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To .................... ~ ................ : ........... ~ ........... .................................... Dr. i -i
7 :a
iii
C:
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For Labor done during the Month of ..... ~ ........... .19.'2.P 5
z
UI
MONTH I DAY TIME DESCRIPTION OF WORK DONE
I
2
3 I I I
4 I I I
I
5
6 I I J
I
7
I
8
9 I
10 I
II I
12
I
13 I
14
15 J i IG( 1
16 1/ }._
17 I
18
19 I
20 I
21 ;·
22 I
23 I
24 I
25 I l-- /4
26 I J..,-7
27 I • I
1
28 • I
29 . '
30 I
31
at $ '3 ~ ~ TOTAL
No. Days 0 per day, amounting to
No. Days at$ per day, amounting to i------i----i-----:.---
Less
Less for
Amount due
Approved by Received Payment:
............................................................................................ Foreman
