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MONTH DAY TIME DESCRIPTION OF WORK DONE
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4
5
6
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7
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9 I
10 I
11
12 I
13 I
14 I
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15
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19
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22 I
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25
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30 I
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No. Days at $ per day, amounting to ~ ·, TOTAL
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No. D~ at $ per day, amounting to
Less
Less for
Amount due
Approved by R eceived Payment:
............................................................................................ Foren1an
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