HomeMy WebLinkAboutCemex Invoice I _RICK58229392
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Plant: Begin Loading: To Job ArrrveJi Start Unload Finish Unload: Leave-Job: Return Plant:
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Customer Code Customer Name: Customer Job Number: 1.Orde<Code/Date:
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Project Code: Protect Name: ProjectP:O,Number: Order P.O.Number:
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Ticket Date: Delivery Address. Map Page Map/Row(Column:
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Delivery Instructions: r Dispatcher:
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Due On Job: 4 Slump: Truck Number: Driver Number: -Driver Name:
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LOAD " CUMULATIVE ORDERED MATERIAL CODE PRODUCTION DESCRIPTION i UOM UNIT PRICE AMOUNT
QUANTITY QUANTITY QUANTITY j
(t« .L _3a .:3;.} _35"7C.G5 w;,`-�jt�)r_:9 FrErJ
w� C.Ic� ;r� t; :!. f }tJjl Lyy. )(t•7�{�_)I{Ftprml�{t(�(F�{fit_ SEA` �r'4IC�6:45
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Cash Check#/Auth Code: Signature of Driver Receiving Cash: 'Cash Received; Total COD Order Amount to Collect }
g Without Standby Charges:
,( Check
Charge
Comments; '
WATER ADDED: GAL YARDS IN DRUM: {
WHEN ADDED.
t' SIGNATURE
CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST:
I
r wry__,.,-_ i r._t41i, FEE
SIGNATURE
L'AR 1 Ii�L � FUL,L, LOAD _ VAM3 -p LOAD WAS_TESTED BY: I
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 longecguaranteed^. WARNING: Product may cause skin and/or eye irritation. CAUTION: Material j
terms of sale and delivery and accepts concrete as is. Due to important factors which are out of our aza may be,h ousrtoo your safety and*�ealth. Please refer to the backside of this ticket for important
control after delivery,this Company will not accept any responsibility for the finished results. Ne credit for safety -ling Information,and to the.rrfaterial safety data sheets for additional information.
returned concrete. Buyers exceptions and claims shall be deemed waived unless made to us in writing AUS ORIZED SIGNATURE
within one business day after the receipt of materials. Q
68UNIVERSAL R INVOICE..---�'''� LOCK) NUM. I �
--—T ---- - h---ference BuyerTSICOUsly execL�This Deliver Ticket incor orates here ,--c Credit Application., if any, Seller's Standard
y p y refers y and Seller sonfirms�-
Terms and Conditions,Seller's Q1Ct.ic �� i including limitations of warranties),as if fully
« f any,a, Seller will p 3e the Stand �" ti ,:ms and Conditions upon request.Buyer agrees
set forth on this Delivery Ticket( � erg-,,,) Sel''�1 uantit' nd items w 'u`ud,,!
that,unless otherwise noted on the front he.� all �,i`'�q ere delivered as indicated and further expressly agrees to
pay.in accordance w.ith.the Agreement. q
AGGREGATE / Cj,.l k 1 r vCRETE PRODUCTS /FLY ASH
Aggregate products are naturally occurring matetcll�din 111�: imestone,dolomite,granite,volcanic rock,sand,gravel,and other
siliceous .materials. Cement products include Portl , ementt, masonry, pozzolan (Type IP), roof tile, and stucco. Concrete
products include Portland cement and aggregate products'114 lrNing limestone,dolomite,granite,volcanic rock;sand,gravel,and
other siliceous materials.These products,i.ncl.uding 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- r
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 NIOSI-1-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 rnedical 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.cetneu-sa.com.
Este ticket de entrega incluye como referencia al comprador (ya previamente ejecutada en su aplicaci6n de cr6dito); cualquier
tdrmino estdndar, condiciones del vendedor, propuestas del vendedor y orden de eonfirmaci6n del vendedor (con limitaciones y
garantfas),como acuerdo total del ticket de entrega("Contrato").El vendedor proveera los terminos estandares y condiciones detal-
lados en caso de as ser requeridos.Con este documento,el comprador acepta los mismos ya antes me:rcionados y que Las cantidades
y rnate.r..ia.les fueron entregados como se expresa on el mismo.Acepta pagar el monto de acuerdo al contaato; al inenos que se identi-
Pique con una nota al frente de este documento.
AGREGADOS / CEMENTO / PRODUCTOS DE CONCRETO / CENIZAS VOLANTES
Los productos do agregados son materiales naturalcs como piedra caliza,dolomita, granito,coca volcanica, arena, Brava y otros
materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albanileiia, pozzolan (tipo IP), azulejo de
azotea y estuco. Los productos de conereto incluyen cemento Portland y productos de agregados como piedra caliza, dolomita,
granito,coca volcanica,arena,grava,y otros materiales silicios.Estos productos inclL,,'Cll cenizas volantes (fly ash) la cual puede
contener mas de 0.025% de silicio cristalino.
r � rN
Peligros: Mezcla de cemento fresco y/o cenizas volantes pueden causar irritaci6n en Jos Ojos,quemaduras en pies y ojos,y
reacciones al6rgicas en la piel.Concreto seco y polvo de agregados,pueden causar irritaci6n en los ojos.pie] y/o en i
la zona respiratoria. Polvo del manejo en el trituramiento,pulido,corte y/o perforaci6n puede contener tnate.riales
si.licos,Jos cuales pueden causar silicosis pulmonar y cancer si son inhalados.En caso de 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 liberaci6n del amoniaco. La inhalaci6n del amoniaco puede causar toner,irritacionn o
quemaduras en la nari.z,garganta y pulmones.Acudir inmediatamente al medico. El ri.esgo en ]a sal.ud depende en
la duraci6n y el nivel de la exposici6n.
i
Seguridad:Evite el contacto con ojos y contacto prolongado con la piel.Use guantes,protecci6n en los ojos y), y
Primeros adecuada para protection.Ldvese las manor con jab6n suave y agua despu6s del manejo de materiales.Ev.ite•
auxilios• polvos. Si se expone a polvos mas de los limiter recomendados, use protecti6n respiratoria. '
Primeros auxilios:En caso de contacto en los ojos,in.m.ediatamente fluya agua en la parte afectada P,-" ds• P
Si se inhala polvo,exp6ngase a aire fresco. Si el cemento fresco tiene contacto con sus ojos, lav o2�f� `Con
agua.Acuda a atenci6n m6dica inmediatamente si la irritaci6n continua.
CEMEX,Memorial Hermann Tower tf�%,,eaa�Psd,
929 Gessner,Suite ..1900
V7 combinado Houston,Texas 77024 ti2�9 f
02/1.2 Para rnfis informaci6n visita www.ce ,gxusa.com. s9
ZZCC-MGX 582'29871
Plant: Begin Loading: To Job: Arrive Job: Start Unload: Finish Unload: leave Job: Return Plant:
Customer Code: Customer Name: I'
Customer Job Number: Order Code/Date:
C !'�l lillL..i_Il9 i -#••j•• I IN' r.l~r-� l{ri.,{_.*, t l�.•14:, F f�'` JC:....fit 1 s .. rt.F" 5
Project Code: Project Name: Project P.O.Number: Order P.O.Number: _
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Ticket,Date: Delivery Address: Map Page: Map/Row/Column:
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Delivery Instructions: Dispatcher:
vl
Ticket Number:
Due On Job: Slump: Truck Number: Driver,Number: Driver Name: End Use:
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LOAD CUMULATIVE ORDERED MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT
QUANTITY QUANTITY QUANTITY pq
e,� :_,ej.{",i.J _.it�'i„�tJ {....[ad l=)
k f Vrli li.•,
Cash Check#/Auth Code: Signature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect
Without Standby Charges:
Check '
Charge
Comments: �'�
WATER ADDED: 0 GAL YARDS IN'DRUM:
r WHEN ADDED.
SIGNATURE
CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST:
r� l - i f•. Ll / l� SIGNATURE
i_-1fli.:,' l/ Yrr i:tL �
❑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 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 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 SIGNATURE:
within one business day after the receipt of materials. O
68UNIVERSAL .1_'e' TF.,.r INVOICE
This Delivery Ticket incorporates herein by reference Buyer's previously executed Credit Application, if any, Seller's Standard
Terms and Conditions,Seller's Q t.ion,if any,and Seller's Order Confirma (including.limitations of warranties),as if fully
set forth on this Delivery Ticket(` cement").Seller will provide the Stand u_ _arms and Conditions upon request.Buyer 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,-ravel,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%n 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 anunonia 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, condieiones 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 proveerd los terminos estarrdares y condiciones detal-
lados en caso de asf ser requeridos.Con este documento,el comprador acepta Jos 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 menos que se i.denti-
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, 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,coca volcanica,arena,grava,y otros materiales silicios.Estos productos incluyen cenizas volantes (fly ash) la cual puede
contener mas de 0.025% de silicoo cristalino.
