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Del Valle Co. To ... d<L ........ ~ .................................................. Dr. C
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For Labor done during the Month of. ...... ~ ......... ~ ....... 19 .. 1::.?> 0
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MONTH DAY TIME DESCRIPTION OF WORK DONE
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No. Days '} Iv at $ J- 0 O per day, amounting to T OTAL
No. Days at$ per day, amounting to ___ __
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Less
Less for 1- ':•- 1--1---!--
Amount due
Approved by R eceived Payment:
(Sign Here ) ........ ~.{ ..... .JJ..1 ................................................... .
............................................................................................ Foreman
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