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De Valle Co. To __ /_,t~~=-~__::;;:_____::=--==--=--=:c._.._------Dr.
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For Labor done during the Month of~~~~~~~----192_ 5
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MONTH DAY TIME DESCRIPTION OF WORK DONE
1
2
3
4 It It
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6
7
8
9
10
11
12
13
14
15
16
17
18
I
19
20
21
22
23
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25
26
27
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31
--u--
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N o. Days U per d;:iy, am onntmg to
N o. D ays at $ per day, amo unting to __ _
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Less
:..:::::.__ _ _____ ....:.......:.,~-~-------------- , __ f.__, __ ~-1----1----- 1---
I .,ess for
Amount d ue
Approved by Recei,·ed Paym~
______________ Foreman (Si gn H ere) __________ ~"'-------l--
______________ Supt.
