Example
Worksheet E003 Modified (FD Patches) Showing Adjusted Square Yards for Payment
based upon Overdepth/Underdepth Existing Pavement
	Rev 11/12											Modified Form  E003			-99	-20
	Line No.:			Project No.:											-30.0001	-15
	Item Code:			Category No.:											-20.0001	-10
	Description:			Contract ID:						Page No.:					-10.0001	.
															10.0001	10
								Plan	Measured						20.0001	15
								Patch	Pavement						30.0001	Extra Work
			Patch Location		Length	Width	Patch	Thickness	Thickness	Adjusted	To Date
	Date	Sta	Sta	(Side)	(ft)	(ft)	(SY)	(in)	(in)	(SY)	(SY)	By:
	06/02/08	100+00	100+50	Rt	50.00	12.0	66.667	10.000	12.000	73.334	73.334		20	10
	06/02/08	200+00	200+10	Rt	10.00	12.0	13.333	10.000	8.000	12.000	85.333		-20	-10
	06/02/08	250+00	250+06	Lt	6.00	12.0	8.000	10.000	10.000	8.000	93.333		0	.
	06/02/08	250+60	250+70	Rt	10.00	12.0	13.333	10.000	14.000	Extra Work	93.333		40	Extra Work
							0.000			0.000	0.000		#DIV/0!	#DIV/0!
							0.000			0.000	0.000		#DIV/0!	#DIV/0!
							0.000			0.000	0.000		#DIV/0!	#DIV/0!
							0.000			0.000	0.000		#DIV/0!	#DIV/0!
							0.000			0.000	0.000		#DIV/0!	#DIV/0!
							0.000			0.000	0.000		#DIV/0!	#DIV/0!
							0.000			0.000	0.000		#DIV/0!	#DIV/0!
							0.000			0.000	0.000		#DIV/0!	#DIV/0!
							0.000			0.000	0.000		#DIV/0!	#DIV/0!
							0.000			0.000	0.000		#DIV/0!	#DIV/0!
							0.000			0.000	0.000		#DIV/0!	#DIV/0!
							0.000			0.000	0.000		#DIV/0!	#DIV/0!
	Qty. Awarded:			Authorized:				Method of Measurement:
	CO Adjust.:			Quantity Paid:				Basis of Payment:
				% Authorized:		0.0		Checked By:
								Audited By:
	Note:  This form can be used to track daily patching quantities and daily or weekly totals can be transferred to Fieldbook to Worksheet E003.