Worker Interview - DSA

Worker Interview

General Information

Project Name: Parker Elementary School - HISD

Prime Contractor: Patriot Contracting, LLC

Subcontrctor: NAH Sports Flooring, LLC

Interview Detail

Date

Worker Name

Auditor Name

Remarks

02/01/2018 10:46 AM

Alex Robbins

Jorje Munoz

Don’t know Pay rate

ethnicity

gender

ssn

badge

Hispanic

Male

1536

No

Job Classification

Union Member?

Apprentice?

Period

Floor Layer/Finisher

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

01/29/2018

01/31/2018

12.00

0.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Saturday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Tape Measure

Knife

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

None

4.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature