Worker Interview - DSA

Worker Interview

General Information

Project Name: Milby High School - HISD

Prime Contractor: DivisionOne Construction, LLC

Subcontrctor: Himmel’s doors

Interview Detail

Date

Worker Name

Auditor Name

Remarks

12/04/2019 12:47 PM

Larry kent

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

9868

No

Job Classification

Union Member?

Apprentice?

Period

Laborer-Skilled

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

11/21/2019

12/03/2019

8.00

24.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hand Tools

Drills

Hammer

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

26.00

Other Work?

Other Training?

Experience

Certifications

None

None

25.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature