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I hereby certify that the hours shown were worked by me during the week ending shown above, and were properly certified by an authorized representative of the
named client. 

 (Hours to nearest ¼ hour)                                                                                      Total Hours                           

It is hereby understood that Tea for Two is established to provide temporary/permanent support. It is agreed that should we (above named company) desire to employ
above-named employee, we will first contact Tea for Two. We agree to abide by Tea for Two terms not to employ the above-named employee within six months from last
date employed by above-named company or to put above-named employee on above-named company’s payroll without first contacting Tea for Two.
                                                                                                                                                                                             

                           Customer Signature                                                                                                                 Date