WEEK ENDING SUNDAY				EMPLOYEE NAME (PRINT)					EMPLOYEE SIGNATURE
EMPLOYEE NUMBER				CLIENT NAME					ADDRESS
DAY		DATE		START		FINISH		LUNCH		TOTAL REG		TOTAL OT
MONDAY
TUESDAY				>		>		>
WEDNESDAY				>		>		>
THURSDAY				>		>		>
FRIDAY				>		>		>
SATURDAY				>		>		>
SUNDAY				>		>		>
AUTHORIZED SIGNATURE				TITLE			Print Hours			REG HRS	REG MIN	OT HRS	OT MIN
CLIENT NAME (PRINT)				IS THIS EMPLOYEE    YES CONTINUING THIS    NO  ASSIGNMENT?			TOTAL HOURS TO THE NEAREST QUARTER HOUR				TOTAL HOURS

* EMPLOYEE: I CERTIFY THAT THE HOURS SHOWN HEREON REPRESENT THE TOTAL HOURS WORKED THIS WEEK BY ME, AND WERE PROPERLY VERIFIED.
** CLIENT: YOUR SIGNATURE REPRESENTS THAT YOU ARE IN AGREEMENT WITH ALL THE TERMS AND CONDITIONS AS SET FORTH ON THE FRONT HEREOF AND THAT THE HOURS SHOWN ARE CORRECT AND THE WORK WAS COMPLETED IN A SATISFACTORY MANNER.
EMPLOYEE INFORMATION
All work performed in excess of 40 hours per week (Mon-Sun) will be at straight time, unless otherwise stated by the client. Overtime (at time and 1/2) is permitted ONLY if requested and approved by the client. Approval MUST FIRST be obtained from us by the client. IF YOU DO NOT CONTACT US after each assignment, we will assume you are not available for work.
CLIENT INFORMATION
Should your firm or any of its affiliates of clients hire the consultant named on this time card on a full-time or consultant basis at anytime during contracting period or within one year of end-date of contract, your firm agrees to pay our placement service charge as follows:
         30% of the hourly rate multiplied by 2080. For example: hourly rate $10 X Factor 2080 = $20,800.00 X 30% = $6,240,00 Conversion Fee