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Del Valle Co. C
ai
--1
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ID
C
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For Labor done during the Month oL .......................................................... 19 ......... . 0
z
Ill
MONTH DAY TIME DESCRIPTION OF WORK DONE
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
I
26
27 I
28 I
29 I
30 I
31
TOTAL
No. Days at$ per day, amounting to
No. Days at $
Less
Less for
Amount due
Approved by Received Payment:
............................................................................................ F oreman ( Sign Here) ............ ~ ... ~ ................................................................. .
···························································································supt.