Gary Indiana
Your Subtitle text

Vendor Work Order Employee Request Form

Did you know that your company may be eligible for a hefty tax benefit if you hire ex-offenders?

Please follow the directions below to request a pre-screened hourly (minimum of 4 hrs), daily, weekly or possible permanent employee.

As a result of some folks that think they do not have to pay the workers, it will now be required to deposit a $300.00 retainer with Its Garys Time Inc., prior to any workers being provided. If the $300.00 is not used on your project, you will be refunded the difference between what is owed the workers and your retainer balance immediately upon completion of your project. If your project caused the retained to be exhausted on worker pay, then a new retainer may be necessary to keep workers coming. My sincere apologies for this trouble, but I must protect the guys coming out to work.

Below is a copy of the form, if you like you can either copy this form to a document, fill it in and email or fax it to me
. or you can use the contact form at the bottom, be sure to include an email address or a fax number so that I can get the form to you.

My email is and my fax is (866) 410-9825. I am also open to suggestions to improve the form. Thank you for wanting to help!

Roger Hayward, Founder

Its Garys Time Inc

Office / Cell (219) 775-6898
Conference Line 305-848-8888
Room code 2484859961#

"Lets Get Busy"

In this World, It is not what I Take Up, But, what I Give Up, that makes me Rich



I, __________________________________________, as representative for the company listed below do request from Its Garys Time Inc., men / women to perform duties as described in this work order. I also agree to pay for the labor that I receive in accordance with the terms below

Company making request: ____________________________________________________(Vendor)

Billing Address: _____________________________________________

_______________________ _____________________

Contact Name: ___________________ Phone # (        ) _____ - ________

Number of workers requested:___________

Hrs required per man:____________ (Actual hours may vary)

Date(s) needed: _____ / _____ / _____


From _____ / _____ / _____ to _____ / _____ / _____

Vendor will pay $7.25 per hour per man for this project

Addresss(s) where work is to be performed: Workers Name: Workers Initial

1. ________________________ 1. ______________________ __________

2. ________________________ 2. ______________________ __________

3. ________________________ 3. ______________________ __________

4. ________________________ 4. ______________________ __________

Brief description of work to be performed

I/we agree to pay for any and all labor within 7 (seven days) of any labor that is performed. Checks are to be made payable directly to the workers, I will deliver them for you, with copies being made for my records. Vendor understands that any labor provided by Its Garys Time Inc. are not employees of Its Garys Time Inc. but rather Its Garys Time Inc. is merely acting as a facilitator to match Vendor with workers

Intending to be legally bound by my signature below

Vendor: ____________________________________ _____ / _____ / _____

Print Vendor: _______________________________________________

Approved ________________________________________ _____ / _____ / _____

vrfw; rev 2/2011

Vendor Work Order Request Form

Thank you for wanting to help me help these folks help themselves, by doing so and providing opportunity, we will be headed in the right direction of making Garys Indiana and the surrounding communities a safer place to live. Please fill in the form below with enough information for me to understand your needs or concerns. Please be sure to click the submit button when complete, I will get a copy and respond accordingly. Also, please feel free to make any suggestions that you may have. I can not do this on my own, but together we can make a difference in the lives of many, Thank you!

First and Last Name:
Company name if different from above :
Address Street :
Billing address if different from above :
Zip Code: (5 digits)
Daytime Phone:
Evening Phone:
Please ask any additional questions you may
have in this box.

Please be sure to provide enough information for me to send you the VRFW (Vendor Request for Workers)

Thank you in advance for wanting to help!

Roger Hayward, Founder

Web Hosting Companies