Title Page

  • Document No.

  • Project Number

  • Project Name

  • Conducted on

  • Superintendent Name

  • Location

Project Type

  • Who authorized this work to be performed on a time and material basis?

  • Type the contact's name here

  • What type of project is this?

  • Was material used?

  • Description

  • Material
  • How many?

  • Was material used?

  • Add signature

  • Description

  • Material
  • How many?

  • Was material used?

  • Description

  • Material
  • How many?

  • Was material used?

  • Description

  • Material
  • How many?

  • Was material used?

  • Description

  • Material
  • How many?

  • Is there rental equipment onsite?

  • Is there WestPro equipment onsite?

  • Describe the additional work completed

  • How many total regular time man hours were used to completed today's work?

  • How many total overtime man hours were used to completed today's work?

  • How many total double time man hours were used to completed today's work?

  • Take a picture of the completed work.

  • Confirmation Signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.