HomeMy WebLinkAboutCemex InvoiceL� CC -MC- X 57722742
RECEJ1' _D JUL 2 8 205
-- 5-51
Plant:
Begin Loading:
To.Job:
Arrive Job:
Start Unload:
I Finish Unload:
Leave Job:
Return Plant:
Customer Code: Customer Name:
3173335 COASTAL BUILDING CONTRACTORS
Project Code: Project Name:
Ticket Date: Delivery Address:
r•_;'t'i"c''1 r' 15 LOT# 1. 1,3 5 NETTLES IGLAI'M
Delivery Instructions:
Customer Job Number:
Project P.O. Number:
Order Code / Date:
5.18 07/21./i5
Order P.O. Number:
PaOua�: Va.Ld 1.3
"" • i' .
Map Page: Map/Row/Column:
Dispatcher:
GFanning
Ticket Number:
3 =r8a49t::4.4
Due On Job:
Slump:
Truck Number:
Driver Number:
Driver Name:
End Use:
1 1 : 33
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1 d)o25 31 t7
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TOM I) 1 G �K i
UNASSIGNED
LOAD CUMULATIVE ORDERED MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT
QUANTITY QUANTITY QUANTITY
ti r 13.00 1300 1509995 5 ,:;r0� C) L3I....ENDEDPRPM YD,
u
JUL 21 AY11.43
1:4:02749-
ENV I RONMENTAI._ CHARs73E
1371.1-*a5':-"
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Cash Check# /Auth Code:
Signature of Driver Receiving Cash:
Cash Received:
Total COD Order Amount to Collect
Check
j
,.
Without Standby Charges:
Charg�l
e .."t
Comments:
"yam
WATER ADDED: GAL
YARDS INDRUM:
WHEN ADDED.
SIGNATURE
CURB LINE CROSSED AT OWNER'S/AGENT'S RE QUEST:
CONC I'ET E DISPOSAL FEE SIGNATURE
PARTIAL. FULL_ LOAD -�� Y1=1 NOD Ei ❑LOAD WAS TESTED BY:
Notice: Our drivers will make every effort to place materials where the customer designates, but the SPECIAL TERMS: Any water added is at customers own risk. If water is added on job, concrete strength
Company assumes no responsibility for damages inside curb or property line. Customer agrees to the Is no longer guaranteed. WARNING: Product may cause skin and/or eye irritation. CAUTION: Material
terms of sale and delivery and accepts concrete as is. Due to important factors which are out of our may be hazardous to your safety and health. Please refer to the badkside of this ticket for important
control after delivery, this Company will not accept any responsibility for the finished results. No credit for safety handling information, and to the material safety data sheets for additional information.
returned concrete. Buyers exceptions and claims shall be deemed waived unless made to us in writing AUTHORIZED SIGNATaJRE,
within one business day after the receipt of materials. AUL/
68UNIVERSAL PREV TRK: 1.00254103 INVOICE
LOAD NUM: 3
This Delivery Ticket incorporates herein by reference Buyer's previously executed Credit Application, if any, Seller's Standard
Terms and Conditions, Seller - aot i, if any, and Seller's Order Confi io cluding limitations of warranties), as if fully
set forth on this Delivery Tick 'AL _ nent"). Seller will provide the Stai "- rd'I s and Conditions upon request. Bu agrees
that, unless otherwise noted on the front hereof, all quantities and items were delivered as indicated and further expressly agrees to
pay in accordance with the Agreement.
AGGREGATE / CEMENT / CONCRETE PRODUCTS / FLY ASH
Aggregate products are naturally occurring materials including limestone, dolomite, granite, volcanic rock, sand, gravel, and other
siliceous materials. Cement products include Portland cement, masonry, pozzolan (Type IP), roof tile, and stucco. Concrete
products include Portland cement and aggregate products including limestone, dolomite, granite, volcanic rock, sand, gravel, and
other siliceous materials. These products, including fly ash, may contain more than 0.025% crystalline silica.
Hazards: Freshly mixed wet cement and/or fly ash can cause eye irritation, skin and eye burns and allergic skin reactions.
Dry concrete and aggregate dust may cause irritation to eyes, skin, and/or respiratory tract. Dust from handling,
crushing, grinding, cutting and/or drilling may contain silica, which. may cause silicosis and cancer if inhaled.
If ingested., keep warm, at rest, and drink large amounts of water. Fly Ash may contain trace amounts of ammo-
nia. Moisture can cause the ammonia to be released. Inhalation of ammonia can cause coughing and. irritation
or burns of the nose, throat and lungs. See physician. Health risk depends on duration and level of exposure.
Safety: Avoid contact with eyes and prolonged contact with skin. Wear gloves, eye protection, and appropriate protective
clothing. Wash hands thoroughly with mild soap and water after handling. Avoid breathing dust. If exposed to
dust above recommended limits (see MSDS), wear suitable NIOSH-approved respiratory protection.
First Aid: In case of eye contact, immediately flush eyes with flowing water for 15 minutes. If dust is inhaled, move to fresh
cur. If wet cement contacts skin, rinse thoroughly with water. Get proper medical. attention if .irritation persists.
CEMEX, Memorial Hermann Tower
929 Gessner, Suite 1900
V7 combined Houston, Texas 77024
02/12 For more information please visit www.cemexusa.com.
Este ticket de entrega incluye como referencia al comprador (ya previamente ejecutada en su aplicaci6n de cr6dito); cualquier
t6rmino estandar, condiciones del vendedor, propuestas del vendedor y orden de confirmaci6n del vendedor (con limitations y
garantfas), como acuerdo total del ticket de entrega ("Contrato"). El vendedor proveerd los t6rminos estandares y condiciones detal-
lados en caso de asf ser requeridos. Con este documento, el comprador acepta los mismos ya antes mencionados y que las cantidades
y materiales fueron entregados como se expresa en el mismo. Acepta pagar el monto de acuerdo al contaato; al menos que se identi-
fique con una nota al frente de este documento.
AGREGADOS / CEMENTO / PRODUCTOS DE CONCRETO / CENIZAS VOLANTES
Los productos de agregados son materiales naturales como piedra caliza, dolomita, granito, rota volcanica, arena, grava y otros
materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albanilerfa, pozzolan (tipo IP), azulejo de
azotea y estuco. Los productos de concreto incluyen cemento Portland y productos de agregados como piedra caliza, dolomita,
granito, rota volednica, arena, grava, y otros materiales silicios. Estos productos incluyen cenizas volantes (fly ash) la cual puede
contener mas de 0.025% de silicio cristalino.
Peligros: Mezcla de cemento fresco y/o cenizas volantes pueden causar irritaci6n en los ojos, quemaduras en piel y ojos, y
reacciones al6rgicas en la piel. Concreto seco y polvo de agregados, pueden causar irritaci6n en los ojos, piel. y/o en
la zona respiratoria. Polvo del manejo en el trituramiento, pulido, torte y/o perforaci6n puede contener materiales
silicos, los cuales pueden causar silicosis pulmonar y cancer si. son inhalados. En caso de ser ingeridos, mantenerse
en temperativa calida, reposar y tomar grandes cantidades de agua. Las cenizas volantes pueden contener amoniaco.
Seguridad• La humedad puede causar la liberaci6n del amoniaco. La inhalaci6n del amoniaco puede causar toser, irritaci6n o
quemaduras en la nariz, garganta y pulmones. Acudir inmediatamente al medico. El riesgo en la salud depende en
la duraci6n y el nivel de la exposici6n.
Seguridad: Evite el contacto con ojos y contacto prolongado con la piel. Use guantes, protecci6n en los ojos y ropa
Primeros adecuada para protecci6n. Llvese ]as manos con jab6n suave y agua despu6s del manejo de materiales. Evite inhalar
auxilios• po.lvos. Si se expone a polvos mds de .los limites recomendados, use protecci6n respiratoria.
Primeros auxilios: En caso de contacto en los ojos, inmediatamente fluya agua en la parte afectada por 15 minutos.
Si se inhala polvo, exp6ngase a aire fresco. Si el cemento fresco tiene contacto con sus ojos, lavel.os a fondo con
agua. Acuda a atenci6n m6dica inmediatamente si la irritaci6n continua.
