HomeMy WebLinkAboutCemex InvoiceTI�6 A /-/
Plant: Begin Loading: To Job: Arrive Job: Start Unload: Finish Unload: Leave Job: Return. Plant:
Customer Code: Customer Name:
r
Project Code: Project Name:
Ticket Date: Delivery Address:
Delivery Instructions:
Customer Job Number:
Project P.O. Number:
Order Code / Date:
Order P.O. Number.
Map Page: Map/Row/Column:
Dispatcher:
Ticket Number:
Due On Job:
Slump:,
Truck Number:
Driver Number:
Driver Name:
End Use:
LOAD CUMULATIVE ORDERED MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT
QUANTITY QUANTITY QUANTITY
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1� Je� ,• � �i. .{�, __ t:1 i"tag Y ti`-15,3P
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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:
GAL YARDS IN DRUM:
WHEN ADDED.
RECEIVED APR 0 7 2014 SIGNATURE
CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST:
• ,� � \ SIGNATURE
❑ LOAD WAS'T�ESTED BY:
Notice: Our drivers will make every effort to place materials where 'lhe 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.' I ARNING: 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 har dling 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. r ,O
68UNIVERSAL CUSTOMER
is Delivery Ticket incorporates herein_ by .reference .Buyer's previously executed,Credit Application, if any, Seller's Standard
erms and Conditions, Seller's Quotal if any, and Seller's Order Confirmation uding limitations of warranties), as if fully
set forth on this Delivery Ticket ("Agri mt"). Seller will provide the Standard Te ind Conditions upon request. Buyer agrees
that, unless otherw, e noted on the front hereof, all quantities and items were delivered as indicated and further ex.pressly.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.com.
Este ticket de entrega incluye como referencia al comprador (ya previamente ejecrctada en su aplicaci6n de credito); cualquier
termino estdndar, 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 proveerd Jos term. inns estdndares y : condiciones detal-
lados en caso de asf ser requeridos. Con este documento, el comprador acepta los mism6s ya antes mencionados y que las cantidades
y materiales fueron entregados como se expresa en el mismo. Acepta pagar el monto de acuerdo al contrcto; al menos que se identi-
fique con una rota al frente de este documento.
AGREGADOS / CEMENl'O / PRODUCTOS DE CONCRETO / CENIZAS VOLANTES
Los productos de agregados son materiales naturales como piedra caliza, dolomit'a, granito, coca volcdnica, arena, gravy y otros
materiales s.ilicios. 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 Portlandy productos de'agregados como pi.edra cal.i.za, dolomita,
granito, coca volcdnica, arena, grava, y otros materiales silicios. Estos productos incluyen cenizas volantes (fly ash) la eual puede
contener mds de 0.025% de silicio cristalino.
Peligros: Mezcla de cemento fresco y/o cenizas volantes pueden causar irritaci6n en los Ojos, quemaduras en pie] y Ojos, y
reacdones alerg:icas en la p.iel. Concreto seco y polvo de agregados, pueden causar i.rri.taci6n. en los Ojos, piel y/o en
la zona respiratoria. Polvo del manejo en el trituramiento, pulido, torte y/o per..foraci6n puede contener materiales
silicos, los cuales pueden causar silicosis pulmonar y cancer si son inhalados. En caso de ser ingeridos, mantenerse
en temperatura cdlida, reposar y tomar grandes cantidades de agua. Las cenizas volantes pueden contener amoniaco.
Seguridad: La humedad puede causar la libe.raci6n del amoniaco. La inhalaci6n del amoniaco puede causar toser, in•itaci6n 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. p )
el in
Seguridad: Evite el contacto con ojos y contacto prolongado cot IN pi6�. tJS� g�ridr9tesl,'protecci6n en los Ojos y ropy
Primeros adecuada para protecci6n. Ldvese las mans con jab6n suave y agua despues del manejo de materiales. Evite inhalar
auxilios: polvos. 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 1.5 m.inutos.
Si se inhala polvo, exp6ngase a aire fresco. Si el cemento fresco tiene contacto con sus Ojos, ldvelos a fondo con
agua. Acuda a atenci6n medica inmediatamente si .la irritation continua.
CEMEX, Memorial Hermann Tower
929 Gessner, Suite 1.900
V7 combinado Houston, Texas 77024
02/12 Para mds informaci6n visita www.cemexusa.com.
PIP;
EMEX
56378003
Plant:
Begin' Loading:
To Job:
Arrive Job:
Sta �,11oatl:
Finish.Unload: �.
