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Derv alle Co. To <J#c Dr.
0
(/)
-t
::0
m
C
For Labor done during the Month of 192 -t
0
z
(/)
MONTH DAY TIME DESCRIPTION OF WORK DONE
1
2
3
4
5
6
7
8
9 0
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
/4 TOTAL
o. Days at $ per day, amountin g to
I
No. Days at $ per day. amoun tin g to
L ess
L ess for
Amount due
A pproved by Recei ved Payment:
Foreman (Sign Here)
Supt.
