TO BE COMPLETED BY THE RLP SITE SUPERVISOR Customer Site RLP Job No. Supervisor Date INSTRUCTED BY Name Position Signed Date Time REASON FOR DAY WORKS Give a brief explanation of the work required which is additional to contract NAMES AND RECORDING OF HOURS Name Mon Tue Wed Thu Fri Sat Sun Rate (£) Total (£) MATERIALS / PLANT/ EQUIPMENT Quantity Description Rate (£) Total COMPLETION OF WORK APPROVALS Name Position Signed Date Client Position Signed Date Signature