Leave Job:
Retum Plant: '
Customer Code: Customer Name: Customer Job Number: Order Code / Date:
p^ e,. -j4, {•••• I t'. w"Y�i... ^: 1 .. y'`} E
r�t� �t_E
Protect Code: Project Name: Project P.O. Number. Order P.O. Number.
Ticket Date: tDelivery Address: �, Map Page: Map/RoW/Column:
,yt_ rr_:.7' '..4 NET-ri—r_,:^' .j. 'Jc_f N I I L 01' rf 9
Delivery Instruct ions> y Dispatcher:
I 3}tEt ;
1 , Ticket Number:
Due On Job:
Slump:
Truck Number:
Driver Number'
Driver Name:
End Use:
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LOAD
QUANTITY
CUMULATIVE
QUANTITY
ORDERED
QUANTITY
MATERIAL CODE
PRODUCTION DESCRIPTION
UOM
UNIT PRICE
AMOUNT
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« f➢$.i 5 3� t)()
i dt:J.«5()gyp 2,000
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RO!`lMEN'i"%)I.•. CHARGE
JCash Check # / Auth Code: Sid,ature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect
t, Without Standby Charges:
] Check
Charge
Comments; �,/✓
WATER ADDr�!�GAL YARDS IN DRUM:
WHEN ADDED.
SIGNATURE
h ' CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST:
• � „ J / SIGNATURE
!!��'l✓✓�,fffi ❑ 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. WARMING: 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,•iiealth. 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: ,IYJJ
within one business day after the receipt of materials.
68UNIVERSAL P..RE V TRK, 1 0f:t264- r INVOICE `f' i_O�i�'.i NUM. & .7
This Delivery Ticket .incorporates herein by reference Buyer's previously executed Credit Application, if any, Seller's Standard
Terms and Conditions, Seller's Quote, if any, and Seller's Order Confirmation - luding limitations of warranties), as if fully
set forth on this Delivery Ticket ("Agi gent"). Seller will provide the Standard Te 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 w.ith'dre Agreement.
AGGREGATE / CEMENT / CONCRETE PRODUCTS / FLY ASH
Aggregate products are naturally occurring materials including limestone, dolomite, granite, volcanic rpck, slid, 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 rgck, sand, gravel, and
other siliceous materials. These products, including fly ash, may contain more than 0.025% ciystallinp silicd.
Hazards: Freshly mixed wet cement and/or fly a�Ti can cause eye irritation, skin and eye burns and allergic skin reactions.
Dry concrete and aggregate dust may can se irritation to eyes, skin, and/or respiratory tract. Dust from handling,
crushing, grinding, cutting and/or drillidg-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 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 aI comprador (ya previamente ejecutada en su aplicaci6n de cr6dito); cualquier
t6rmino estdndar, 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 proveerd los t6rminos estdndares y condiciones detal-
laclos en caso de asf ser requeridos. Con este documento, el comprado.r acepta los mismos ya antes mencionados y que las cantidades
y materiales fue.ron entregados como se expresa en el mismo. Acepta pagar el monto de aeuerdo al contrato; al menos que se ident.i-
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 volcdnica, arena, Brava 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, roca volcdnica,�arena, grava, y otros materiales silicios. Estos productos incluyen cenizas volantes (fly ash) la cual puede
contener mds de 0.025% de silicio cristalino.
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 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 perforaci& puede contener materiales
silicos, los cuales pueden causar silicosis pulmonar y cancer si son inhalados. En caso de ser ingeri.dos, man.tenerse
en temperatura cdlida, reposar y tomar grandes cantidades de agua. Las cenizas volantes pueden contener amoniaco.
Seguridad• La humedad puede causar la liberaci6n del amoniaco. La inhalaci.6n del amoniaco puede causar toner, irri.taci6n 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
CD
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 limiter recomendados, use protecci6n respiratoria.
Primeros auxilios: En caso de contacto en los ojos, inmediatamente fluya agua en la parte afectada por 1.5 minutos.
Si se inhala polvo, exp6ngase a wire fresco. Si el cemento fresco tiene contacto con sus ojos, ldvelos a fondo con
agua. Acuda d atenci6n m6dica inmediatamente si la irritaci6n continua.
CEMEX, Memorial Hermann Tower
929 Gessner, Suite 1.900
V7 combinado Houston, Texas 77024
02/1.2 Para mds informacion visita www.cemexusa.com.