;CUIDADO'.
Peligros: Mezcla de cemento fresco y/o cenizas volantes pueden causar irritacion en los Ojos,quemaduras en pie].y ojos,y
reacciones alergicas en la piel.Concreto seco y polvo de agregados,pueden causar irritaci6n en los ojos,pie] y/o en
la zona respirato.ria.Polvo del manejo en el. trituramiento,pulido,Corte y/o perforaci6n puede contener materiales
silicon,Los cuales pueden causar silicosis pulmonar y cancer si son inhalados.En caso de 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 liberaci6n del amoniaco. La inha1aci6n del amoniaco puede causar toser, irritacion o
quemaduras en la nari.z,garganta y pulmones.Acud.ir 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 core la piel.Use guantes,protecci6n en Los ojos y ropa
Primeros adecuada para protecci6n.Lavese Las mans con jab6n suave y agua despues del manejo de materiales.Ev.ite inhalar
auxilios: polvos. Si se expone a polvos mas de los limites recomendados,use protecci6n respiratoria.
Primeros auxilios: En caso de contacto en Los ojos,inmediatamente fluya agua en la pane afectada por 15 minutes.
Si se inhala polvo,exp6ngase a wire fresco. Si el cemento fresco tiene contacto con sus ojos, lavelos a fordo con
agua.Acuda a atenci6n medica inmediatamente si la irritacion continua.
CEMEX,Memorial Hermann Tower
929 Gessner,Suite 1.900
V7 combinado Houston,Texas 77024
02/12 Para mas informaci6n visita www.cemexusa,cm.
ZZCEMC-X 58229872
Plant: Begin Loading: To Job: Arrive Job: Start Unload: Finish Unload: Leave Job: Retum Plant:
Customer Code: Customer Name: Customer Job Number: Order Code/Date:
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f' 3; .:' : f'ti4�..; i1i11, • F?N E►;k f_1...1.; I4. / 7 .
Proleot Code: Project Name: Project P.O.Number: Order RO.Number:
1 =/; ;,@ MCi _1'f'k14 T:Ei,.t TI—IR,t 1/, Fr.Cr ',r: 1,:�i�It`I•!?�• � r r� �=t"d=�t;d
Ticket Date; Delivery Address: F Map Page: Map/Row/Column:
'" '.'9 �tY�Ff.r7:sC ND
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Delivery Instructions: Dispatcher:
3 $..t°'
Ticket Number:
7;3.
Due On Job: Slump: Truck Number: Driver Number Driver Name: End Use:
7. a„•..r?. 6�� t:tr :t t:?t��::. .r•_,Er,:i 'l.tY-9tl2i�' 13 11 FN R 1 CK Eil_.i_MI:i b vtra!_
LOAD CUMULATIVE ORDERED MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT
QUANTITY QUANTITY QUANTITY
t _ 1.-_- r. trtx,__3. ,•J _t-•f r C IG
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t->t t F . 78 s?? FIlE4_ 2'42
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:
`7— WHEN ADDED.
SIGNATURE
CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST:
C��ittlrf?f�;�i _ I�k.t:if--'��nF3j ±"•�;�_ �/ /"7
SIGNATURE
_._.._ -�-,- •• -~ ❑LOAD WAS TESTED B
Notice: Our drivers will make every effort to place materials where the customer designates,but the SPECIAL TERMS: Anyi6/,',gadded is,et 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 guarantee!W�rRN�NG: 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/y9u fsafety azd FPealth. 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 infor,atjoy:,On td�.tFh� aterial safety data sheets for additional information.
returned concrete. Buyers exceptions and claims shall be deemed waived unless made to us in writing AUTHORIZED SIGNA'T,,jtE-/��
within one business day after the receipt of materials. 0 / 1/`
68UNIVERBAL l-' af="'I Z Ft'f !._0VIK1 I\!>_�M a .i
INVOICE
This Delivery Ticket .incorporates I n by .reference Buyer's previously execr Credit Application, if any, Seller's Standard
Terms and Conditions,Seller's Quo __n,if any,and Seller's Order Confirmati( icluding limitations of warranties),as if fully
set forth on this Delivery Ticket("Agreement").Seller will provide the Standard Terms and Conditions upon request.ljuyer 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.
