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Sub, and Subordinate Sub work effort on separate sheets. Prime Subcontractor Subordinate Subcontractor Description of Work Done this Date: LABOR NO. POSITION TOTAL HOURS RATE TOTAL HOURS RATE EQUIPMENT NO. UNITS KIND MATERIAL USED QUANTITY KIND RATE Signature Contractor Signature Inspector NOTE: This record to be made in duplicate, one copy to be retained by the Contractor and one copy attached to the Extra Work Summary (form 700-050-59) for each Work Order. RECYCLED PAPER.

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