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DeI-v alle Co. To _____ G _(_,)_~_L _. __ •1 .......:'t-'----'-,_ t_t:,..__ _____ Dr.
0 ~·. 0
~
::0
_ -~_ A _____ l92_ ~
For Labor done during the Month of_ ~-:. __ «---' _ _ ±:-___ ..
z
(/)
MONTH DAY TIME DESCRIPTION OF WORK DONE
1 C
2
G.j .,,6.,, -/7 . ,r- /
____ _ _ 3_---.,.l _ ___ ,~_ -c:;_~ ~, ~ ---------'-------- --------+---,
4 t) . ,,, /
5 9 /.- • • ·c
6 J
7 tCf·
- ./ /
8
9
10
12 -
11
13 ()
14
15 rJ
16 0
17
18 0
19
20
21
22 t)
23
24
25 6
26
27 D
28
29 v
30 ~
31 J
V U
No. Days l 6 at$ ), f per da y, am ounting to .., ,,._,... I TOTAL
No. Days at $ per day. amounting to , ___ I
1- 1--1----!
Less ,_I I
,.
"---------------- ---------------- ---1---1-----~-
Less for
Arnount due I
"--------------------------------,---,--,----,---- -1-------' 1
;::::::==============================:....__--======------=====-t- -=---~
Approved by Recei ved Payment:
______________ Foreman (Sign Here)~ ~ - ( -,---~ - ~- 9~--
--------------~Supt.
~----------'