3J VoidPayments Balance $6,-051.50 Fee.Loa rastAace mt le cktde dyer ed paS't rta m''ee 3etaitx: Rzprint Rece pt In,kd'eTrusrtrarr�otiwismPaymenrDetaifr I * F PayS�„'w•s 6:8rtess •o6da�c��tems, Print Cad _ --_ Exit IF iBarOrder ._----.-' REQUESTf FOR CHECK Date: z::::3�i 3 Payable To: ! '!5�'T aE pivv Address: 3'T�1°EET City: S.yirE•P/�'q �o State: e'. Zip Code: $7f�ig Amount: i Project Nam : Tract No. Cost Code: Special InstFction :Requested By: =Approyed Check Issued By: /v Check No. � Check Dale: I 'please bring tl�e receipt for Accounting. JJJ i t&)Cl ov- 1 IL-taL{ s i _ i - 1 . ..,eck#: 2111 a Date: 312008 Vendor#: 12 Clty of — ` San Bernerdwo Invoice# JoWDescnption E0700286 99999 Allocable Balance Retain Discount This Check - 6;:51.50 6,451.50 i I I i GFC ENTERPRISES, LLC 2111 434 N:, CA 91, //�� 20 E.FOOTHILL BLVD UPLAND; 0-1.91766 RSf3Ca &TM96r UPLAND, CA 91788 (9091,949-7400 90-7049'/3222 10/03/2008 $ '6,451.50 SIX THOUSAND FOUR::HUNDREDIFIFTY=,ONE AND 50/100 DOLLARS E PAY City of San Bernardino DATE AMOUNT TO THE 300 North-"D" Street ORDER -San Bernardino CA 9241 B--001 OF T :GV AUTII RIZEDSIGNATUREc 11'00211111" 1: 3 2 2 2 7049 51: 11 39818846611' GFC ENTERPRISES,LLC Check#: 2111 Date: 10/03/20081 2111 'Amount: 6,451.50 Vendor: 12 City of San Bernardino Invoice# Job/Description ' E0700286 99999 Allocable Balance Retain Discount 6,451.50 This Check 6,451.50 L 1$Ar{GUARD: u*llo us4 TO REORDER,CALL YOUR LOCAL SAFEGUARD DISTRIBUTOR AT 800.¢7.8741 vsu-cKismnzL H99LHJ0010100 Y06SF004736 �ebFNARpFNO Sp �, v T Y O U g z a �OG~pFp IN\0`O CITY OF SAN BERNARDINO DEPARTMENT OF DEVELOPMENT SERVICES PUBLIC WORKS RECEIPT Activity## : E0801235 Lane Closure Permit SITE ADDRESS: PARCEL: RECEIVED FROM: WC ENTERPRISES,LLC RECEIPT NUMBER: R08006153 TRANSACTION DATE: 10/09/2008 TOTAL PAYMENT: 736.42 TOTAL PAID FROM TRUST: .00 TOTAL PAID FROM CURRENCY: 736.42 TRANSACTIONS: Type Method Description Amount ---- -------- --------------------------- ------------ Payment Check 2113 736. 42 TOTAL: 736.42 ACCOUNT ITEMS: Description Account Code Current Pmts �P -----------------------------` - J, Archival Fee 001-000-4789 " PW-Issuance Fee 1.00 - PW-Lane Closure Fee 001-000-4352 001-000-4351 45.00 676.00 Technology Fee 001-000-4715-000 1 TOTAL: 736.42 RECEIPT ISSUED BY: LJQ INITIP,LS: LQ ENTERED DATE: 10/09/2008 TIME: 10: 14 AM COMMENTS NOTICES I I REQQUES FOR CHECK Date: o6-dam Payable To:;,j Address: — City: S"/�ji' .Piv� > I State: ,r,� Zip Code: 9.2yig Amount: $ 7y6 yx — Project Nam : Lr�wt�o Fsrsrc I Tract No. Cost Code: Special Instr ction Requested By: APProved By: /,�/, ,G•; /J/ Check Issued By: �lf•� IJ— BOG 9te q,4` Check No. "Please brio Check Dale: g tl;e receipt for Accounting. i i i Record#: 395 Check#: 2113 Date: 10/06/2008 Description: 10 Day Lane Closure Permit Amount: 736.42 Vendor#: 12 Payee: City of San Bernardino Address: 300 North:D" Street San Bernardino CA 92418--001 GFC ENTERPRISES, LLC 2 113 434 N.2N DAVE. ^� 20 E.FOOTHILL BLVD. UPLAND, CA 91786 ilf kt4KK8TRU5T UPLAND, CA 91786 (909)949-1400 90-7049/3222 10106/2008 $ '736.42 SEVEN HUNDRED THIRTY-SIX AND 42/100 DOLLARS f PAY City of San Bernardino 300 North-"D" Street DATE AMOUNT TO THE San Bernardino:CA 92418--001 ORDER Memo: 10 Day Lane Closure Permit AUTHORIZED SIGNATURE w E� 00P. IL3111 1: 3222 ?0 � r :'° i6 t. G5;I` GFC ENTERPRISES,LLC 2113 Record#: 395 Check#: 2113 Date: 10/0612008 Description: 10 Day Lane Closure Permit Amount: 736.42 Vendor#: 12 Payee: City of San Bernardino Address: 300 North=D" Street San Bernardino CA 92418--001 sp TO REORDER,CALL YOUR LOCAL:SAFEGUARD DISTRIBUTOR 8064 .AT 266]41 � er�eone9- UiM0U5> 6F6L2 CIIiSWIt:L R991HJ6610700 VO65F00.136 I