Form 700-050-58 "Daily Record of Extra Work Site Source Record" - Florida

Form 700-050-58 is a Florida Department of Transportation form also known as the "Daily Record Of Extra Work Site Source Record". The latest edition of the form was released in September 1, 2017 and is available for digital filing.

Download a PDF version of the Form 700-050-58 down below or find it on Florida Department of Transportation Forms website.

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Download Form 700-050-58 "Daily Record of Extra Work Site Source Record" - Florida

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700-050-58
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
CONSTRUCTION
09/17
DAILY RECORD OF EXTRA WORK
SITE SOURCE RECORD
Date
Financial Project ID No.
Road No.
Work Order No.
NOTE:
Report Prime, Sub, and Subordinate Sub work effort on separate sheets.
Prime
Subcontractor
Subordinate Subcontractor
Description of Work Done this Date:
LABOR
NO.
POSITION
TOTAL HOURS
RATE
EQUIPMENT
NO. UNITS
KIND
TOTAL HOURS
RATE
MATERIAL USED
QUANTITY
KIND
RATE
Inspector__________________________________________ Signature ________________________________________
Foreman __________________________________________ Signature ________________________________________
NOTE: This record to be made in duplicate, one copy to be retained by the Contractor and one copy attached to the Cost
Estimate for Increase, Decrease or Alterration in the Work (Form 700-050-59) for each Work Order.
700-050-58
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
CONSTRUCTION
09/17
DAILY RECORD OF EXTRA WORK
SITE SOURCE RECORD
Date
Financial Project ID No.
Road No.
Work Order No.
NOTE:
Report Prime, Sub, and Subordinate Sub work effort on separate sheets.
Prime
Subcontractor
Subordinate Subcontractor
Description of Work Done this Date:
LABOR
NO.
POSITION
TOTAL HOURS
RATE
EQUIPMENT
NO. UNITS
KIND
TOTAL HOURS
RATE
MATERIAL USED
QUANTITY
KIND
RATE
Inspector__________________________________________ Signature ________________________________________
Foreman __________________________________________ Signature ________________________________________
NOTE: This record to be made in duplicate, one copy to be retained by the Contractor and one copy attached to the Cost
Estimate for Increase, Decrease or Alterration in the Work (Form 700-050-59) for each Work Order.
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