Worker Interview - DSA

Worker Interview

General Information

Project Name: Lamar High School - HISD

Prime Contractor: Gilbane Building Company

Subcontrctor: A/W Mechanical Services, LP

Interview Detail

Date

Worker Name

Auditor Name

Remarks

07/27/2017 12:00 AM

Raymond Turner

Yolanda Gaines

Independent contractor and paid STRAIGHT time.

ethnicity

gender

ssn

badge

White

Male

1234

Yes

Job Classification

Union Member?

Apprentice?

Period

Welder-Pipe

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

07/02/2017

07/26/2017

10.00

0.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Welding machine

Hand Tools

Drills

Hard hat

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

Yes

Yes

55.00

Other Work?

Other Training?

Experience

Certifications

None

Welding. Portable AC

30.00

Welding/ fork/scissor lifts, portable AC

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature