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PERMITTING
Plant:
Begin Loading:
To Job: •
Arrive Job.
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Plant:
CustomerCode:- Customer'Name: ,• Customer Job Number., Order Code l Date* '
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Delivery Instructions:, ." Disp etcher,
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Cash Check # / guth Code:
Signature of Driver Receiving Cash':
Cash Received:
Total COD order Amount to Collect
-
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Without Standby Charges:
Check
%
I.Charge
Comments:
fA�i
WATER ADDED:
YARDS IN'DRUM:
�GAL
j
WHEN ADDED.
SIGNATURE
V .
CURB LINE CROSSED AT OWNER'S/AGENT'S' REQUEST:
s % ?►.z A!.� FEESIGNATURE
....•.___..__.._ .._........_.___ ❑'LOAD WAS TESTED BY:
Notice: Our drivers will make every effort to place materials wherd the customer designates, but the SPECIALfTEI2MS: 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,lonserguaranteed. 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 safetyfiandling 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 SIGNATi
within one business day after the receipt of materials. r
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68UNIVERSAL P`iiE:' V T F K s: . i )02,'r.Gt' i'j 1G,U-9TOMER.1..it'ai='I 'a
Law �1 r,it..ai�i S D
This Delivery Ticket incorporates herein by reference Buyer's previously executed Credit Application, if any, Seller's Standard
'Terms and Conditions, Seller's Quo n, if any, and Seller's Order Confirmatia icluding limitations of warranties), as if fully
set forth on this :Delivery Ticket ("AL, vent"). Seller will provide the Standard.' is 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, gravel, and other
siliceous materials. Cement products include Portland cement, masomy, pozzo.lan (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 amino-'
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 imitation 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 confirmac.ion del vendedor (con .limitaciones y
garantfas), como acuerdo total del ticket de entrega ("Contrato").:El vendedor proveerd los terminos estdndares y. condiciones detal-
lados en caso de asf ser requeridos. Con este documento, el comprador aceptw1os 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 co.ntrato; 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 natura.les como piedra caliza, dolomita, granito, rota vol.canica, arena, grava y otros
materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albahilerfa, 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% de si..licio cristal..ino.
Peligros: Mezcla de cemento fresco y/o cenizas volantes pueden causar irritaci6n en los Ojos, quemaduras en pie] y ojos, y
reactions alergicas en la pie]. Concreto seco y polvo de agregados, pueden causar iiTi.taci6n en los ojos, piel y/o en
la zona respiratoria. Polvo del manejo en el trituramiento, pulido, torte y/o perforation puede contener materiales
silicos, los cual.es pueden causar silicosis pulmonar y cancer si. son inhalados. En caso de ser ingeridos, mantenerse
en temperatura calida, reposar y tomar grander cantidades de agua. Las cenizas volantes pueden contener amoniaco.
Seguridad: La humedad puede causar la liberaci6n del amoniaco. La inhalaci6n de] amoniaco puede causar toser, irritaci6n o
quemaduras en 1a nariz, garganta y pulmones. Acudir inmediatamente al medico. El riesgo en la salud depende en
la duraci61i y el nivel de la exposici6n.
Seguridad: Evite el contacto con ojos y contacto prolongado-conla piel. Use guantes, protecci6n en los ojos.y ropa
Primeros adecuada para protecci6n. Lavese has menos con jab6n suave y agua despu6s del .manejo de materiales..Evite inhalar
auxilios• pollvos. Si se expone a polvos mas de los limiter recomendados, use protecci6n respi.ratoria.
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 of cemento °fresco tiene contacto con sus ojos, lavel.os a fondo con_
agua. Acuda a atenci6n medica inmediatamente si la irritation continua.
CEMEX, Memorial Hermann Tower
929 Gessner, Suite 1900
V7 conrbinado Houston, Texas 77024
02/12 Para mas informaci6n visita www.cemexusa.com.
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CEMCX
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.Plan t:
Begin
n Loading:Arrive
To Job:
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Start Unload:
Finish Unload:
Leave Job:
Return
`` Customer Code: Customer Name: Customer Job Number: Order Cod. / Dit.:
21(106980, DDYLE MA8,0NRY-
I Project coae:. Project Name: Project P.O. Number: Order P.O. Number.
PO
,.Ticket Date: Delivery Address:- Map Page: Map/Row/Column:
04/22/4 F, NETLeS I 191IL'AND
Delivery Instructions: Dispatcher:
JE-ii"'ISEN S 1-,X L U C 1 NEC
Ticket Number:
3 43-3 7.4t99
Due On Job:
Slump:
Truck Number:
Driver Number:
Driver Name:
End Use:
5.oOl
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V I NICENIT 110 IRM S
114,17 'ILL
LOAD
cumuLATrvE
QUANTITY
ORDERED
QUANTITY
MATERIALCODE
PRODUCTION DESCRIPTION
UOM'
UNIT PRICE f
7----
AMOUNTQUANTITY
F, C 2 J 5, Q 9 9 qTJ 3C)OC) Di__ENDEPr? VPM YD3
APR 22 oi 9"2�1
RECEIVED
00 .2-q �116 FUEL' Ei� A R -
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APR 2 7- 2016
1f z� c .1 -7, s) r_zirynbNl1E'!�1T1AL CHARC-3-E
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,f DRUM:
t
WHEN ADDED.
SIGNATURE
CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST:.
CONCRETE DISPOSAL FEE
P ARTIAL OAD FULL L /4� -_ " YARDC'a
SIGNATURE
❑ LOAD IAD WAS TESTED \\BY-(
I
L
Notice:' Our drivers will make every effort to place materials where the customer designates, but the
SPECIANTERIVIS: \Any watJadded is elcustomem oX risk. If water is added on job, concrete strength
Company assumes no responsibility for damages inside curb or property line. Customer agrees to the
terms of sale and delivery and accepts concrete as is. Due to important factors which are out of our
is no longegguarantead. WARNING: Product may cause skin and/or eye irritation. CAUTION: Material
may be hazardous to your safely, andj6alfh. 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 handlingyinforrnatloh, and tOthe Fhaterial safety data h
sheets for additional information.-
returned, concrete. Buyers exceptions and claims shall be, deemed waivedunless made to us in writing
within one business day after the receipt.of materials.
AUTHORIZED SIGNATURE:
68UNIVERSAL
P RE V T RK I o0213483 - V f1ffif61tE C RL-17
0 LOAD NUM
I,lw ,.Jc;uvery rrcxer incorporates nere, eterence Buyer's previously executed Credit Application, if any, Sel or's Standard
Terror and Conditions, Seller's . at any, and Seller's Order Cofifi.rrrration (i. ding limitations of warranties), as .itfully
set forth. on this Delivery Ticket (``Agreem I t"). Seller will provide: the Standard. TenAMad Conditions upon request. Buyer agrees
that, unless otherwise noted on the :front hereol,'all quantities and items were delivered as .indicated and further expressly agrees to
pay in accordance with the Agreement.
AGGREGATE / CEMENT / CONCRETE PRonT cmg / FT Y ARM
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 bunts 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 warn, 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 inclmye conio referencia al-comprnd r,;l rr previamente ejccutada en su °al31ic1cibn' de credito); cualquier
tc rnuno estandar, condiciones del vendedor, propuestas del ven.i&dor y orden de confi.r.mac.i6n del vendedor (con .l.inri.taciones y
garantlas), Como acuerdo total del ticket de entrega ("Contrato").:El vendedor proveera los t6rminos estandares y condiciones detal-
lados en caso de asf ser requeridos. Con este doculment'O, el comprador acepta los rnisrnos ya antes mencionados y que las cantidades
y materiales fueron entregados como se expresa en el mi:5mo..Acepta pagar el rnonto de acuerdo a.] contrato; al m.enos que se identi-
fique con una nota al frente de este documento.
AGREGADOS / CEMEN'TO / PROP UCTOS DE CONCRETO / CENIZAS VOLANTES
Los productos de agregados son materiales naturales como piedra caliza, do.lornita, granito, coca vol.canica, arena, Brava y otros
materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, do albahilerfa, pozzolan (tipo I.P), azulejo de
azotea y estuco. Los productos de concreto incluyen cemento Portland' y productos de agregados corno piedra caliza, dolomita,
granito. rota volcanie'a., arena, grava, y ot.ros materiales silicios. Est.os productos incluyen cenizas volantes (fly ash) ]a cual puede
contener rnas de 0.025'Yo de silic.io cr.istalino.
Peligros: Mezcla de cemento fresco y/o cenizas volantes pueden causar irritaci6n en los Ojos, quemaduras eri piel y ojos, y
reacciones alcrgicas en la piel. Concreto seco y po.lvo de agregados, pueden causar irri.taci.cin en.l.os ojos, pi.e.l y/o en
]a zona respiratoria. Polvo del manejo en el trituramiento, pulido, torte y/o perforation puede contener materiales
silicon, los cuales pueden causar silicosis pulmonary cancer si. son .ir. halados. En caso de se.r ingeridos, mantenerse
cn tenrperatu ra calida, reposar y tomar grandes canzidades de aqua. Las cenizas volantes pueden contener amoniaco.
Seguridad: La hurnedad.pbede causar la liberaci6n del amoniaco. La .inhalaci6n del atnoniaco puede causar toser, irritacibn o
quemiovu gs. eil la nariz, l arganta y pUli-nones. Acudr' rnmediatamente al medico. El riesgo en ]a salud depende en
la duraci6n.y el nivel de la exposici6n.
Sc:grrridad: 1:?viti; el contacto con ojos y contacto prolongado con la pie]. Use guantes, protecei6n en los ojos y ropa.
Primeros adecuada para protecei6n. lAvese las manos con jabbn suave y agua despues delrnmejo de materiales. Evite in:h.alar
auxilios: polvos. Si se expone a polvos mas de l.os lirnitcs .recomendados, use protecei6n respiratoria.
Prirneros auxilios: En caso de contacto en los ojos, inmediatamente fluyaagua,en la parse afectada por 15 minutos.
Si se inha.la polvo, exp6ngase a aire fresco. Si el.cemento fresco ti.ene contacto con sus ojos, l.avelos a fondo con
aqua. Acuda a atenci6n niddica immdiatamente si la irritaci6ri continua.
CE.MEX. Memorial Hermann Tower
929 Gessner, Suite 1900
V7 conibinado Houston, "Texas 77024
02/12 Para mas informacion visita www.cemextisa.com.
L..CMG
Plant:
Begin Loading-
To.Joti:.'
;d Arrive'Uob° ,, ';.
$tart Unioad`:f
Finish Unload:
Leave Job:
Return Plant:
Customer Code: Customer Name: Customer Job Number: Order Code / Date:
_30�tt),S980?._` DO LE_NASWRY .7,NL. �� � �w...,� • v
_. .
I'Prolect Code: Project Name. � ProlectP.O. Number. Oider P.O. Number.
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Ticket Date: r elivery Address. Map Page: Map/Row/Column:
t)/3i.twl,-/ 4J i_O i �=•L /�.t 14 iw 1 i 4 �_. Ast,7,•.4lltid! _ _ ne:r~
Delivery, Instructions: - Dispatcher:
Ticket Number:
t 2
Due On Job:
Slump:
Truck Number:
Driver Number:
Driver Name:
End Use:
J. to.1
j 4j()2,34'33
. 109(- c•3
V I CTO ClaU '
C'I._DNG . WALL ;
LOAD'',-'• CUMULATIVE ORDERED
MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT
4QUANTITY .' QUANTITY QUANTITY
t,a3_ltv't3`g1.+?�:.`1.1 R�'>t!t S'u`
e
1. ttti ; 44781 €=[...IE 1 :iJ�IliCk 1AIR.�`.fE t
1. 1- Q ° La 0274.9 ' EN I I•dC1�:!MENTAL_ CHARGE I
Cash . Check # / Auth Codh: Signature of Driver Receiving Cash:. Cash Received: Total COD Order Amount to Collect
Without Standby Charges:
Check r
Charge r r
/ Comments: + i -j- V ' t
�; ! ' °I , . • a = WATER ADDED: GAL YARDS IN DRUM:
WHEN ADDED.
Yr Y t4 ; SIGNATURE
CURB.LINE CROSSED AT OWNER'S/AGENT'S REQUEST:'
r,JNCRl I:. 'DI IOE'PAi_ FEE SIGNATURE
IRT IAL ' FULL ❑'LOAD W
_L Lt3M _ YA{ T)a i I ~
. , - srt AS TESTED
Notice: Our drivers will make every effort to place materials where the Customer designates -butt the, SPECIAL TERMS• ; Any at er adde�'is apt c�ustor wn risk: If water is added on job, concrete strength
Company assumes no responsibility for: damages inside curb or p�pperty'line.; Customer, aglees to the' is no'longer guaranteed ARNING: -ProductJnaV'cause skin and/or eye irritation. CAUTION:.' Material
terms of 'sale and delivery and 'accepts concrete as is. Due to'important facl'ors wh=ch: aie out of our, may be�Fiazardous to' yoyr1safefy and•healt��. PI ase refer, to the backside of this ticket for important
control after delivery', this Company will not accept any responsibility far, the finished results No credit for_ safety h drii{ig.inforr ation, 8 d totherinaterial safet data sheets for additional' information.
returned concrete. Buyers exceptions and claims shall be deemed waived unless made'to us in writing AUTHORIZE SIGNATURE: /
rwithin one business day after the receipt of materials. \
0MVERSAL PREV TRK g INV
f, eI
OICE, •. LCtFlL) NUMo J.
/fhis Delivery Ticket incorporates herein by reference Buyer's previously executed Credit Application, if any, Sel�r's'Stildard
Terms and Conditions, Seller's Quota ' � any, and Seller's Order Confirmation (in- uding limitations of warranties), as if fully
set forth on this Delivery Ticket (`'Agr t"). Seller will provide the Standard. TerlWnd Conditions upon request. Buyer agrees
that, unless otherwise noted on the front hfflz of, all quantities and items were delivere ifs indicated and furtlier expressly agrees to
pay in accordance with the Agreement. - •
ACTGREGAT.F / 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, wluch may cause silicosis and cancer if inhaled.
If ingested, keep warin, 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 pings. See physician. I-Ie;alth ri.sk.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 .NIOSLI-approved respiratory protection.
First Aid: In case of eye contact., immediately flush eyes with flowing water .for 15 minutes. If dust .is inhale(], move to fresh
air. If wet cement contacts skin, rinse thoroughly with water. Get proper medical attention. if irritation persists.
CEMEX, Melorial Herrhann 'Power
929 Lessner. Suite 1900"
V7 conibined Houston, Texas 77024
02/12 For more. information please visit www.cemexusa.com.
Este ticket de entrela incluye como referenda al eomprador (ya previamente ejecutada en su aplicaci6n de crddi.to); cualqu.ier
t6rmino estandar, condiciones del vendedor, pr•opuestas del vendedor y orden de• confirmac.i6n del vendedor (con .limitaciones y
garantfas), corn acuerdo total del ticket de entrega ("Contrato"). El vendedor proyeen! los t6rminos estandares y condiciones detal-
lados en caso de asf ser requeridos. Con este docurnento, el compra.dor acepta. los mistnos ya antes•mencionados y que las canticlades
y materiales fueron entregados como se ex.presa en el mismo. Acepta pagar el monto de'acuerdo al co.ntrato; al .m.enos que se identi-
fique con Una nota al frente de este documento.
'Y � � '7 � � r � r ti -� v � r i r �
A.GREGAUOS / CEMEN I O / PRODUC TOS':DE CONC.,RE I O / CENIZAS VOLAN 1 ES
Los productos de agregad.os son materiales natu.rales como piedra caliza, dolomTita, granito, coca vole{mica, arena, Brava y otros
materiales silicios. Los productos de cemento incluyen Cerfrcnto de tipo Portland, de albahilerfa, pozzo.lan (tipo IP), aztrlejo de
azotea y est'uco. Los productos de concreto incluyen cemento Portland y productos de agregados corno piedra caliza, dolomita,
granito, coca volcanica, arena, Brava, y otros materiales silicios. Est.os prodUCt.os incluyen cenizas volantes (fly ash) la cual puede
contener mas de 0,0251h de silicio cristalino.
Peligros: M:ezcla de cemento fresco y/o cenizas volantes pueden causar irritati6n en los Ojos, quemaduras en piel y ojos, y
reacciones al6rgicas en la piel. Concreto seco y polvo de agregados, pueden causar.irri.tac.i6n en los Ojos, piel y/o en
la zona respiratoria. Polvo del rnanejo en el trituramiento, pulido, torte y/o perforaci6p puede contener materiales
silicos, los cuales pueden causar silicosis pulmonar y cancer si son inhalados. En caso de se.r ingeridos, mantenerse
en temperatura calida, repoar y tomar grandes cantidades cfe aqua. Las cenizas volantes pueden contener amon.iaco.
Seguridad: La humedad •puede causar la liberaci6n del arnoniaco. La inhalaci6n del amoniaco puede causar toser, irritaci6n o
quemaduras en Ja nariz, garganta y pulrriones. ACudir inniMiatarnente al medico..El riesgo en la salud depende en
la duraci6n y el nivel de la exposici6n.
Seguridad: f: vote el corrtacto con Ojos y contact.o prolongado con la piel. Use gUantes, protecti6n en los ojos y ropa
'rimeros adecuada Para prolecci6n. l.avese las manos con jab6n suave y agua despu6s del .manejo de materiales. Evi.t:e in.halar
auxilios: po.lvos. Si se expone a polvos mas de Jos liinites .reCOMendados, use protecci6n respirator.•ia.
Primeros auxilios: En caso de cont.acto en'los ojos, inmediatarriente fluya. agua en la parse afectada por 1.5 rninutos.
Si se inhala polvo, exp6rigase a aire fresco. Si el gtimente fresco tiene corrtacto con sus ojos, ldvelos a fondo con
agua. Acuda a atenc:i6n mddica inmediatamente si l',Virritaci6n continda.
CEM.EX, Memorial Hermann Tower
929 Gessner, Suite 1900
V7 ccamb nado Houston, Texas 77024
02/12 Para mas informaci6n visita www.cemexusa.coni.
ITAN 2'
C:40NCRIETIE
Materials for. Life`
"Thank you !.We appreciate your business"
Ticket no.
gmaeteo b TLY-)R I
FL. :�: yc{u;• :,-;:JY�r?Y� ,
Delivery date' ;Plant Truck fq� Driver �,S Truck size Type job
La:' t, `" ;ir: �'fii�'t s=`L7f:]'FEIR
�i.4�i �,
I Customer no. Customer name Zone Tax CID
fi,Itliflrc �,E3 I liLa'w'!._E iY V) C_iNRY
Tarmac project no.
Customer P.O. no.
Order no.
Terms code 1-Charge delivered 3-C.O.D.
Time due
%313
1 2-Charge F.O.B. 4-C.0.1) -F.O.B.
9 - .l
Delivery name and address
Lot
Block
County
i�EE TTLES PL l.:VJI : I -T WIG . P._+:: T i
J'Er:i`LdSrEN
)-R- ltwhl•
Instructtiions��t
Slump
P y ff t, 11 11 �i
L'Ji lwf..t,�' i- f-Y 1 :�f NETTLES I E
_
-
LANIX
i,y fit
Quantity
roduct
UlM;
Unit priced 1'4mount
Load
Cumulative Ordered Code
Descriptiofi
`. 001
: � 00 11,, fr "i C� A _1:3,5-Py -1 Q1
. =i::=7 PM
{�-:,VII-A0,,
+
1, i ui
1 „ !.+i!I r'i 80 Ii DI rf
ENV I RCIN UI'-,'CVR--j E^.o
+'
Load
1Y
Arrive job site Start discharge Finish discharge Leave job site Arrive plant
Subtotal•
Sales tax
TOTAL
dditional water added to this concrete will reduce its strength. Any water added,is at customers risk.
Gallons of water added: Gallons bf water added: Gallons of water added: Amt of'CY Retained:. \�
Customer Approval: ✓� Customer Approval: Customer Approval: I Customer Approval:
Tested Tested properly No. Authorized•and-received•by)
C�N^ I yk 2r17� j6 I_
Yes Q'No ❑ Yes ❑ No , n� _•/
'Safety is a constant state of mind, with
every employee feeling responsible
and empowered to act to cause him•
and others to work safely, on the belief
that all accidents are preventable and
Ithat zero incidents is the' only goal. .
Lot:
Block:
Address: Correct
Not Correct
N FLORIDA LLC
'ERMS AND CONDITIONS OF SALE
1. All saieAr l be subject to these terms and cond�L.., ("Contract").andl it*buying on credit, to Buyer's credit agreement with Seller, incorporated herein
/ by rei.&ence; all other terms, including any tetra contained in Buyer's purchase order, are excluded unless agreed to by Seller in writing. Any changes
must be in writing and signed by each party. This Contract will be construed in accordance with the laws of the state of Florida. For all disputes relating
to this Contract, Buyer hereby consents to the' juin`3dici+Ion and venire of the state and federal courts, for the location of the delivery site of the goods sold
hereunder. '
2. Payment terms: Net the last day of the month following the month of delivery, without deduction, retainage, set off or charge backs. A cash discount of
1% 101, proximo maybe deducted if no previous balances are past due. Interest at the lesser of V/2% per month or the maximum rate allowed by law will.
be imposed on outstanding and delinquent invoices from the date, of delivery until paid. Buyer will pay to Seller all applicable federal, state and local
sales and use taxesAn addition to any other available rights and remedies, Seller will be entitled to recover from Buyer• all costs of collection and litigation
including, but not limited to, reasonable attorneys' fees. Seller reserves the right to require payments in advance or to cancel the unfilled portion of this
Contract without notice in the event of Buyer default of any Contract provisions, or if the financial status of Buyer becomes impaired or deemed unsat-
isfactory to Seller. Failure of Seller to exercise any of -its rights _will not be deemed,a waiver of any such right.
3. Regular delivery hours are 7:00 a.m. -, 5:00 p.m., Monday tli orlgh Friday. An additional charge may be added for deliveries outside of these hours and
for any waiting/unloading periods in excess of 60 minutes. Prices are based on fiill loads; an additional charge will apply to loads of less than seven cubic
yards. The minimum load for each delivery is .I'h. cubic yards.
4. Buyer will g}ye Seller at least 48 hours prior notice of the time and rate of requested deliveries. Delivery schedules will be mutually agreed upon between
Seller and Buyer. Deliveries will be made to the best of Seller's ability to dispatch, however, Buyer waives any claims associated with any delays in
6elivery.
5. Buyer must provide suitable approaches to delivery points beyond paved streets. For delivery beyond curb lines, Buyer assumes all liability for damage
c to vehicles, sidewalks, driveways, pipes, septic tanks, and/or other; propgq,4 and Buyer will indemnify and hold Seller harmless from and against any and
a all liability, loss and expense incurred as a result of such delivery, including but not limited to towing charges, except to the extent caused by Seller's
gross negligence or willful misconduct. Buyer waives any right of subrogatiou.against Seller. .
.. `Buyer is responsible for full payment of, including all costs of disposal-anl Seder's return charge per truck for, (i) orders not cancelled at least one.hour - .
prior to delivery time; (ii) concrete delivered due to Buyer's mr'stake off;/in excess of requirements; (iii) concrete not deliverable due to unsuitable
..ppfoaches:
ed
7 Concrete
place". Yield
dilquantities
be testablished in a cordance with applicable ASTM sttandaron thexet volumeat:the time of ds. Buyere from hwill pay allcharges incidenare� not sold t to inspectionenf' or or t sts maderby
or on behalf of Buyer.
8. Limited Warranty: Buyer is soled responsible for determining the type and quantity of goods to be purchased. Seller warrants that its products will, meet
or exceed applicable American Society for Testing Materials ("ASTM") and American Concrete Institute ("ACI") standards, when tested in accordance
with ASTM and.evaluated byACI standards. Seller will repair or replace -any goods supplied by Seller that fail to meet this limited warranty, within one
year after delivery thereof. Seller will uphold its warranty obligations cinder Florida statute 718.203, as applicable. ALL OTHER WARRANTIES,
WHLTHEK;EXPkLSS OR IMPLIED, INCLUDING WITHOUTLIMITAI'IONTHE WARRANTIES OF MERCHANTABILTI.'YAND,FI'I'NESS FOR
A PARTICULAR PURPOSE, ARE HEREBY EXPRESSLY EXCLUDED. THE REMEDY SET FORTH. IN THIS SECTION 8 WILL CONSTITUTE"
THE SOLE REMEDY OF BUYER. UNDER THIS LIMITED WARR.ANTY.- „
9,, Seliar will not be responsible for slump, strength. or quality of any conereie to whichwater or other material. has been added by or on behalf of Buyer.
P..uyer will be responsible to see that the concrete -is handled accordance with best constntetiou.nr-arK-;er Seller has no control'over the pl wing or
handling of concrete after--unloai ing-and-acesitot guarantee the tip sned work in which it is used. Buy er will be responsibleto prevent concrete after
unloading from coming into contact with any material, such as ahiminum, which may adversely impact concrete strength.
10. Buyer will furnish any admixtures or ingredients it desires that �e not regularly supplied by the Seller in thw rparketpiace. Buyer will be sdlely respon-
sible for the effect of such admixture or ingredients on. the cof Crete. Any extra product which may be requir -d in excess.of the mix design quoted, or
which may be required to provide workability, strength: setting tfi ne'or water/cement.ratio. }vill resole in an additional ingredient charge pay�rble by Buyer.
l l . Concrete will be batched and delivered in accordance with ASTM,C-94. Concrete tenel)c: ature will be dictated by th.e enviroi.mentai anti material condi-
tions at the time of delivery. Any requirement beyond these cotidhions will require the implementation of controlled measures during pfoduction at the
expense of Buyer.
12. Buyer mast give Seller written notice within 48 hours after dam) .yery of any claim against Seller as a result of any alleged nonconforming materials or any
other cause whatsoever.(gtlnertlVri fiailure to meet compressive strength, in which event the'time for notice will be within 48 hours after the customary
time for analysis of the -test, cyl-tider), time being of the essence. Seller will be given reasonable opportunity to investigate all claims. Any failure by
Buys. to give written nonce,within such 48 hour period will be deemed a conclusive waiver by Buyer of all such�claits against Seller.
13. SELLER WILL NOT BE L1.4BLE,,UNDER ANYCCIRCUMSTA'NCES FOR ANY SPECIAL, INCIDENTAL, PUNITIVE OR CONSEQuE-NTIAL
DAMAGES INCLUDING, WITHOUT L1MiTACION, ANY DAMAGES RELATED TO BELAY, V1','ETIIER CBI-Giv-SWI"U'I 1. TOI<i,
CONTRACT, OR OTHERWISE, AND WHETHER OR NOT ARISING I -ROM SEt.LER:'S-NE&' l('-?7Cfi. STRICT LIABTO Y OR FAULT. IN NO n
EVENT WILL SELLER BE RESPONSIBLE POP p Ilr =To , :L A-C'rfb_NS OF OTHERS OR TI-IE FAILURE OF BUYER TO COMPLY a
WITH ITS OBLIGATIONS. SELLER'S LIABILITY ','(.)R AN Y` CLAIi%IS WILL BE LIMITED TO THE PURCHASE PRICE OF THE GOODS SOLD '
UNDER TIiIS CONTRACT, 11
14. Notice. All notices to Seller will be sent in writing to the sales office issuing the price quotation, with a copy to Credit Department, 455 Fairway Drive,'.
Deerfield Beach, FL 33441.
15. Severability. The unenforeeabi.lity of any provision of this Contrace will not affect the enforceability of any other provision of. this Contract, and each
other provision of this Contract will be seve, :ble•and enforceable to the extent permitted by law. '
WARNING: CAUSES SKIN IRRITATION -.INJURIOUS TO EYES. I
CONTAINS PORTLAND CEMENT. FRESHLY MIXED CONCRETE MAY CAUSE SKIN IRRITATION OR INJURY. AVOID CONTACT WITH SKIN
WHERE POSSIBLE. WASH EXPOSED AREAS PROMPTLY WITH WATER. IF ANY MIXTURES GET INTO THE EYE, RINSE IMMEDIATELY
WITI-1 WATER AND GET PROMPTMEDICAL Y07ENTION. KEEP OUTOF REACH OF CHILDREN.
MATERIAL SAFETY DATA SHEETS (MSDS)'ARE AVAILABLE AT WWW.TITANAMERICA.COM. .1
^�-v'd 2-08
f