CEMEX, Memorial Hermann Tower
929 Gessner, Suite 1900
V7 combinado Houston, Texas 77024
02/12 Para mas informacion visita www.cemexusa.com.
5,7722738
Plant:
Begin Loading:
To Job:
Arrive Job:
Start Unload:
Finish Unload:
Leave Job:
Return Plant:
rf
Customer Code: Customer Name:
' 31 i,:: 3 5 COASTAL... BUILDING C NT RAC:1 oRS
Project Code: Project Name: t
Ticket Date: Delivery Address:
o'7/21. / 1 L.IJT' i 1335 hdE "i"1 LE;a IS L_t lF
Delivery Instructions:
TO 'E BEACH
Customer Job Number: Order Code / Date:.
Project P.O. Number: Order P.O. Number:
Map Page: Map/Row/Column:
Dispatcher:
GFatfi' niriig,
Ticket Number:
Due On Job:
Slump:
Truck Number:
Driver Number:
Driver Name:
End Use:
S. 00
1i�->�
ir F s lTFf
UNASSIGNED10.- :.
LOAD CUMULATIVE ORDERED MATERIAL -CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT
QUANTITY QUANTITY QUANTITY
• t 4 �
0 12. 00 '15Q9')05 ;;:lt /(i �'L F �f�l i?F'fI y D?I
JUL 21 AM1023
+. 00
12()2,749
ENVIRONMENTAL xC�i-iAP'GE
Cash Check # /Auth Code:
Signature of Driver Receiving Cash:
Cash Received:
Total COD Order Amount to Collect
Check
Without Standby. Charges:
Charge
'
Comments:
WATER ADDED:
GAL YARDS IN DRUM:
WHEN ADDED.
SIGNATURE
CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST:
CONC,R(ETE DISPOSAL FEE I'
_.___.. PARTIAL _ FULL L()AD �Y YARDS ❑ LOAD WAS TESTED BY:
Notice: Our drivers will make every effort to place materials where the customer designates, but the SPECIAL TERMS: Any water added is t ii
Company assumes no responsibility for damages inside curb or property line. Customer agrees to the is no longer guaranteed. WARNING: Pfoc
terms of sale and delivery and accepts concrete as is., Due to important factors which are out of our may be hazardous to your safety and hekg
control after delivery, this Company will not accept any responsibility for the finished results. No credit for safety handling information,fpnd to�her' ate
returned concrete. Buyers exceptions and claims shall be deemed waived unless made to us in writing AUTHORIZED IGNATURM !`
within one business day after the receipt of materials.
68UNIVERSAL P(' EV TRK a 10025318 INVOICE J
SIGNATURE I
s own risk. If water is added on job, concrete strength
cause skin If
eye irritation. CAUTION: Material
3se refer to the backside of this ticket for important
/ data sheets for additional information.
This Delivery Ticket incorpora— her(--- by reference Buyer's previously executed Credit Application, if any, Seller's Standard
Terms and Conditions, Seller's tat if any, and Seller's Order Confirn*rn I udirig limitations of warranties), as if fully
set forth on this Delivery Ticket k Agreement"). Seller will provide the Stand'a7u. Tei and Conditions upon request. Buy,,-c ggrees
that, unless otherwise noted on the front hereof, all quantities and items were delivered as indicated and further expressly agrees to
pay in accordance with the Agreement.
AGGREGATE / CEMENT / CONCRETE PRODUCTS / FLY ASH
Aggregate products are naturally occurring materials including limestone, dolomite, granite, volcanic rock, sand, gravel, and other
siliceous materials. Cement products include Portland cement, masonry, pozzolan (Type IP), roof tile, and stucco. Concrete
products include Portland cement and aggregate products including limestone, dolomite, granite, volcanic rock, sand, gravel, and
other siliceous materials. These products, including fly ash, may contain more than 0.025% crystalline silica.
Hazards: Freshly mixed wet cement and/or fly ash can cause eye .irritation, skin and eye burns and allergic skin reactions.