CAUTION!
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,inunediately flush eyes with flowing water for 1.5 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.er6dito); cualquier
t6rmino estandar, condiciones del vendedor, propuestas del vendedor y orden de confirmaci6n del vendedor (con limitaciones y
garan.tfas),como acuerdo total del ticket de entrega("Contrato").El vendedor proveera.los t6.rminos 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 so expresa en el mismo.Acepta pagar el monto de acuerdo al coutrcto; al menos que se identi-
fique con una rota al frente de este documento.
AGREGADOS / CEMENTO /PRODUCTOS DE CONCRETO / CENIZAS VOLANTES
Los productos de agregados son materiales naturaley como piedra caliza,dolomita, granito,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 pi.edra caliza, dolomita,
granito,coca volcanica,arena,Brava,y otros materiales silicios.Estos productos incluyen cenizas volantes (fly ash) la cual puede
contener mas de 0.025% de silicio cystalino.
ICUIDADO!
Peligros: Mezcla de cemento fresco y/o cenizas volantes pueden causar irritaci6n en los ojos,quemaduras en pie] y ojos,y
reacciones al6rgicas en la pie].Concreto seco y polvo de agregados,pueden causar irritaci6n en los ojos,pie].y/o en
la zona respiratoria. Polvo del manejo en el.trituramiento,pulido,corte y/o perforaci6n puede contener materiales
silicos,Jos cuales pueden causar silicosis pulmonar y cancer si son inhalados.En caso de ser ingeridos,mantenerse
en temperatura caliza,reposar y tomar grandes cantidades de agua.Las cenizas volantes pueden contener amoniaco.
Seguridad: La humedad puede causar la liberacibn del amoniaco. La inhalaci6n del amoniaco puede causar toser,.irritaci6n o
b quemaduras en la nari.z,garganta y pulmones.Acudir inrnediatamente al medico. El riesgo on la salud depende en
la duraci6n y el nivel de la exposici6n.
Seguridad: Evite el contacto con ojos y contacto prolongado con ]a piel.Use guantes,protecei6 r en l.os ojos y ropa
Primeros adecuada para protecci6n.Ldvese las manor con jab6n suave y agua despu6s del manejo de materiales.Ev.ite inhalar
auxilios• polvos. Si se expone a polvos mas de los limites recomendados,use protecci6n respiratoria.
Primeros auxilios: En caso de contacto en los ojos,inmediatamente fluya agua on la parte afectada por 15 minutes.
Si se inhala polvo, exp6ngase a aire fresco. Si el cemento fresco tiene contacto con sus ojos, lavelos a fordo con
agua.Acuda a atenci6n m6dica himediatamente si la irritaci6n continua.
CEMEX,Memorial Hermann Tower
929 Gessner,Suite 1.900
V7 combinado Houston,Texas 77024
02/12 Para mas infornraci6n visita www.cemexusa.corn.
zzcc-mc-X
58229865
Plant: Begin Loading: TO�Job: Arrive Job: Start Unload: Finish Unload: " Leave Job: Return Plant,
Customer Code: Customer Name: Customer Job Number:_ Order Code/Date:
:'•"'+> t:' l�»SI f;;{i'-P �� L.i :.`TTt:-N '. C,ERVIQES jLC ;,;—< , d'? yyn(_t -y._,.::, il-t jrtaj ,i5
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Project Code Project Name Project P.O.Number. OrderP P.O.Number.
t (_rc, 1'r i` !` E 3"#f`i Ei1—i.! �j a� ? � y' �I t"� f�
Ticket Date: Delivery Address: Map Page: Map/Row/Column:
%,Delivery Instructions: Dispatcher:
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Ticket Number:
Due On Job: Slump: Truck Number: Driver Number: Driver Name: End'Use: '
L M ,..{taR�lE,-_1:? FLOW) - +?i...f�l`?fae Ir.J�IE_L
LOAD CUMULATIVE ORDERED MATERIAL CODE PRODUCTION DESCRIPTION UOM "UNIT PRICE AMOUNT
QUANTITY QUANTITY QUANTITY t
y11 1 f f _ s .
fi.�;''`: I LJrr."_.L f7L.�i1I_.i-PI�4i:..�,_ ,
t t +c t 4.03 Cl'1:I '^741._ f 1.� )R G
Cash Check#/Auth Code: Signature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Coilect
Check Without'Standby Charges:
a
Charge
Comments:
,WATER ADDED: fGAL,- -YARDS N DgUl M:•3
�r tNI"IEN ADDDDEEDD.
' r / SIGNATURE
' CURB LINE CROSSED AT OWNER'S AGENT'S REQUEST:
_._.�..... PART.—MI.— _'__ PUL.L. 1, 0 A L11 ( tY ARkJC SIGNATURE"
❑LOAD WAS TEST ED-I�Y:
Notice: Our drivers will make-every effort to place materials where the customer designates,but the SPECIAL TERMS: "water added is A�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 guaranted. WARNING: Prqduct may.gause 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� o your safety and health. Please,refer to the backside of this/licket for important
control after delivery,this Company will not accept any responsibility for the finished,results. No credit for safety handling,ipfofmation,and to the aterial safety data sheets7ad�iiloVnaimfm'ation.
returned concrete.`Buyers exceptions and claims shall be deemed waived unless made to us in writing AUTHORIZED IG'ATURE:
within one business day after the receipt of materials. X
6BUNIVERSAL !"r P;i::.�i €��' ° INVOICE S r ul`!n 1.
This Delivery Ticket incorporates herein by reference Buyer's previously executed Credit Application. if' any, `_ietlsr•:: Standard
Terms and Conditions,Seller's Quo* gin,if any,and Seller's Order Confirrnati, "nc.luding limitations oi'warraiitil•.,'.  if fully
set forth on this Delivery Ticket('V ,ment").Seller will provide the Standard ns and Condition, capon request.)5>>Y er agrees
that,unless otherwise not on the rrurrc hereof,all quantities and items were delivered as indicated anct further expressly-agrw_s to
pay in accordance with the Agreement.
AGGREGATE / CEMENT / CONCRETE PRODUCTS / FLY ASH _
Aggregate products are naturally occurring materials.includinf7 limestone,dolomite,granite,volcai, rock,sand,gravel.,c.ind other
siliceous materials. Cement products include Portland cement, masonry, pozzolan ("Igype IP;. roof tile, and stucc:.,. ;•;concrete
products include Portland cement and aggregate products inciading lir,eestone,dolomite,grate ,volcanic rock,sard, gravel,and
other siliceous materials.These products,including fly ash,may contain.more than 0.02.5%crystalline silica.
Hazards: Freshly mixed wet cement and/or fly ash can cause eye irritation,skin and eye burns and alle•t is skint reactions.
Dry concrete and aggregate;dust rely cause irritation to eyes,skin,and/or respiratory tract. Dust from handling,
crushing,grinding,cutting anal/or::billing may contain silica,which may cause silicosis and cancer if inhaled.
If ingested,keep warm,at re:;t,aix.l 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,eliroat..ind " nags. See physician.Health risk depends on duration and level of exposure.
Safety: Avoid contact with eyes and prolonged contact with si.in.Wear gloves,eye protection,and appropriate protective
clothing. Wash hands thorouSlrly 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 A►:d: 1n case of eye contact,immediately flush e.ye; with flowing water for 1.5 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 c: )Ynccl Houston,Texas 77024
0,2i 3 For more information please visit www.cemexosa.com.
Fst:_ ticket de entrega incluye comp 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 limitaciones y
garantfgs�,como acuerdo total del ticket c.;;;;ntrega("Contrato").El vendedorSroveera los terminos estindares y condiciones detal-
lados en caso de,as(ser requeri dos.d_'r,,; <+,,flc)Cunlento,e.l comprador aceptli os mismos ya antes inencionados y que las cantidades
y materiales fueron entregados comp, sc:::,., resa en el mis.mo.Acepta pagar el monto de acuerdo al contacto; al rnenos quo se identi-
fique con u.na nota al frente de este dorismento.
AGREGADOS / CE.MENTO / PRODUCTOS DE CONCRETO / CENIZAS VOLANTES
I_os productos de agregados son neat+,,riales naturales eomo piedra caliza•,dolomita,granito,roca volcanica, arena.Brava y otros
weteriales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albanilerfa, pozzolan (tipo IP), azulejo de
azotea 1, estuco. Los productos de con.reto incluyen cemento Portland y productos de agregados como piedra caliza, dolomita,
granito,roc,; volcanica,arena,gray ,a,y otros materiales silicios.Estos productos incluyen ceni.zas volantes (fly ash) la cual puede
contener ma= de 0.025% de silicio cristalino.
Peligros: Mezcla de cemento fresco i,.) ,,;mizas volantes pueden causar irritaci6n en Jos ojos,quemaduras on pie] y -6jos,y
reacciones al6rgicas en la piel.Concreto seco y polvo de agregados,pueden causar irritaci6n en los ojos,pie] y/o en
la zona respiratoria.Polvo del manejo en el trituramiento,puli.do,cone y/o perforaci6n puede contener materiales
silicos,Jos cuales pueden causar silicosis pulmonar y cancer si son inhalados.En caso de ser ingeridos,mantenerse
en temperatura calida,reposar y to mar grandes cantidades de agua.Las cenizas volantes pueden contener amoniaco.
Seguridad• La humedcrd puede causar la liberaci6n del amoniaco. La inhalaci6n del amoniaco puede causar toser,irritaci6n o
quemaduras en la nariz,gargania y pulmones.Actrdir inrnediatamente al medico. El riesgo en la salud depende en
la duraei6rr y el nivel de la exposici6n.
Seguridad: Evite el contacto con ojos y contacto proiongado con.la pie].Use guantes,protection en los ojos y ropa
Primeros adecuada para proteccion.Lavese las m.anos con jabon suave y agua despues del manejo de materiales.Evite inhalar
auxilios: polvos. Si se expone a polvos mas de los limits: ro,comendados,use r:otecci6n respiratoria.
Primeros auxilios: En caso de contacto en Jos oios,.Wr.rediatamente tluya agua en la parte afectada por 1.5 rni.nutos.
Si se inhala polvo,exp6ngase a airs fresco. Si•t:�i cenwlito fresco tiene cu,,tacto con strs ojos,lavelos a fondo con
agua.Acuda a awnci& medica inmediatamcnte si la irritaci^ar continua.
t ;
CEMEX,Memorial Herm�;nn Tower
929 Gessner,Suite 1.900
V7 combinado Houston,Texas 77024
02/12 Para mas information visita w� v cemexusa com.
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823280
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Plant: Begin Loading: To Job: 111 Arrive Job: Start Unload: Finish•Unload: Leave Job: Return Plant: I
Customer Code: Customer Name: Customer Job Number: Order Code/Date:
'•+ca -! f'l+ Cr r:y.y} f�7� °..`f'7�.�Ai ' C' } j• ...Ir ,at"�.
rPro ect Codee':- +Pro ect Name. - Prd/ Number:-' Order P.O.Number.'
i
Tick 2Datef4k ITr(D'eliverlAddr ssy i k°r: li(� :'E_t)• .' .(,;
6 Map`Page: Map'/Row/Column;
Delivery•lhstructions: ! Dispatcher:
Ticket!'Numberr} �• ri
RO-,: _ Ef)cP_ ` C, 1'/i �.' 'fl' 'I. tm} r»Z
rS�.{`i',-�-} 1..j1� 1'..lD�.tFr y':ii�jl k..i� !_.:h•�f i'i't:.. •1+! r„,t:�3�(. `�, �'��I.:.I S�}it�i i...:��.t�t (''��-tt��+ar^
•: -,�...., .. .. .... .. .,. !••-5^'Sk" ..,,r1' 1 r»,..it : f�.A t 7•(t+.•"" K•.{w` a.i rhr—'A
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Due On Job: - Slump: Truck Num`6'er: Driver Number: briver Name: End Use: '
�d .t ,ti C t�.�..' .•-F C""rf , q r"1:Y��'^,7'6 Tf'1^ f"f'I r_nr r+,r'.1 R9f Y^.S.)f_^.., K�"/'« C'.!_I C..'i
LOAD CUMULATIVE ORDERED MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT
QUANTITY QUANTITY QUANTITY
00 !; F.,E_;7.0 i*n- G
. . �. , f�,f:, :i.;�f�x����:•�:� t""�i`�4� �;'�:'C•.%�rtrt�(`t.'i•.�. f �-(;,tS��E= ,
Cash Check#/Auth Code: Signature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect
Check
Without Standby Charges: lot
'
!
Charge +t-
Comments:
WATER ADDED: GAL YARDS IN DRUM: ;
WHEN ADDED.
r '
SIGNATURE
CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST:
°ART I r•?L F, �fI_.L (. EY-4D 'y'trIC4D�'i SIGNATURE 2E
❑ 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 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 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 backside of this ticket for important nportant
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 SIGNATURE: F
within one business day after the receipt of materials. _ 0
6BUNIVERSAL FD RIE'.! T R(%N 10022.607 INVOICE L 0 P P N UA �
1V emecute lication, if any, Sellers Standard
i ket incorpor�
This Delivery Tic ,ns,Seller'' previously executed Credit Application, if any, Seller's Standard
Terms and Conditio very Tlcice `D lyder Cq we mation (including limitations of warranties),as if fully
set forth on this Delill lloted on the front he- wide the dard Tern-,and Conditions upon request..Buyer agrees
that,unless otherwise 1,"ghe Agreement. and items were delivereLYas indicated and further expressly agrees to
pay in accordance with ti�\,,GREGATE l
AGGV%�-.max„ using materials inc]4 / CONCRETE PRODUCTS /.FLY ASH
Aggregate products are.naturally Occurrii'�b Jude Portlan1uding limestone,dolomite,granite,volcanic rock,sand.,gravel,and other
siliceous materials. Cement products includeate Pr nitlld'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.
11N=
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 11Ow.ing water for 1.5 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 previa.mente ejecutada en su aplicaci6n de cr6dito); cualquier
t6rmino 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 estandares y condiciones detal-
lados en caso de asi ser requeri.dos.Con este documento,el comprador acepta los mismos ya antes mencionados y que las cant.idades
y materiales fueron entregados como se expresa en el .mismo.Acepta pagan 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,granito, rota volcanica, arena,Brava y otros
materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de a[banilerfa, 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 sil.icios.Estos productos incluyen cenizas volantes (fly ash) la cual puede
contener mas de 0.025%de silicio cristalino.
ICUIDADO!
Peligros: Mezcla de cemento fresco y/o cenizas volantes pueden causar irritaci6n en los Ojos,quemaduras en pie] y Ojos,y
reacciones al6rgicas en la pie[.Concreto seco y polvo de agregados,pueden causar irritaci6n en los Ojos,piel y/o en
la zona respiratoria. Polvo del. nlanejo en el trituramiento,pul.i.do,torte y/o perforaci6n puede contener materiales
silicos,los cuales pueden causar silicosis puimonar y cancer si son inhalados.En caso de ser ingeridos,mantenerse
en temperatura calida,reposar y tomar grandes cantidades de agua.Las cenizas volantes pueden contener amoniaco.
Seauridael: La humedad puede causar la liberaci6n del amoniaco. La inhalaci6n del amoniaco puede causar toser, irritaci.6n o
5 quemaduras en la nariz,garganta y pulmones.Acud:ir inmedi.atmente al medico. El ri.esgo on la salud depende oil
la duraci6n y el nivel de la exposic16n.
Seguri.dad: Evite el contacto con Ojos y contacto prolongado con.la pie].Use guantes,protecci6n en los ojos y ropa
Primeros adecuada para protecci6n.Ldvese las manor con jab6n suave y agua despu6s del manejo de materiales.Evite inhalar
auxilios: polvos.Si se expone a polvos mds de los limites recomendados, use protecci6n respiratoria.
1
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 cxjos, lavelos a fordo con_
agua.Acuda a atenci6n m6dica inrriediatamente si la irritaci6n continua.
CEMEX.Memorial Hermann Tower
929 Gessner,Suite 1900
V7 combinado Houston,Texas 77024
02/.12 Para mas informati6n visita ww____w.com(ZxuA�a.corn.
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BEST p A¢+Ya. C ��'yy"'jj''�}�.y x _:, �y'. _ �r .4 f,, "r C�.lR���,l��.'C(3�S��"�?`/3�''�1{A►NtE�2'3FAG .r 'a
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Natloa OUrIr)vets bylll mdke.�Vary efrott la p ec9 matoHele,.W @ratth�cjiiat�fne a
Company as3(fjlias flo rasp
oilsi¢Il�ty:rXoi dem9ges i ltte gttb o f fine u 6e6 a e}g.bkF ode rSP CjaWzI f 3 tY wa a gctts i l a¢Ear}Jery:gWtt fsk'It: teC�eadd§3on jo[r ponaete titre
tertna of sate„at°d doll, end ttcee tS epncret ^s i Due'for>i ehi! etots- � &tees fo the ls.7e;foiiQe� are �� °feed 6 Pradudtrpaya4seeKlRearl/or,,eye:lrtftetlon,.frAyTIPN:.fNete al
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