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<br />EXHIBIT VIII-V, Con!. <br /> <br />RECORD OF EMPLOYEE INTE'I~VIEW FORM <br /> <br />RECORD OF EMPLOYEE <br />INTERVIEW <br /> <br />Project Nc me: <br /> <br />(Labor Standards) <br />1. Name of Employee <br /> <br />Contractor or Subcontractor (Employer) <br /> <br />2. Home Address & Phone Number <br /> <br />3. Last Day You Worked on <br />Project Before Today: <br /> <br />4. Your Hourly Pay Rate: <br /> <br />----------------- <br />Number 01' Hours Worked on <br />Project on That Date: <br /> <br />$ <br /> <br />5. Your Job Classification/s? <br /> <br />Yes <br /> <br />NQ <br /> <br />Appn,ntice <br /> <br />6. Your Duties? <br /> <br />7. Tools or Equipment Used: <br /> <br />8. Paid at Least Time and One-Half for all Hours <br />Worked in Excess of 40 in a week? <br /> <br />Ye,,--JiQ <br /> <br />9. Ever Threatened, Intimidated, or Coerced into <br />Giving Up Any of Your Pay? <br /> <br />10. Duties Observed by Interviewer: <br /> <br />yes <br /> <br />NQ <br /> <br />yes NQ <br /> <br />Conform to Classification <br /> <br />11. Remarks (Continue on Reverse Side if Necessary) <br /> <br />12. Signature of Interviewer <br /> <br />Date of Interview <br /> <br />PAYROLL EXAMINATION <br /> <br />13. Remarks (Continue on Reverse Side if Necessary) <br /> <br />14. Signature of Payroll Examiner <br /> <br />Date of Examination <br /> <br />Reprint of HUD -11 (8-69) <br /> <br />VIII-V-3 <br /> <br />{Revised 5199) <br />