RENTED EQUIPMENT SUMMARY RECORD

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Indicate size, capacity, horsepower, make and model as appropriate

DATES AND HOURS USED

RATE PER HOUR

TOTAL COST

VENDOR

INVOICE NO.

DATE AND AMOUNT PAID

CHECK NO.

W/OPR

W/OUT OPR

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

GRAND TOTAL

I CERTIFY THAT THE ABOVE INFORMATION WAS OBTAINED FROM PAYROLL RECORDS, INVOICES, OR OTHER DOCUMENTS THAT ARE AVAILABLE FOR AUDIT.