Dry concrete and aggregate dust may cause irritation to eyes, skin, and/or respiratory tract. Dust from. handling,
crushing, grinding, cutting and/or drilling may contain silica, which may cause silicosis and cancer if inhaled.
If ingested., keep warns, at rest, and drink large amounts of water. Fly Ash may contain trace amounts of. ammo-
nia. Moisture can cause the ammonia to be released. Inhalation of ammonia can cause coughing and. irritation
or burns of the nose, throat and. lungs. See physician. Health risk depends on duration and level of exposure.
Safety: Avoid contact with eyes and prolonged contact with skin. Wear gloves, eye protection, and appropriate protective
clothing. Wash hands thoroughly with mild soap and water after handling. Avoid breathing dust. If exposed to
dust above .recommended limits (see MSDS), wear suitable NIOSH-approved respiratory protection.
First Aid: In. case of eye contact, immediately flush eyes with flowing water for 15 minutes. If dust is inhaled, move to fresh
air. If wet cement contacts skin, rinse thoroughly with water. Get proper medical attention if irritation persists.
CEMEX, Memorial Hermann Tower
929 Gessner, Suite 1900
V7 combined Houston, Texas 77024
02/12 For more information please visit www.cemexusa.com.
Este ticket de entrega incluye como referencia al comprador (ya previamente ejecutada en su aplicaci6n de credito); cualquier
termino estandar, condiciones del vendedor, propuestas del vendedor y orden de confirmaci6n del vendedor (con limitaciones y
garantfas), como acuerdo total del ticket de entrega ("Contrato"). El �vendedor proveera los t6rminos estdndares y condiciones detal-
lados en caso de asf ser requeridos. Con este documento, el comprador acepta los mismos ya antes mencionados y que las cantidades
y materiales fueron entregados como se expresa en el mismo. Acepta pagar el monto de acuerdo al contrato; al m.enos que se identi-
fique con una nota al frente de este documento.
AGREGADOS / CEMENTO / PRODUCTOS DE CONCRETO / CENIZAS VOLANTES
Los productos de agregados son materiales naturales como piedra caliza, dolomita, granito, roca volcanica, arena, grava y otros
materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albanileria, pozzolan (tipo IP), azulejo de
azotea y estuco. Los productos de concreto incluyen cemento Portland y productos de agregados como piedra caliza, dolomita,
banito, roca volcdnica, arena, grava, y otros materiales silicios. Estos productos incluyen cenizas volantes (fly ash) la coal puede
contener mas de 0.025% de silicio cristalino.
Peligros: Mezcla de cemento fresco y/o cenizas volantes pueden causar irritaci6n en Jos ojos, quemaduras en piel y ojos, y
reacciones alergicas en la piel. Concreto seco y polvo de agregados, pueden causar irritaci6n en los ojos, piel y/o en
la zona respiratoria. Polvo del manejo en el trituramiento, pulido, corte y/o perforaci6n puede contener materiales
silicos, los cuales pueden causar sil.icosi.s pulmonar y cancer si. son inhalados. En caso de ser ingeridos, mantenerse
en temperatura calida, reposar y tomar grandes cantidades de aqua. Las cenizas volantes pueden contener amoniaco.
Seguridad• La humedad puede causar la liberaci6n del amoniaco. La inhalaci6n del amoniaco puede causar toser, irritaci6n o
quemaduras en la nariz, garganta y pulmones. Acudir inmediatamente al medico. El riesgo en la salud depende en
la duraci6n y el nivel de la exposici6n.
Seguridad: Evite el contacto con ojos y contacto prolongado con la piel. Use guantes, protecci6n en los ojos y ropa
Primeros adecuada para protecci6n. Lavese ]as manos con jab6n suave y agua despues del manejo de materiales. Evi.te inhalar
auxilios• polvos. Si se expone a polvos mas de los limiter recomendados, use protecci6n respiratoria.
Primeros auxilios: En caso de contacto en los ojos, inmediatamente fluya agua en la parte afectada por 15 minutos.
Si se inhala polvo, exp6ngase a aire fresco. Si el cemento fresco tiene contacto con sus ojos, lavel.os a fondo con
agua. Acuda a atenci6n medica inmediatamente si ]a irritaci6n coniin6a.
