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U.S. Department of Labor PAYROLL <br /> Employment Standards Administration (For Contractor's Optional Use;See Instructions at www.dol.gov/esa/whd/forms/wh347instr.htm) <br /> Wage and Hour Division Persons are not required to respond to the collection of information unless it displays a currently valid OMB control number. Rev. Dec.2008 <br /> NAME OF CONTRACTOR OR SUBCONTRACTOR® ADDRESS OMB No:1215-0149 <br /> RAIN FOR RENT 9 PIONEER DRIVE NORTH OXFORD,MA 01537 Expires: 12/31/2011 <br /> PAYROLL NO. FOR WEEK ENDING PROJECT AND LOCATION PROJECT OR CONTRACT NO. <br /> 2 04/23/2011 Well Installation&Hydraulic Load Testing-Mashpee,MA <br /> 54001809 <br /> (1) (2) (3) (4)DAY AND DATE (5) (6) (7) (8) (9) <br /> i m W DEDUCTIONS <br /> H o rr Su Mo T. We Th Fr Sao NET <br /> NAME AND INDNIDUAL IDENTIFYING NUMBER ,=a GROSS WAGES <br /> (e.g.,LAST FOUR DIGITS OF SOCIAL SECURITY O z w WORK O 04117 O4"8 0419 °"20 09m 0°� 04� TOTAL RATE AMOUNT w'TH STATE LOCAL TOTAL PAID <br /> NUMBER)OF WORKER zC 3 5 CLASSIFICATION HOURS OF PAY EARNED FICA HCTAX G TAX TAX OTHER DEDUCTIONS FOR WEEK <br /> HOURS WORKED EACH DAY <br /> Acuna,Rodolfo A LABORER GROUP D <br /> 3.00 1 3.00 71.3447.5 356.70 <br /> 1 1 935.41 <br /> Mar Stat: M XXX-XX-1918 Gender.M E0: Hisoanic or Latino S 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 47.56147.5E 1,262.05 71.31 12623 53.38 0.00 75.72 326.64 #273937 <br /> Project Totals""`"` 3.00 356.70 20.15 35.68 15.09 0.00 21.40 92.32 <br /> 0 <br /> S 0.00 <br /> 0 <br /> S <br /> 0 <br /> S <br /> 0 <br /> S <br /> 0 <br /> S <br /> 0 <br /> S <br /> 0 <br /> S <br /> While completion of Form WH-347 is optional,it is mandatory for covered contractors and subcontractors performing work on Federally financed or assisted construction contracts to respond to the information collection contained in 29 C.F.R.SS 3.3,5.5(a).The Copeland <br /> Act(40 U.S.C.S 3145)contractors and subcontractors performing work on Federally financed or assisted construction contracts to"furnish weekly a statement with respect to the wages paid each employee during the preceding week."U.S.Department of Labor(DOL) <br /> regulations at 29 C.F.R.S 5.5(a)(3)(ii)require contractors to submit weekly a copy of all payrolls to the Federal agency contracting for or financing the construction project,accompanied by a signed"Statement of Compliance"indicating that the payrolls are correct and <br /> complete and that each laborer or mechanic has been paid not less than the proper Davis-Bacon prevailing wage rate for the work performed.DOL and federal contracting agencies receiving this information review the information to determine that employees have received <br /> legally required wages and fringe benefits. <br /> Public Burden Statement <br /> We estimate that it will take an average of 55 minutes to complete this collection,including time for reviewing instructions,searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information. If you have <br /> any comments regarding these estimates or any other aspect of this collection,including suggestions for reducing this burden,send them to the Administrator,Wage and Hour Division,ESA,U.S.Department of Labor,Room S3502,200 Constitution Avenue,N.W., <br /> Washington D.C.,20210. <br />