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
Lifting,
Reg. OT A, B, C, Hours Hrs. Year H.P., Size or Gas, Diesel, Hauling or
Name Class Type Model Mounting
Hrs. Hrs. D Oper'd Idle Mfg. GVW Electric Bucket
Capacity

MATERIAL
Qty. Unit Description

Contractor Signature Title

ODOT Signature Title

Original to "ODOT FILE", Copy to "CONTRACTOR"
Equip. No.