CEMEX, Memorial Hermann Tower
929 Gessner, Suite 1900
V7 combinado Houston, Texas 77024
02/12 Para mas informaci6n visita.www.cemexusa.com.
ata
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' V
-57722737
Plant:
Begin Loading:
To Job::
Arrive Job':
Start •Unload,
Finish Unloacl:
Leave Job:
Return Plant:
019 13i l
Customer Code:
Customer Name:'
Customer Job Number:
Order Code / Date:
...r 1 '..ro...
+f„rl,�i-ildr r �;L BUILDING
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CONTRACTORS ORS ... - 1194
510 07 O'C: 1 15
ect Coder m -
Project Name:
Project P.O. Number:
Order P.O. Number.
.
.'P.O.94
Ticket Date':
Delivery Address:
Map Page: Map/Row/Column:
4-7 1� 1 15
OTt 1.,335 NETTLES
isri.s"�I'4�#T���
DeUvery Instructions
�.
Dispatcher:
7 '•krLE.NBC s :NACi
Wan 'nirip ?
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Ticket Number: *
Due On Job:
Slump:
Truck Number:
Driver Number:
Driver Name: -
TOM C-1f,>ILS
LOAD
QUANTITY
CUMULATIVE
QUANTITY ,
ORDERED
QUANTITY
MATERIAL CODE
_ 'PRODUCTION DESCRIPTION
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a. 12021749 ENV 1 RUNMENT
U- CHARGE
Cash Check # / Auth Code:
Signature of Driver. Receiving Cash:
Cash Received:
Check,
Charge
Comments:,
nd Use
k.iNASS x i:�NE
UOM I UNIT PRICE 'AMOUNT.-
YLl;.,4
r ,
JUL 21 Am 9:56
�na+t
Total COD Order Amount to Collect
Without Standby Charges:
WATER ADDED: GAL YARDS IN DRUM:
WHEN ADDED.
CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST:
SIGNATURE
CONCRETE DISPOSAL FEE SIGNATURE
PARTIAL _ FULL LOAD _ YARDS Ll LOAD WAS TESTED BY:
Notice: Our drivers will make every effort to place materials where the customer designates, but the SPECIAL TERMS: Any water added is at customers n risk. If water is added on job, concrete strength
Company assumes no responsibility for damages inside curb or property line. Customer agrees to the is no longer guaranteed. WARNING: Product ma cause skin and/or eye irritation. CAUTION: Material
terms of sale and delivery and accepts concrete as is. Due to important factors which are out of our may be hazardous to you afety and healt�Please refer to the backside of this ticket for important
control after delivery, this Company will not accept any responsibility for the finished results. No credit for safety handling inform; io and to the mate''ial safety data sheets for additional information.
returned concrete. Buyers exceptions and claims shallr be deemed waived unless made to us in writing AUTHORIZED SIGNAT RE:
within one business day after the receipt of materials
a
68UNIVERSAL . }�
!f, INVOICE / LI7A1::fIUM> 1
V
This Delivery Ticket incorporates herein by reference Buyer's previously executed Credit .Application, if any, Seller's Standard
Terms and Conditions, Seller' - ot, , if any, and Seller's Order Confir, ion - Jud.ing limitations of warranties), as if fully
set forth on this Delivery Ticki kg lent"). Seller will provide the Stand Ti and Conditions upon request. Btur agr. es
that, unless otherwise noted on the front hereof, all quantities and items were delivered as indicated and further expressly agrees to
pay in accordance with the Agreement.
AGGREGATE / CEMENT / CONCRETE PRODUCTS / FLY ASH
Aggregate products are naturally occurring Materials including limestone, dolomite, granite, volcanic rock, sand, gravel, and other
siliceous materials. Cement products include Portland cement, masonry, pozzolan (Type IP), roof tile, and stucco. Concrete
products include Portland cement and aggregate products including limestone, dolomite, granite, volcanic rock, sand, gravel, and
other siliceous materials. These products, including fly ash, may contain more than 0.025% crystalline silica.
Hazards: Freshly mixed wet cement and/or fly ash can cause eye irritation, skin and eye burns and allergic skin reactions.
Dry concrete and aggregate dust may cause irritation to eyes, skin, and/or respiratory tract.. Dust from handling,
crushing, grinding, cutting and/or drilling may contain silica, which may cause silicosis and cancer if inhaled.
If ingested, keep warm, at rest, and drink large amounts of water. Fly Ash may contain trace amounts of ammo-
nia. Moisture can cause the ammonia to be released. Inhalation of ammonia can cause coughing and irritation
or burns of the nose, throat and lungs. See physician. Health risk depends on duration and level of exposure.
Safety: Avoid contact with eyes and prolonged contact with skin. Wear gloves, eye protection, and appropriate protective
clothing. Wash hands thoroughly with mild soap and water after handling. Avoid breathing dust. If exposed to
dust above recommended limits (see MSDS), wear suitable NIOSH-approved respiratory protection.
First Aid: In case of eye contact, immediately flush eyes with flowing water for 15 minutes. If dust is inhaled, .move to fresh
air. If wet cement contacts skin, rinse thoroughly with water. Get proper medical attention if .irritation persists.
CEMEX, Memorial Hermann Tower
929 Gessner, Suite 1900
V7 combined Houston, Texas 77024
02/12 For more information please visit www.CeMexusa corn.
Este ticket de entrega incluye como referencia al comprador (ya previamente ejecutada en, su apl..icaci.6n de credito); cualquier
ternino estandar, condiciones del vendedor, propuestas del vendedor y orden de confirmation del vendedor (con limitations y
garantfas), como acuerdo total del ticket de entrega ("Contrato"). El vendedor proveera los terminos estandares y condiciones detal-
lados en caso de asf ser requeridos. Con este documento, el comprador acepta los mismos ya antes mencionados y que las cantidades
y materiales .fueron entregad.os como se expresa en el. mismo. Acepta pagar el monto de acuerdo al Contrato; al menos que se identi-
fique con una nota al frente de este documento.
AGREGADOS / CEMENTO / PRODUCTOS DE CONCRETO / CENIZAS VOLANTES
Los productos de agregados son materiales naturales como piedra caliza, dolomita, gran ito, coca volcanica, arena, grava y otros
materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albanilerfa, pozzolan (tipo IP), azulejo de
azotea y estuco. Los productos de concreto incluyen cemento Portland y productos de agregados como piedra caliza, dolomita,
granito, rota volcanica, arena, grava, y otros materiales silicios. Estos productos incluyen cenizas volantes (fly ash) la cual puede
contener mas de 0.025% do silicio eristalino.
Peligros: Mezcla de cemento fresco y/o cenizas volantes pueden causar irritacion en los ojos, quemaduras en piel y ojos, y
reacciones alergicas en la piel. Concreto seco y polvo de agregados, pueden causar irritacion en los ojos, piel ',y/o en
la zona respiratoria..Polvo del .manejo en el triturarniento, pulido, Corte y/o perforation puede contener materiales
silicon, los cuales pueden causar silicosis pulmonar y cancer si son inhalados. En caso do ser .ingeridos, mantenerse
en temperatura calida, reposar y tomar grandes cantidades de agua. Las cenizas volantes pueden contener amoniaco.
Seguridad• La humedad puede causar la liberation del amoniaco. La inhalation del amoniaco puede causar toser, irritacion o
quemaduras en la nariz, garganta y pulmones. Acudir inmediatamente al medico. El riesgo en la salud. depende en
la duration y el nivel de la exposition.
Seguridad: Evite el contacto con ojos y contacto prolongado con la piel. Use guantes, protection en los ojos y ropa
Primeros adecuada para protection. Lavese .las manos con jabon suave y agua despues del manejo de materiales. Evite .inhalar
auxilios• polvos. Si se expone a polvos mas de los limites recomendados, use protection respiratoria.
Prim.eros auxi.lios: En caso de contacto en .los ojos, inmediatamente fluya agua en la parte afectada por 15 minutos.
Si se .inhala polvo, expongase a aire fresco. Si el cemento fresco tiene contacto con sus ojos, l.avelos a fondo con
agua. Aeuda a atenei6n medica inmediatamente si la irritaci6n continua.
CEMEX, Memorial Hermann Tower.
929 Gessner, Shiite 1900
V7 combinado Houston, Texas 77024
02/12 Para mds information visita www.cemexusa.com.
82914
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Due On Job: . Slump: 71uck Number. Driver Number: • , Driver Name: End Use:
LOAD cQANTITY QUANTITY TIVE ORDERED'
QUANTITY QUANTITY MATERIAL COOF PRODUCTION D[SCRIPTION UOM UNIT PRICE - AMQUNT
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Cash Chcuk # / Auth Code: Slgnatdt.e of Driver Receiving Cash: \ Cash Rece(ved: Totet COD Order Amount to Collect
Cheek Without Standby Charges:
Comments:
WATER ADDED:/GAL YARDS IN DRUM:
WHEN ADDED,
SIGNATURE
CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST:
I. l:9i 9;;41... rl...i . SJGNATURE
,
L JUL '...."JAD � 7��5;�� ❑LOAD WAS TESTED BY:
Notice: Our drivers will make every effort to piece materials where the customer deaignatea, but the SPECIA}. TERMS; Any water added Is at customer$ a n risk.�.,ndlo
dded on Job, concrete strength
Company assumes no responsibility for damageS inside curb or property line. Customer agrees to the Is nolonger guaranteed, AIR ING: Product me) cau skitinitation. CAUTION: Material
termsof sale and delivery and accepts concrete oS Is. Due to important factors which are out of our may be hazardous to you safety end health�Pl
t1cLe of this ticket for impoitant
control slier delivery, this Company will not accept any responsibility for the finlahed results. No cretllt for safety handling information. nd td the mater_ate for additional formation.
returned concrete. Buyers exceptions and claims shall be deemed waived unless mode to us in writing AUTHARIYep SIGNATURE:
within one business day after the receipt of materials•
6SUNIVEFtSAL 1s%?r.".I f�i�i•a INVOICE 3'I .. �`,4 1 J , +
58 2, 2- 9 16 5
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Z$ T r
Custgraer. Code! CustomerNime.•
Customer Job Number.
Order Code t Date:
'A 3U 7, L D 1 1 'G'
-,Ck., 3
1i 1-21'217:�,S*
ode;
braer P.O. Number: '
•
fl . rk% Data: 5811viary Address:
map Pa*. Mav/RowlColdmn!
is 1—
Delivery Id�irUci�onsDispatch6r.
C-10
.:.
.
Ticket Number:
Caah CheCR it/ AWth Code:
Check
71 Charge
Comments:
5UM]FLA .0v
V -T R*4,11%v?-'.11
sigrkqture or Driver Receiving Cash:
WATER ADDED:
A1110:25 2:arj
IN DEW
-------- ----
CURB LINE CROSSED AT 0WNEKStAGE0f1REQ'UESTi
SIGNATURE
Ir! /:,)', FE.
. ......... 0 LOAD WAS TESTED BY:
Notice: Our drivers will Make every effort to place materials where the customer designate*, but the SPECIAL TERM Any Id4dIsb1custornereown risk. if water Is added an job, concrete strength
11* ZM
"Oc, RNIN
Company assumes no responsjbility far damages inside curb or property line. cuslorner agreea-lo the is no longer 9vamn, WARNIN�Pr.uct may cause skip and/or ttya Irritation. CAUTION: Material
In
J safety
termsE." sale end delivery and accepts concrete as Is. Du2lo important ractors which are out of our may be hapardou your sefst health. Please refer to the backside off this ticket for important
tyforthefinishedre8UH8. No safety handling tion, and t material safety Juda sheets fa nal Information.
control after delivery, this Company will not accept any resporislolli )o returned wrictate. Buyers exceptions and claime shall be deemed waived riess made to ue in writing AUTHORIZ
within one business day after the receipt of rnsteflgls. . . . 0 7
. . . . . , . . .•
. . . . . — (' .,- 1=z
oBUNIVEASAL
INVOICE