How to read this sheet. One line per worker per day. “What was done”
describes the actual work performed at the address above. Bill rates are the rates in the
signed work authorization referenced above. Amount = Hours × Bill Rate. Materials and
equipment are listed separately below. Questions on any line? Call before the due date and
we will walk it with you.
Date
Worker
Classification
What Was Done
Hrs
Bill Rate
Amount
Labor subtotal (this sheet)
Materials and equipment (per signed work authorization)
Permits and inspection fees (at cost)
TOTAL DUE THIS PERIOD
Acknowledgement. The hours and work described above were performed at the
job address on the dates shown, at the rates set out in the signed work authorization
referenced above. Signing confirms review of this backup sheet. It is not a waiver of any
warranty or claim.