Contract Services Time Sheet
Anesthesia Partners of Montana
Contractor Name: Carl Jay Gutierrez - |
For Dates: Beginning: JUNE 4 Ending: JUNE 15 Date Submitted: |
Day | Date | Off | Regular | On Call | Callback | Callback | Regular Hours | Overtime Hours | Total Hours | |||
In | Out | In | Out | In | Out | |||||||
M | 6/4 | N | 0700 | 1600 | N | 8 | 1 | 9 | ||||
T | 6/5 | N | 0700 | 1800 | N | 8 | 3 | 11 | ||||
W | 6/6 | N | 0700 | 1630 | N | 8 | 1.5 | 9.5 | ||||
T | 6/7 | N | 0700 | 1500 | N | 8 | 8 | |||||
F | 6/8 | N | 0700 | 1500 | N | 8 | 8 | |||||
S | 6/9 | Y | N | |||||||||
S | 6/10 | Y | N | |||||||||
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Contractor Signature Department Verification Carl Gutierrez, MD |