Worker Interview - DSA

Worker Interview

General Information

Project Name: Pilgrim Academy - HISD

Prime Contractor: DT Construction, LP

Subcontrctor: Moody Flooring Services, LLC

Interview Detail

Date

Worker Name

Auditor Name

Remarks

03/06/2018 11:11 AM

Jorge Rodriguez

Jorje Munoz

Don’t know hourly pay

ethnicity

gender

ssn

badge

Hispanic

Male

6368

No

Job Classification

Union Member?

Apprentice?

Period

Tile Setter

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

03/03/2018

03/05/2018

8.00

0.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Tape Measure

Trowel

Hammer

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

8.00

Other Work?

Other Training?

Experience

Certifications

None

None

3.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature