Submitted by
Description of Work
Email
Phone
Department
Building/Room
Account number
Date Submitted
Completion By
Received by
Hours Worked Record
Date
Time
Initials
Quantity
Item
Amount
Total $
Date
Item/Vendor
Amount
Total $
Stock & Ordered Materials Total $
Total hours _______________ x $_______ per hour + Other Misc. Charges of $______________ =
Total charges for the sheet $
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