Worker Interview - DSA

Worker Interview

General Information

Project Name: Wharton K-8 Dual Language Academy - HISD

Prime Contractor: DivisionOne Construction, LLC

Subcontrctor: Alexjer Communications Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

06/27/2018 10:16 AM

Jesus Romo

Victor Bowen

Biweekly pay

ethnicity

gender

ssn

badge

Hispanic

Male

9104

No

Job Classification

Union Member?

Apprentice?

Period

Electronic Data

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

06/25/2018

06/25/2018

8.00

15.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hand Tools

Hand Tools

Hand Tools

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

None

30.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature