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Del Valle Co. 0
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MONTH DAY TIME D~SCRIPTION 01" WORK DONE
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No. Days at $ per day, amounting to
No. Days at
Less
Less for
Amount due
Approved by Received Payment:
-··························································································Foreman ( Sign Here ) .............................. -......... 1 ••••••••••••••••••••••••••••••••••••••••••••••••.
···························································································supt.
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