C-34

DAILY REPORT OF FORCE ACCOUNT WORK

Project No.:

Co./Rt./Sec.:

Date:

Contractor:

Subcontractor:

Work Description:

Reason for F. A.:

[A]

Owned Equipment - On Project (Bid Work)

[C]

Owned Equipment - Brought to Project (Non-Bid Work)

[B]

Rented Equipment - On Project (Bid Work)

[D]

Rented Equipment - Brought to Project (Non-Bid Work)

LABOR

EQUIPMENT

Name

Class

Reg. Hrs.

OT Hrs.

A, B, C, D

Hours Oper'd

Hrs. Idle

Year Mfg.

Type

Model

H.P., Size or GVW

Gas, Diesel, Electric

Lifting, Hauling or Bucket Capacity

Mounting

Equip. No.

MATERIAL

Qty.

Unit

Description

Contractor Signature

Title

ODOT Signature

Title

Original to "ODOT FILE", Copy to "CONTRACTOR"