South Florida's Trusted Resource for Skilled Trades

WEEK ENDING (SUNDAY)
JOB NUMBER
CUSTOMER INFORMATION







JOB SITE LOCATION







REPORT ALL INJURIES TO YOUR SKILLED STAFFING BRANCH OFFICE IMMEDIATELY
SKILLED STAFFING IS A DRUG – FREE WORKPLACE

TIME WORKED IS FOR ONE WEEK ONLY. Start with MONDAY and end on midnight SUNDAY.

Entire time nearest quarter hour (.00; .25; .50; .75) only.

DO NOT LEAVE ANY DAY BLANK! If no hours are worked, mark an “X” in the day’s column.

Skilled Staffing Employee Mon Tue Wed Thu Fri Sat Sun Totals
Regular—Overtime
Grand Total

CUSTOMER APPROVAL

The hours as shown are correct. By signing this Customer Approval we acknowledge that we are bound by the terms of the conditions of assignment as stated on the reverse hereof and certify that the listed employees have satisfactorily performed service for the hours shown. Additionally, I am not aware of any work-related injuries or accidents which may have occurred during this pay period involving any of the above named employees except as noted at the bottom of this form.

I Agree*

Signature*

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