Worker Interview - DSA

Worker Interview

General Information

Project Name: Lamar High School - HISD

Prime Contractor: Gilbane Building Company

Subcontrctor: Milam & Co. Painting, Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

05/16/2019 02:24 PM

Frumencio Gonzalez

Jorje Munoz

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Painter

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

04/29/2019

05/15/2019

8.00

13.25

Pay Type

Pay Day

deductions

OSHA

Paycheck

Thursday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Paint brush

Roller

Broom

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

12.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature