Worker Interview - DSA

Worker Interview

General Information

Project Name: Milby High School - HISD

Prime Contractor: DivisionOne Construction, LLC

Subcontrctor: EVYS Electric, Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

10/10/2019 01:03 PM

Sergio bravo

Gabriela Uribe

Biweekly pay

ethnicity

gender

ssn

badge

Hispanic

Male

9200

No

Job Classification

Union Member?

Apprentice?

Period

Electrician

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

08/14/2019

10/09/2019

8.00

30.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Blueprints

Drills

Bandsaw

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

25.00

Backhole. Forklift. Boom lift

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature