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Date: i('2-1� ONSM Project No. / Za <br />Project; <br />Localion: <br />Firm:.,' <br />Address: <br />Description of work: <br />Labor No. Men Reg. OT Total <br />Bricklayer Foreman: <br />Bricklayer: <br />Labor Foreman: ` yr <br />Laborer. I / //p <br />Miscellaneous: <br />Materlals <br />Quantity Equipment Hours <br />Block <br />Lull <br />Brick <br />Mixer <br />Grout <br />Table Saw <br />Mortar <br />CutOff Saw <br />Sand <br />Hammer Drill <br />Joint Rein <br />HIM S <br />Misc. 1 <br />iso. t <br />Misc. 2 <br />Above additional wmken. gpge u e to _ion_ p a� tl a m au pact unless olhemise Apulated. <br />'t"�'t4o* 18 oddedd SSCOpet a to SUbCOntMCL <br />Authorized Signa ure: Ticket No. <br />Data:T <br />(Signature) ONSM Representative: 03950 <br />F-7 <br />Attachment number 3 <br />Page 148 <br />