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Del  Valle  Co.                                                                             0
                                                                                                                          ii
                                                                                                                          -t
                                                                                                                          :!!
                                                                                                                          11
                                                                                                                          C:
                                                                                                                          -t
                                                                                                                          0
                                               For  Labor  done                                                         ' i
            MONTH     DAY ,   TIMIC                             DESCRIPTION OF WORK DONE



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                                                                                                                TOTAL
               No.  Days                                  at          per  clay,  amounting  to
               No.  Days                                 at           per  day,  amounting  to  ._ ___ .

                       Less
                                                                                                I-
                       Less  for
                       Amount  due


               Approved  by                                      Received  Payment:


                      ........................................................................................... Foreman

                      .......................................................................................... Supt .

                ........................................................................................................................................................................................................................ ·---······························
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