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Invoice
SHIP TO:
EAST FLORIDA DIVISION #5190969
52-SIMMERMACHER 7912 S OCEAN' DR
FL
US
BILL TO:
CRYSTAL POOLS #5910375
4680 N. US HWY 1
VERO BEACH FL 32907
US
H88!8�4449699
CE DATE
19/18
!02
E.
PAGE
1 of 1
PLANT
4P52 . FPI Ft Pierce
DELIVERY
E HOD
_ CARRIER
REMIT TO: VCNA Prestige Gunite, Inc.
P.O. Box 742981 Atlanta GA 30374-2981
Invoice Inquiries: Please call Credit Thank you {or your Business
Department at 407 802 3540
CIF
SALES REPRESENTATIVE
Gregory McFadden
FOR COMPLETE TERMS AND CONDITIONS. PLEASE
CHECK OUR WES61TE
www.prestlgeconcreteproducts.com
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Di.14 III NI L971111 WAS)
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0142 Water Tower Road, Lake Park FL 33403
Office: 1-877-484-9994 / Fax: 561-844-7102
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Juuin tasi rlonaa uivislon ulspatcn: ou 1.044-nu14 uenirai rlonaa ulvlslon ulspaicn: 4Ur-33y-031
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Concrete Tested ❑ Yes ❑ No LOT #
'� ater Added at Customer's
Cylinders Taken ❑ Yes FIND
Request
17 gals. to full load
Comments
gals. to 2/3 load
i t , gals. to 1/3 load
Customer's Rep - Water AddW
PIP=PL iI-I-TI
St..Lucie Cou
r°� ra�c v .e Ga+.r:i i rcLPa..r. a
NOT RESPONSIBLE FOR
WARNING IRRITATION TO THE SKIN AND EYES
ADDITIONAL WATER ADDED TO THIS
VARIATION IN COLOR OR
SURFACE DISCOLORATION
Cement polymer or freshly mixed concrete may cause skin injury. Avoid contact with
skin and wash exposed skin areas promptly with water. if any cement powder or
CONCRETE WILL REDUCE ITS STRENGTH
mixture gets into eyes, rinse immediately and repeatedly with water and get prompt
medical attention. Keep children away from cement powder and all freshly mixed
cement products_
AND DURABILITY. ANY WATER ADDED IS
AT CUSTOMER'S OWN RISK.
BATCH TIME ,.
E 22 PI.1.12_00
l, y
PLANT
TICKET# ORDER
#
TRUCK #
LOAD SIZE
Mix n SLUMP
DATE
1 �L+
879367
226 :.
75
70 00
500174t PRPM
So 0121)
. 12/21 / 17
CUSTOMER #
SOLDTO
P.O. #
PROJECT#
.:00
COD/ Coastal Conctruc t ion
TSC:O CO IC BETE
10404
DELIVERY ADDRESS
ZONE#
USE
DRIVER
7912 S Ocean Dr ._ Jansen bok
JM91RTIN
PILINGS
Mike Cross
INSTRUCTIONS
TIME DUE
Lot 4 le •Diamond Sands
12—.512 PM
• •
•
•
• • 1
•
• •
• • DESCRIPTION
I.I.O.M.
•
70 00
7a 00
7.00
50540000
f50C lei PRF1M
yd
a110e VA
7-1 00
1e
121.00
ENVIRO
ENVIRONMENTAL DIS!'O
roa
1�20o00
;a0.0lb
1.1110
0.00
2.
FUEL SURCF ARDE
ea
1320.00
;i20. 0_0
SIGNATURE
OR RECEIPT- CONCRETE
AND AQKNOWLEDGEMEN]TCMAZARD'WARNING"-'^•^---
• asc meyer Concrete ompany wZ nova some a_ i Ity or any_prope ty amage or any SUB -TOTAL
ICA.Ch
equipment damage for any, e-PI n5-Viftond the curb line.--•�`--
+'
TAX
L¢ o.lGt
r �AUTHORIZEDBYl�e
SHIPMENT SUBJECT TO CONDITIONS, ONI E.V.ERSE 1DE. TOTAL
1� Customer agrees to provide asuitable roadway for our trucks from the street pavement to the place of delivery of material.
Usuch suitable roadways are not provided, we reserve the right to stop deliveries until conditions are remedied and, in such
event, customer will beheld responsible for any loss caused thereby. _
2. When delivery is made beyond the curb line at the customer or customer representative's request, any damages including,
but not limited to, Gidewa\ks.'ddvemxaym.buildings, trees, shrubbery, septic tanks and septic systems, including the drain
field, are adthe owner's risk.
3. The customer agrees to reimburse said Company for loss of time and equipment by reason of such delivery, and also 10
indemnify and save hannies.,ssaid Company from any and all claims, demands and suits for ornnaccount oforinany
manner caused bvurarising from private driveway delivery.
_
4. Customer acknowledges that all material and services shown have been received, that truck times shown are correct, and
that the amount ofwater added atthe customer's request is shown correctly. CAUTION: The addition of water reduces
concrete strength and durability.
�
5. VVeare not responsible for finished results obtained from this load ofconcrete; many important factors affecting the ultimate
quality ofthe completed job are beyond our scope ofresponsibility and control.
- '
�A charge of $-1.00 per minute will be charged after 8 minutes per cubic yard unloadingdnmeioewomedod.
`
7, The customer agrees toprovide asuitable wash down facility for our trucks and tools at the place of delivery of material.
8. The customer hereby pgrees to pay all costs and expenses of collection, including a reasonable attorney'afee, ifheshall
fail to pay for the merchandise reflected in this invoice, when due. Past due accounts are subject toe1-1/2%service
charge onthe unpaid past due balance. The customer hereby acknowledges receipt of the complete copy of this contract.
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