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De1V alle Co. To_fr~/8-_.£..-_/,____~ _ Dr.
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-4
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ID
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For Labor done during the Month of __ :3 __ ....,..~'---------192 -4
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MONTH DAY TIME DESCRIPTION OF WORK DON E
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
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31
\S~~ ¥
No. Days at $ per dar. a:nonnting to + l-i"'i2 ___ __ T_o_T_A_L __ __ _
1 1 1
f
No. Days
::::....:.:_-~-=------------_____::,~------'---"-- ----'---_...,;.__-'----.,---=--- 1---1-----1--
Less
1 0 _!:?__1---1------1-----'
J,ess for
Amoun t due
Approved by RectiYed Payment:
_ _ _____________ Foreman
_______________ Supt.
