Page 6 - delvalleco1921november
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De Valle Co.
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ID
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MONTH DAY TIME DESCRIPTION OF WORK DONE
1
2 I /
'1
,) I~
4
5 ,
6
7 I
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28 T ;
29 ' I
30 I I
31
TOTAL
o. Days at $ per day, amounting to
_____ . . _______________ a_t_$,._ __ ____,l~)e_r __ d~a}"--'._a_m_o_u_n_ti_ng,_,_r _t<_> ___ 1 __ , ____ _ _____
No. Days
1 1 1
Less
Less fo_r
:____ ___________________ , __ l- 1--1--u-) _c;,_ 1---'----
Amount due
A ppro\'ed by Rec1=ived Pay met t:
________________ Foreman (Sign Here)-----,-----------1-
----------------~upt.
