Force Account Record Template
Company or Agency Name: [Company Name]
Project Name: [Project Name]
Project Number: [Project Number, if applicable]
Record Date: [Date]
Reference Number: [Reference Number, if applicable]
Work Location: [Location]
Work Order / Change Order Number: [Number, if applicable]
Supervisor or Foreman: [Full Name]
Prepared By: [Full Name]
Description of force account work performed:
[Describe the work performed]
2. Labor Record
Employee 1 Name: [Full Name]
Classification: [Laborer / Operator / Technician / Other]
Hours Worked: [Number]
Rate: [$Amount]
Labor Cost: [$Amount]
Employee 2 Name: [Full Name]
Classification: [Laborer / Operator / Technician / Other]
Hours Worked: [Number]
Rate: [$Amount]
Labor Cost: [$Amount]
Employee 3 Name: [Full Name]
Classification: [Laborer / Operator / Technician / Other]
Hours Worked: [Number]
Rate: [$Amount]
Labor Cost: [$Amount]
Total Labor Cost: [$Amount]
3. Equipment Record
Equipment 1: [Description]
Equipment ID or Unit Number: [Number]
Hours Used: [Number]
Rate: [$Amount]
Equipment Cost: [$Amount]
Equipment 2: [Description]
Equipment ID or Unit Number: [Number]
Hours Used: [Number]
Rate: [$Amount]
Equipment Cost: [$Amount]
Equipment 3: [Description]
Equipment ID or Unit Number: [Number]
Hours Used: [Number]
Rate: [$Amount]
Equipment Cost: [$Amount]
Total Equipment Cost: [$Amount]
4. Material Record
Material 1: [Description]
Quantity: [Number]
Unit Cost: [$Amount]
Total Cost: [$Amount]
Material 2: [Description]
Quantity: [Number]
Unit Cost: [$Amount]
Total Cost: [$Amount]
Material 3: [Description]
Quantity: [Number]
Unit Cost: [$Amount]
Total Cost: [$Amount]
Total Material Cost: [$Amount]
5. Other Charges
Additional charges, if any:
[Fuel]
[Subcontracted service]
[Delivery]
[Disposal]
[Other]
Amount: [$Amount]
Total Other Charges: [$Amount]
6. Daily or Work Notes
Weather Conditions: [Conditions, if applicable]
Site Conditions: [Conditions, if applicable]
Additional notes regarding delays, access issues, approvals, or work progress:
[Insert notes]
7. Cost Summary
Total Labor Cost: [$Amount]
Total Equipment Cost: [$Amount]
Total Material Cost: [$Amount]
Total Other Charges: [$Amount]
Total Force Account Cost: [$Amount]
8. Attachments
Attached or available supporting documents:
☐ timesheets
☐ equipment logs
☐ receipts or invoices
☐ delivery tickets
☐ photos
☐ daily field notes
☐ other: [Describe]
9. Signatures
Prepared By Signature: __________________________
Name: [Full Name]
Title: [Job Title]
Date: [Date]
Supervisor Signature: __________________________
Name: [Full Name]
Title: [Job Title]
Date: [Date]
Owner / Manager / Authorized Reviewer Signature: __________________________
Name: [Full Name]
Title: [Job Title]
Date: [Date]