1. 100 Cummings Center
Suite 206L Week ending: 8/13/2006
Beverly, MA 01915
Weekly Work Schedule Consultant: Shawn Boike
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
8/7/2006 8/8/2006 8/9/2006 8/10/2006 8/11/2006 8/12/2006 8/13/2006
Time In Total 8:00 AM Total 7:00 AM Total Total Total Total Total
Time Out 0.00 12:15 PM 4.25 12:00 PM 5.00 0.00 0.00 0.00 0.00
MEAL BREAK
Time In Total 1:00 PM Total 1:00 PM Total Total Total Total Total
Total
Hours
Time Out 0.00 4:45 PM 3.75 0.00 0.00 0.00 0.00 0.00 Worked
Total 0.00 8.00 5.00 0.00 0.00 0.00 0.00 13.00
Is Assignment Complete? Yes No If Yes, Last Day Worked was:
Consultant Name: Shawn Boike Consultant's signature certifies that this form is a true and accurate summary of
(please print) all hours worked, reflecting Consultant's own record of each day's starting time,
ending time and break times. In addition, Consultant's signature certifies that
Consultant Signature: the Consultant sustained no injuries on the assignment.
Client Name: Client Representative signature certifies that the Client Representative is
(please print) authorized by the client to approve this Consultant timesheet. In addition, the
signature certifies that the Client Representative has reviewed this timesheet,
Client Signature: the timesheet has been properly and accurately completed, and the Consultant
has satisfactorily worked the hours reported.
Weekly Per Diem Documentation (If Applicable)
Maximum number of days of Per Diem allowed n/a Consultant Signature:
each week per the "Per Diem Agreement":
Consultant's signature certifies that for every Per Diem day claimed, the Consultant
Number of Days claimed (as limited by the "Per n/a was overnight away from their permanent home and was in compliance with the terms
Diem Agreement") for week ending shown above: terms of the "Per Diem Agreement" and the "Certification of Per Diem Eligibility"
agreement between the Consultant and Oxford Global Resources, Inc.
FAX TO: 1-800-203-9186 The original form and confirmation should be kept by the
Consultant for their own records.
Please call 1-800-628-2104 if you have any diffuculty faxing
To: Oxford Payroll this form.
Date: ____________________ Time: __________________
Faxed From Telephone # :_______________________ Assignment #:
Work/Contact Telephone # :______________________ Customer #:
Customer Name:
Consultant is required to: Consultant #:
x Complete and sign Consultant timesheet
x Obtain client signature Consultant Name:
Give client representative a copy
Fax this form to Oxford any time on Monday Oxford Dept #:
Save the fax confirmation with copy of timesheet
It is the goal of Oxford to maintain the highest possible standard of employee safety.
All Oxford employees are expected to obey safety rules and exercise caution in all work activities.
Safety is everyone's responsibility.