Worker Interview - DSA

Worker Interview

General Information

Project Name: Lamar High School - HISD

Prime Contractor: Gilbane Building Company

Subcontrctor: KenMor Electric Company, LP

Interview Detail

Date

Worker Name

Auditor Name

Remarks

12/13/2018 01:37 PM

Aaron Borbor Freeman jr

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Electrician Apprentice

No

Yes

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

10/15/2018

12/12/2018

8.00

21.50

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hand Tools

Drills

Screwdriver

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

15.00

Scissor

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature