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Attachment 4a <br />REPORT OF SERVICES / LABOR VALUE APPRAISAL <br />Name of Project: <br />Name of Person Performing Services: <br />Address: <br />Telephone: <br />Did you receive any compensation for the time you <br />devoted to thisproject? <br />Yes No <br />If yes, who paid you? <br />How much were you paid? <br />Month: <br />I Year: <br />Sunday <br />Monday <br />Describe the services you performed. (Ifyou supervised others, include their names <br />andpositions.) <br />Wednesday <br />I low was the hourly rate shown below determined? <br />$25.00 per hour is the value of donated labor as established by the Heritage Bam <br />Advisory Committee. <br />Saturday <br />Total number of hours worked each day during this mouth: <br />Beginning <br />Sunday <br />Monday <br />Tuesday <br />Wednesday <br />Thursday <br />Friday <br />Saturday <br />Totals <br />$25.00 <br />Per hour <br />Amount charged to <br />$ <br />project: <br />I hereby swear that I devoted the time reported above, performing the <br />work described on the project named. This time has not been reported <br />for any other Federal or State project. <br />Date <br />I supervised or coordinated this person's work and verify that it was <br />performed as indicated above. <br />Date <br />R.sa sTnrn' o�, <br />State of Washington • Department of Archaeology 8 Historic Preservation a _ u <br />m <br />P.O. Box 48343 • Olympia, Washington 98504-8343 • (360) 586-3065 nor isso eeyn <br />www.dahp.wa.gov <br />INSTRUCTIONS: <br />Washington State Department of Archaeology and Historic Preservation <br />Total hours this <br />1063 S. Capitol Way, Suite 106 <br />voluntary, which is claimed against a grant or used <br />month: <br />for the matching share of a grant. Complete it on a <br /># of hours <br />Hourly rate: <br />$25.00 <br />Per hour <br />Amount charged to <br />$ <br />project: <br />R.sa sTnrn' o�, <br />State of Washington • Department of Archaeology 8 Historic Preservation a _ u <br />m <br />P.O. Box 48343 • Olympia, Washington 98504-8343 • (360) 586-3065 nor isso eeyn <br />www.dahp.wa.gov <br />INSTRUCTIONS: <br />Washington State Department of Archaeology and Historic Preservation <br />Use this form to document all labor, whether paid or <br />1063 S. Capitol Way, Suite 106 <br />voluntary, which is claimed against a grant or used <br />PO Box 48343 <br />for the matching share of a grant. Complete it on a <br />Olympia, WA 98504-8343 <br />timely basis, i.e., fill it out immediately after the <br />service is provided. <br />R.sa sTnrn' o�, <br />State of Washington • Department of Archaeology 8 Historic Preservation a _ u <br />m <br />P.O. Box 48343 • Olympia, Washington 98504-8343 • (360) 586-3065 nor isso eeyn <br />www.dahp.wa.gov <br />