Worker Interview - DSA

Worker Interview

General Information

Project Name: Sharpstown High School - HISD

Prime Contractor: ICI Construction

Subcontrctor: CLS Technology, Inc

Interview Detail

Date

Worker Name

Auditor Name

Remarks

10/06/2017 12:00 AM

Efrain Feliciano

Jorje Munoz

0

ethnicity

gender

ssn

badge

Hispanic

Male

3623

No

Job Classification

Union Member?

Apprentice?

Period

Electronic Data

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

10/06/2017

10/06/2017

0.00

21.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Wednesday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hammer

Screwdriver

Drills

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

None

2.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature