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HomeMy WebLinkAboutCEMEX CEMENTT ccmcx 543-30066 Plant: Begin Loading: To Job: Arrive Job: Start Unload: Finish Unload: Leave Job: Return Plants Customer Code: Customer Name: Customer Job Number: Order Code / Date: �-' ,�' '�{, 'ri'r' y{�; tt �•-i"1,ti._.;��iy7 r-.- ,,). f' <(.! �.. r.. ... .. .v• r rr !.I ,y Project Code: Project Name: Project P.O. Number: Order P.O. Number: Ticket Date: Delivery Address: Map Page: Map/blow/Column: Delivery Instructions: Dispatcher: '.l r y : - Ticket Number: f LOAD QUANTITY CUMULATIVE QUANTITY ORDERED QUANTITY MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT Due Op Job: Slump: Truck Number: Driver Number: Driver Name: End Use: tjf.l i_ ;.1(Y .. 'y... ,. (y+::{4-- �L_Zii''•il3 � E X i 1{';�.L_ '' � t_"-, :.; : � ,�. ,�1 T �t�a.lSti,�::,•t•i rl�_. zy it`;�pp�++:L;f._ _. ., (;t' t - +I•tt, 1.I�1�•���iit.. t-t-' !-'lil',lG:rl.. � :`•fl^i tTi-.'' I Cash Check # I Auth Code: Signature of Driver Receiving Cash: Check Charge Comments: Cash Received: Total COD Order Amount to Collect .�---•---,� Without Standby Charges: WATER ADDED: 9 "GAL YARDS IN DRUM: �,,- WHEN ADDED. \ I CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST: SIGNATURE . _ _ �=��1=?�•:E�71._ ,___.._... F=U_'_. !.._C)f=tD �((lr?D S El LC Notice: Our drivers will make every effort to place materiels where the customer designates, but the SPECIP Company assumes no responsibility for damages Inside curb or property line. Customer agrees to the Is no for terms of sale and delivery and accepts concrete as Is. Due to Important factors w}hIch are out of our may be control after delivery, this Company will not accept any responsibility for the finished results. No credit for safety h returned concrete, Buyers exceptions and claims shell be deemed waived unless made to us In writing AUTHO within one business day after the receipt of materials. n•— TESTED BY: Any water added Is at customers own risk. If we eed. WARNING; Product may ceuskln anHi to your safety and health. Please refer to the motion, and to the materiel safety date sheets for SIGNATURE added on Job, concrete strength iTrrltetlon. CAUTION: Materiel side bf this ticket for Important 68UNIVERSAL. s�-t�C.,t.' INVOICE' J__l 1e=tl? Nlr S` . This Delivery Ticket incorporates herein by ireference Buyer's previously executed Credit Application, if any, Seller's Standa. Terms and Conditions, Seller's Quol �, if ny, and Seller's Order Coufinnatior auding limitations of warranties), as if fully set forth on this Delivery Ticket ("AL vent'). Seller will provide th6 Sterndard T and Conditions upon request. Buyer agrees that, unless otherwise noted on the front here f, all quantities and items were delivered as indicated and further expressly agrees to pay in accordance'with the Agreement. v - AGGREGATE / EMENT / CONCRETE PRODUCTS / FLY ASH Aggregate products are naturally occurring in terials including limestone, dolomite, granite, volcanic rock, sand, gravel, and other siliceous materials. Cement products includ Portland cement, masonry, pozzolan (Type IP), roof tile, and stucco. Concrete products include Portland cement and aggreg to products including limestone, dolomite, granite, volcanic rock, sand, gravel, and other siliceous materials. These products, inc uding fly ash, may contain more than 0.025°lo crystalline silica. Hazards: Freshly mixed wet cement a�d/or fly ash can cause eye irritation, skin and eye burns and allergic skin reactions. Dry concrete and aggregate ust may cause irritation to eyes, skin, and/or .respiratory tract. Dust from handling, crushing, grinding, cutting nd/or drilling may contain silica, which may cause silicosis and cancer if inhaled. Lf..ingested, keep warm, at r st, and drink large amounts of water —Fly Asb may contain trace amounts of ammo- nia. Moisture can cause thel ammonia to be released. Inhalation of ammonia can cause coughing and irritation or burns of the nose, throat 4nd 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 thorn g.hly 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, imn air. If wet cement contacts CEMEX, 101.00 Ke V8 combined Houston, 01/17 For more -1y flush eyes with flowing water for 15 minutes. If dust is inhaled, move to fresh rinse thoroughly with water. Get proper medical attention if irritation persists. emorial Hermann Tower Freeway, Suite 300 xas 77043 please visit www.cemexusa.com. Este ticket de entrega incluye como referencii( al comprador (ya previamente ejecutada en su aplicacion de credito); cualquier termino estandar, condiciones del vendedor, piopuestas del vendedor y Orden de confirmation del vendedor (con limitaciones y garantfas), como acuerdo total del ticket de entr�ga ("Contrato"). El vendedor proveera los terminos estandares y condiciones detal- lados en caso de asf ser requeridos. Con este doOmento, el comprador acepta los mismos ya antes mencionados y que las cantidades y materiales fueron entregados como se expres en el mismo. Acepta pagar el monto de acuerdo al contrato; al menos que se identi.- fique con una nota al frente de este documentoI AGREGADOS / CEMENTO / PRODUCTOS DE CONCRETO / CENIZAS VOLANTES Los productos de agregados son materiales na urales como piedra caliza, dolomita, granito, coca volc6mica, arena, grava y otros materiales silicios. Los productos de cemento ncluyen Cemento de tipo Portland, de albaf ilerfa, pozzolan (tipo IP), azulejo de azotea y estuco. Los productos de conereto in luyen cemento Portland y productos de agregados como piedra caliza, dolomita, granito, rota volcdnica, arena, grava, y otros m teriales silicios. Estos productos incluyen cenizas volantes (fly ash) la cual puede contener mas de 0.025% de silicio cristalino. Peligros: Mezcla de cemento fresco y/o ce reacciones alergicas en la piel. Cc.! la zona respiratoria. Polvo del m, silicos, los cuales pueden causar en temperature cal.ida; reposar y tc Seguridad: La humedad puede causar la libe. quemaduras en la nariz, garganta la duration y el nivel de la exposi ms volantes pueden causar irritation en los Ojos, quemadu.ras en piel y Ojos, y ;veto seco y polvo de agregados, pueden causar irritation en los Ojos, piel y/o en -jo en el trituramiento, pulido, torte y/o perforation puede contener materiales icosis pulmonar y cancer si son inhalados. En caso de ser ingeridos, mantenerse iar grandes cantidades de agua. Las cenizas volantes pueden contener amoniaco. -ian del anioniaco. La inhalation del amoniaco puede causar toser, irritation o pulmones. Acudir inmediatamente al medico. El riesgo en la salud depende en on. Seguridad: Evite el contacto con Ojos y contacto prolongado con la piel. Use guantes, proteccion en los Ojos y ropa Primeros adecuada para proteccion. Lavese las manos con•jabon suave y agua despues del manejo de materiales. Evite inhalar auxilios: polvos. Si se expone a polvos ma. de .los limi.tes recomendados, use proteccion respiratoria. Primeros auxilios: En caso de cc Si se inhala polvo, expongase a agua. Acuda a atencion mddica i V8 combinado 01/17 CEMEX, M 10100 Katy Houston, TE Para mas in. to en los Ojos, inmediatamente fluya agua en la parte afectada por 15 minutos. fresco. Si el cemento fresco tiene contacto con sus Ojos, .lavelos a fondo con diatamente si la in•itacion continua. •ial Hermann Tower way', Suite 300 77043 visita www.cemexusa.com. `` CEMC-X 54829338 Plant: Begin Loading: To job: .,Arrive Job: Start Unload: Finish Unload: Leave Job: Return Plant: Customer Code: Customer -Name: CustomerJobNumber: Order Code I Date; Project Code: Project Name; Project P.O. Number: Order P.O, Number: Ticket Date: Delivery Address: Map Page: Map/Row/Column: T Delivery Instructions: Dispatcher: Ticket Number: Due On Job: Slump: Truck Number: Driver Number: Driver Name: End Use: !3, !-1 -OR L.) [\If A %-:� r", , G N r--. T) E I LOAD QUANTITY CUMULATIVE CUMULA QUANTITY ORDERED QUANTITY MATERIAL CO DE PRODUCTION DESCRIPTION -7 UOM UNIT PRICE AMOUNT t - 7Cash Check Check #/ Auth Code: Signature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect Without Standby Charges: Charge Comments: e�- WATER ADDED: — GAL YARDS IN DRUM: %I— WHEN ADDED. SIGNATURE CURB LINE CROSSED AT OWNER'S/AGE NT'§,REQUEST: 7 i f f-) -SIqNATURE 7, 1,.. U LOAD WAqXESTED,/BY:. X\/ 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'weOffs added oh.job, concrete strength Company assumes no responsibility for damages Inside curb or property line. Customer agrees to the, Is no longer guaranteed. WARNING: Product i�nqy'6ause 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 iloket 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. 68UNIVERSAL: INVOICE I-Xit•Ix, 1 This Delivery Ticket incorporates h(-~---i by r�ference Buyer's previously executed Credit Application, if any, Seller's Standard Terms and Conditions, Seller's Quot i, if any, and Seller's Order Confirmatioi cluding limitations of warranties), as if fully set forth on this Del..ivery Ticket ("Agreement',y. Seller will provide the Standard 'I..xs 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 / �EMENT / CONCRETE PRODUCTS / FLY ASH Aggregate products are naturally occurring r aterials including limestone, dolomite, granite, volcanic rock, sand, gravel, and other siliceous materials. Cement products inclu e Portland cement, masonry, pozzolan (Type IP), roof tile, and stucco. Concrete products include Portland cement and aggre ate 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 aggregIg to dust may cause irritation to eyes, skin, and/or respiratory tract. Dust from handling, crushing, grinding, cuttir and/or drilling may. contain silica, which may cause silicosis and cancer if inhaled. 11' ingested, keep warm, 4t rest, and drink large amounts of water. Fly Ash may contain trace amounts of ammo- nia. Moisture can causel the ammonia to be released. Inhalation of ammonia can cause coughing and irritation or burns of the nose, thr at 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 recommend d 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 cont cts skin, rinse thoroughly with water. Get proper medical attention if irritation persists. CE EX, Memorial Hermann Tower 101 0 Katy Freeway, Suite 300 V8 combined Ho ston, Texas 77043 01/17 Fo} more information please visit www.cemexusa.com. Este ticket de entrega incluye como r ferencia al comprador (ya previamente ejecutada en su aplicaci6n de credito); cualquier termino estindar, condiciones del ven edor, propuestas del vendedor y orden de confirmaci6n del vendedor (con lirnitaciones y garantfas), como acuerdo total del tick - t de entrega ("Contrato"). El vendedor proveerd los terminos estdndares y condiciones detal- lados en caso de asf ser requeridos. Co, este documento, el comprador acepta los mismos ya antes mencionados y que las cantidades y materiales fueron entregados como ss,e expresa en el mismo. Acepta pagar el monto de acuerdo al contrato; al menos que se identi- fique con una nota al f ente de este dobumento. 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 d cemento incluyen Cemento de tipo Portland, de albanilerfa, pozzolan (tipo IP), azulejo de azotea y estuco. Los productos de oncreto incluyen cemento Portland y productos de agregados como piedra caliza, dolomita, granito, coca volcdnica, arena, grav , y otros materiales silicios. Estos productos incluyen cenizas volantes (fly ash) la cual puede contener mds de 0.025% de silicio �ristalino. Peligros: Mezcla de cemento fresco y/o cenizas volantes pueden causar irritaci6n en los ojos, quemaduras en piel y Ojos, y reacciones al6rgicas en la piel. Concreto seco y polvo de agregados, pueden causar irritaci6n en Jos ojos, pie] y/o en la zona respiratoria.1 Polvo del manejo en el trituramiento, pulido, corte y/o perforaci6n puede contener materiales silicos, los cuales p eden causar silicosis pulmonar y cancer si son inhalados. En caso de ser ingeridos, mantenerse en temperature Cd u a, reposar y tomar grandes cantidades de agua. Las cenizas volantes pueden contener tunoniaco. Seguridad• La humedad pued causar la liberaci6n del amonRico. La inhalaci6n del amoniaco puede. causar toser, irritaci6n o quemaduras en la ariz, garganta y pulmones. Acudir inmediatamente al medico. El riesgo en ]a salud depende en la duraci6n y el niyel. de .la exposici6n. Seguridad: Evite ee�'I contacto con ojos y contacto prolongado con la piel. Use guantes, protecci6n en los ojos y ropa Primeros adecuada para protecci6n. Ldvese las menos con jab6n suave y agua despu6s del manejo de rnater•iales. Evite inhalar auxilios: polvos. Si se exp i ne a polvos mds de Jos limites recomendados, use protecci6n respiratoria. Primeros auxilro : En caso de contacto en los ojos, inmediatamente fluya agua en la parte afectada por 15 minutos. Si se inhala polv'o, exp6ngase a aire fresco. Si el. cemento fresco tiene contacto con sus ojos, ldvelos a fondo con agua. Acuda a ate' nci6n medica inmediatamente si la irritaci6n continua. jCEMEX, Memorial Hermann Tower 10100 Katy Freeway, Suite -�00 V8 combinado I Houston, Texas 77043 01/17 ; Para mas informati6n visita www.cemexitsa.com. J. `Z rMEMEX 54841969 Plant: Begin Loading: To Job: Arrive Job: Start Unload: Finish Unload: Leave Job: Return Plant: Customer Code: Customer Name: Customer Job Number: L-:AEii-11. 1 i 1 1'1t7VFPAPOR ► -'- GARTP,RS CntICRI Project Code: Project Name: Project P.O. Number: Ticket Date: Delivery Address: 1.a 5,2915 cl-TIf-,n-ti•.'i cou. 1"�7.._.,, 1'.. "j"_ I'•�.1,.�'�.i.�.�rl*,r•%i t�t �'�'r...r ti!`:`t•%'•' Delivery Instructions: NORTI._! ` 5-- LCiST '-. r- {_..I.. US :i -• R 1 Ur s C1'1L!5(.-- I !AY � sT R'.i'{; r...i'.i" i ii u { !l.i _{�i !. I. { ). Eti:'i s`-i4 .t1'IT'I I Order Code / Date: 770 04!27/18 Order P.O. Number: N 0 1�)0 Map Page: Map/Row//ColumLn:: •r Dispatcher: DCf,t=.A146 Ticket Number. 356 74.10 7 Due On Job: Slump: Truck Number: Driver Number: Driver Name: End Use: 1.3. 113 . i)t") 1. ( )(_);_'f=,41. t) J. t-)`3 -'41- �DAVI'I) I F--QNI T I' Ri I i RNI{= n LOAD CUMULATIVE I ORDERED MATERIAL CODEI PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT QUANTITY QUANTITY QUANTITY 1 e _ .. J . C',K) :c -` '.' C)._. (t G E 1 r F; P O1�{Ct_L._ T L:, '°(1)• `, :1, •_,a ;.) 1 o ttii :L . 00 J Cash Check Charge Comments: FUEL. SURCHARGE 17. 00 ' -;'. 6() Ei-'+1V 1 RONNie{`ti_ITil_ C WPIRCE "'tit,. i:)f_t ERV:, CONCRETE F'{Ah{DI-ING FEE F' 11,)0 t,)t-) T()T(1! (lhIOUN T FOF'' ` ,!'! 1 F' 'I" Y CKE T N10`I- T NICL_L]D T IllG C,TANDBY C:F A { E .3 - .i.-,7._a Check # /Auth Code: Signature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect Without Standby Charges: rWATERADDED: GAL YARDS IN DRUM: WHEN ADDED. CURB LINE CROSSED -AT OWNER'S/AGENT'S REQUEST: CONCRETE D I SPOSF'I!._ FEE /// _ PAR I" I AL FULL L`OAD ARDS El LOAD W/1`s TESTZ /BY Notice: Our drivers will make every effort to place materials where the customer designates, but the SPECIAL ErRMS: Any Ater aa�ided Is at cy/stoners y/n risk. If wa Company assumes no responsibility for damages Inside curb or property line. Customer agrees to the is no to er guarantee�.�WARNING: Prooz! may cause skin an �/ terms of sale and delivery and accepts concrete as is. Due to Important factors which are out of our may be hazardous t /�ur afety and health. P ease refer to the• control after delivery, this Company will not accept any responsibility for the finished results. No credit for safety handling inforWation, and to the material safety data sheets for 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 SIGNATURE SIGNATURE tided on job, concrete strength Irritation. CAUTION: Material de of this ticket for important ._..- JNIVERSAL F,REV -I.R g j 0i=t;=`;'r4i" 5 V Ir1NV:OICETLE? LOAD NUM 2 4 r This Delivery Ticket incorporates herein by'reference Buyer's previously executed Credit•Application, if any, Seller's Standard Terms and Conditions, Seller's Qu---on, if any, and Seller's Order Confirmati including limitations of warranties), as if fully set forth on this Delivery Ticket ( emer't" ). Seller will provide theaStandarC ms and Conditions upon request. Buyer agrees that, unless otherwise noted on the tront her of, all quantities and items were delivered as indicated and further expressly agrees to pay in acc6rdance with the Agreement. AGGREGATE /I 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 incl de Portland cement, masonry, pozzolan (Type IP), roof tile, and stucco. Concrete products include Portland cement and aggr gate 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 dust may cause irritation to eyes, skin, and/or respiratory tract. Dust from handling, crushing, grinding, cuttir�lg and/or drilling may contain silica, which may cause silicosis and cancer if inhaled. If ingested, keep warm, t. rest, and drink large amounts of water. Fly Ash may contain trace amounts of ammo- nia. Moisture can caul jthe ammonia to be released. Inhalation of ammonia can cause coughing and irritation or burns of the nose, thr at and lungs. See physician. Health risk depends on duration and level of exposure. Safety: Avoid contact with eyes land 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 recommend 'd limits (see MSDS), wear suitable NIOSH-approved respiratory protection. First Aid: In case of eye contact, i I mediately flush eyes with flowing water for 15 minutes. If dust is .inhaled, move to fresh air. If wet cement conta is skin, rinse thoroughly with water. Get proper medical attention if irritation persists. CE EX, Memorial Hermann Tower 1010 Katy Freeway, Suite 300 V8 combined Hou$ton, Texas 77043 01/17 For r1inore information please visit www.cemexusa.com. Este ticket de entrega incluye como ref6rencia a] comprador (ya previamente ejecutada en su ap.licaci6n de cr6di.to); cualquier t6rmino estandar, condiciones del vendedor, propuestas del vendedor y orden de confirmaci6n del vendedor (con limitaciones y garantfas), como acuerdo total del ticket a entrega ("Contrato"). El vendedor proveera los t6rminos estandares y condiciones detal- l.ados en caso de asf ser requeridos. Con dste documento, el comprador acepta los mismos ya antes rnencionados y que las cantidades y materiales fueron entregados como se �xpresa en el m.ismo. Acepta pagar el monto de acuerdo al contrato; al menos que se identi- fique con una nota al frente de este documento. AGREGADOS/ / PRODUCTOS DE CONCRETO / CENIZAS VOLANTES Los productos de agregados son materiales naturales como piedra caliza, dolomita, granito, coca voledrnica, arena, grava y otros materiales silicios. Los productos de c rnento incluyen Cemento de tipo Portland, de albanilerfa, pozzolan (tipo IP), azulejo de azotea y estuco. Los productos de con veto incluyen cemento Portland y productos de agregados como piedra caliza, dolomita, granito, coca volcanica, arena, grava, y otros materiales sil.ic.ios. Estos productos incluyen cenizas volantes (fly ash.) la coal puede contener mas de 0.025% de silicio cris alino. Peligros: Mezela de cemento fresl o y/o cenizas volantes pueden causar irritaci6n en los ojos, quemaduras en pie]. y ojos, y reacciones al6rgicas en � piel. Concreto seco y polvo de agregados, pueden causar irritaci6n en los ojos, piel y/o en la zona respiratoria. Po o del manejo en el trituramiento, pulido, corte y/o perforaci6n puede contener materiales sil.icos, los cuales pued n causar silicosis pulmonar y cancer si son inhalados. En caso de ser ingeridos, ramtenerse en temperatura calida, r posar y tomar grandes cantidades de agua. Las cenizas volantes pueden contener amoniaco. Se iuridad• La humedad puede cau�ar la liberaci6n del amoniaco.-La inhalaci6n del amoniaco puede causar toser, irritaci6n o b quemaduras en ]a nariz garganta y pulmones. Acudir inmediatamente al medico. El. riesgo en la salud depende en la duraci6n y el nivel d la exposic, 6n. Segur•idad: Evite el co tacto con ojos y contacto prolongado con la piel. Use guantes, protecci6n en los ojos y ropa Primeros adecuada para proteccion. Lavese las mans con jab6n suave y agua despu6s del manejo de materiales. Evite inhalar auxilios: polvos. Si se expone a polvos mas de los limites recomendados, use protecci6n respiratoria. Primeros auxilios: En aso de contacto en los ojos, inmediatamente fluya agua en la parte afectada por 15 minutos. Si se inhala polvo, ex 6ngase a aire fresco. Si el cemento fresco tiene contacto con sus ojos, ldvelos a fondo con agua. Acuda a atenci6 m6dica inmediatamente si la irritaci6n continua. V8 combinado 01/17 'EMEX, Memorial Hermann Tower 0100 Katy Freeway, Suite 300 Iouston, Texas 77043 ova mas informaci6n visita www.cemexusa.com. CEmcx 54 29352 Plant: Begin Loading: To4ob: / - Arrive Job: Start Unload: Finish Unload: _Leave Job: Return Plant: Customer Code: Customer Name: _r". '-•. y..•+ -r_;" _f 1 Project Code: Project Name: Ticket Date: Delivery Address: Delivery Instructions: W l -E Customer Job Number: Project P.O, Number: Order Code I Date: •: r r Order P.O. Number: Map Page: Map/Row/Column: fst_ .. :. Dispatcher: :a Ticket Number: Due On Job: Slump: Truck Number: Driver Number: Driver Name: End Use: n .:r_: �; c" t" I;t . t^rr:_i i f r'=:j `=>%� �f ., I_;"I (J!+'. vc-a- ";.' I_li�ff ��i5�:l: C�l`!i_ri 11 LOAD QUANTITY CUMULATIVE QUANTITY ORDERED QUANTITY MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT iiH �` `Mi.p�."• '1�t,�-' e..i ' j .r[, CL''..Ei ;rjfi101 :', 12� .� n .iia .4 r:� .�;' iL_.�„ .«i.t 1'. C~�fi aF l'., �'„ �. Z' /`�(5 �• l�t r� _ t . ,.tit �' l.._..k.. i. •w.r _'r. .... ^. ._. �'�. %� +r"' .�lit•I ri1^l::. FT'�C 1f �.. r +. �s)".f�iR 1.� Cash Check #! Auth Code: Signature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect Without Standby Charges: Check " Charge J/ l Comments: WATER ADD_ ED: `l•�'tf YARDS IN DRUM: GAL \!� WHEN ADDED' I SIGNATURE CURB DINECROSSED S REQUEST: .I. SI.11743f-1i._ FEE. I� 1 � V SIGNATURE ❑ 1_0J.1WAS� 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 I-,1 E T R I 10 .3;j,,8 At(, ffl-'iI.INV010EiF'.FIS L_OPID NUM, 3 This Delivery Ticket incorporates herein by reference Buyer's previously executed Credit Application, if any, Seller's Standard Terms and Conditions, Seller's Qua ' in, if iny, and Seller's Order Confirmatic icluding limitations of warranties), as if fully set forth on this Delivery Ticket ("A ment'). Seller will provide the Standard' is and Conditions upon request. Buyer agrees that, unless otherwise noted on the front here f, all quantities and items were delivered as indicated and further expressly agrees to pay in accordance with the Agreement. y AGGREGATE / EMENT / CONCRETE PRODUCTS / FLY ASH Aggregate products are naturally occurring m iterials including limestone, dolomite, granite, volcanic rock, sand, gravel, and other siliceous materials. Cement products includ Portland cement, masonry, pozzolan (Type IP), roof tile, and stucco. Concrete products include Portland cement and aggreg ite products including limestone, dolomite, granite, volcanic rock, sand, gravel, and other siliceous materials. These products, inc 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 Ildust may cause irritation to eyes, skin, and/or respiratory tract. Dust from handling, crushing, grinding, cuttingand/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 - ma. 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 irnme iatel flush eyes with flowing water for 15 minutes. If dust is inhaled, move to fresh Y � Y Y g air. If wet cement contacts skin, rinse thoroughly with water. Get proper medical attention if irritation persists. CEMEX, Memorial Hermann Tower 10100 Kay Freeway, Suite 300 V8 combined Houston, exas 77043 01/17 For more nformation please visit www.cemexusa.com. Este ticket de entrega incluye Como referene a al comprador (ya previamente ejecutada en su aplicaci6n de cr6dito); cualquier t6rmino estindar, condiciones del vendedor, propuestas del vendedor y orden de confirmaci6n del vendedor (con limitaciones y garantfas), Como acuerdo total del ticket do ent ega ("Contrato"). El vendedor proveera los t6rminos estandares y condiciones detal- lados en caso de asi ser requeridos. Con este documento, el comprador acepta los mismos ya antes mencionados y que las cantidades y materiales fueron entregados como se expresa en el mismo. Acepta pagar el monto de acuerdo al contrato; al menos que se identi- fique con una nota al frente de este documento�RODUCTOS AGREGADOS / CEMENTO / DE CONCRETO / CENIZAS VOLANTES Los productos de agregados son materiales .n turales como piedra cal.iza, dolomita, granito, coca volcanica, arena, grava y otros materiales silicios. Los productos de cement incluyen Cemento de tipo Portland, de albaiiilerfa, pozzolan (tipo IP), azulejo de azotea y estuco. Los productos de concreto it cluyen cemento Portland y productos de agregados como piedra caliza, dolomita, granito, roca volcanica, arena, grava, y otros i ateriales silicios. Estos productos incluyen cenizas volantes (fly ash) la cual puede contener mas de 0.025% de silicio cristalino. Peligros: Mezcla de cemento fresco y/o c nizas volantes pueden causar irritaci6n en los ojos, quemaduras en piel y ojos, y reacciones al6rgicas en la piel. Goncreto seco y polvo de agregados, pueden causar irritaci6n en los ojos, pie] y/o en la zona respiratoria. Polvo del nianejo en el trituramiento, pulido, corte y/o perforaci6n puede contener materiales silicos, los cuales pueden causar silicosis pulmonar y cancer si son inhalados. En caso de ser ingeridos, mantenerse en temperatura edlida, .reposar-y tomar grandes cantidades de agua. Las cenizas volantes pueden contener amoniaco. Seguridad: La humedad puede causar la liberaci6n del amoniaco. La inhalaci6n del amoniaco puede causar toser, irritaci6n o quemaduras en la nariz, gargant y pulmones. Acudir inmediatamente al medico. El riesgo en la salud depende en la duraci6n y el nivel de .la expo iici6n. Seguridad: Evite el contacto cor ojos y contacto prolongado con la piel. Use guantes, protecci6n en los ojos y ropa Primeros adecuada para protecci6n. Lave, e las manos con jab6n suave y agua despu6s del manejo de materiales. Evite inhalar auxilios: polvos. Si se expone a polvos m's de los limites recomendados, use protecci6n respiratoria. Primeros auxilios: En caso de contacto en los ojos, inmediatamente fluya agua en la parte afectada por 15 minutos. Si se inhala polvo, exp6ngase a aire fresco. Si el cemento fresco tiene contacto con sus ojos, .16ve.los a fondo con agua. Acuda a atenci6n m6dica i nmediatamente si la irritaci6n continua. CEMEX, )Ylemorial Hermann Tower 10100 Katy Freeway, Suite 300 V8 combinado Houston, Texas 77043 01/17 Para mas i iformaci6n visita www.cemexusa.com. --o ZZEMEX 14Y 540029347 Plant: Begin Loading: To Job:. Arrive Job: Start Unload: Finish Unload: Leave Job: Return Plant: Customer Code: Customer Name: 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: -- �p ii: _p ":i �" Due On Job: Slump: Truck Number: Driver Number: Dri, er Name: End Use: _'(.t .. rr i •..i., {=:a_, 7. t( ..yi^• :, ,-t r .i::�•.:,_ 1 •. � �.• yr-i`w,r.-cr ..._._.� i`II i ai p l•,r , _i ti y, .I` ri•_].+- , -EI _Ft,f� �.�.1 �y/. ,,-r_. ,. �l._ '1 l �(. 1_ r'.:"".t�l., LOAD CUMULATIVE ORDERED MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT QUANTITY QUANTITY QUANTITY { {_�' ! r,� .. '+�_ - y �i• P .,t " . 1r i{.' 1 `i. �i i%i:.iti, t•l {7hila' i• L d r i,... `. 1'3' :..J r,i• , .„ •• �r, :;'i�::•rt. ..,., I-�,r.t,s+��_r.. :vz. �-`,_; •�' i .,. .'`.� .�: .. .;wl.' ._1j�,!1... _ j i:. :'+ :?'j�11...1.i`ila i L': 4 ,{ y..r) � .. _ •' L"Clij Cash Check # /Auth Code: Signature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect Without Standby Charges: ] Check Charge Comments: I WATER ADDED: GAL YARDS IN DRUM: %J WHEN ADDED. SIGNATURE CURB D .i. SP05e )!.w FEE//� G' � ' �/ SIGNATURE _...__._ F'(=tI F i t1L /�/ ElLOAD WAS TESTED BY: Notice: Our drivers will make every effort to place materials whera�& customer designates, but the SPECIAL TERMS: Any water added Is at customers own risk. If water is added on job, concret- -e srength- 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 far 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 X 68UNIVERSAL 1- i;tL IJ i I :F .' f_Jf ti' l.f, 05 V I CT DiKVOICE ',-"' C T N i..D AJT) 1�1-!" 4 ; 21 This Delivery Ticket incorporates herein by reference Buyer's previously exec - 1 Credit Application, if any, Seller's Standard Terms and Conditions, Seller's Qu on, if any, and Seller's Order Can, nfirmati including limitations of warranties), as if fully set forth on this Delivery Ticket (", ...-emen t"). Seller will. provide the Standard Terms 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 accbrdance 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, in ludi.ng fly ash, may contain more than 0.025% crystalline silica. Hazards: Freshly mixed wet cement nd/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 est, 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 an 1. prolonged contact with skin. Wear gloves, eye protection, and appropriate protective clothing. Wash hands thor ughly with mild soap and water after handling. Avoid breathing dust. If exposed to dust above recommended Imits (see MSDS), wear suitable NIOSH-approved respiratory protection. First Aid: In case of eye contact, imm diately flush eyes with :flowing water for 15 minutes. If dust is .inhaled, move to fresh air. If wet cement contacts kin, rinse thoroughly with water. Get proper medical attention if irritation persists. CEMEX Memorial Hermann Tower 10100 Katy Freeway, Suite 300 V8 combined Houston, Texas 77043 01./17 For more information please visit www.cernexusa.com. Este ticket de entrega incluye como referen is al comp.rador (ya previamente ejecutada en su ap.licac.i6n de cr6dito); cualquier termino estindar, condiciones del vendedor, propuestas del vendedor y orden de confirmaci6n del vendedor (con limitations y garantfas), como acuerdo total del ticket de en rega ("Contrato" ): El vendedor proveera los terminos estandares y condiciones detal- l.ados en caso de asi ser requeridos. Con este d cumento, el comprador acepta los mismos ya antes mencionados y que las cantidades y materiales fueron entregados como se expre •a en el mismo. Acepta pagar el monto de acuerdo al contacto; al menos que se identi- fique con una nota al frente de este document). AGREGADOS / CEMENTO / PRODUCTOS DE CONCRETO / CENIZAS VOLANTES Los productos de agregados son materiales naturales como p.iedra caliza, dolomita, granito, rota vo.lc{mica, arena, grava y otros materiales silicios. Los productos de cemen o incluyen Cemento de tipo Portland, de albanilerfa, pozzolan (tipo IP), azulejo de azotea y estuco. Los productos de concreto �ncluyen cemento Portland y productos de agregados como piedra caliza, dolomita, granito, coca volcanica, arena, grava, y otros Iateriales sil..icios. Estos productos incluyen cenizas volantes (fly ash) la coal puede contener mas de 0.025% de silicio cristalino.I1 Peligros: Mezela de cemento fresco y/o �enizas volantes pueden causar irritaci6n en los ojos, quemaduras en piel y ojos, y reacciones al6rgicas en la piel. Concreto seco y polvo de agregados, pueden causar irritaci6n en los ojos, piel y/o en la zona respiratoria. Polvo del anejo en el trituramiento, pulido, torte y/o per.•foraci6n puede contener materiales silicos, los cuales pueden caus� r 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 li eraci6n del amoniaco. La inhalaci6n del amoniaco puede causar toser, irritaci6n o quemaduras en ]a nariz, gargarta y pulmones. Acudir inmediatamente al medico. El riesgo en .la salud depende en la duraci6n y el nivel de la exp >sici6n. Seguridad: Evite el contacto con ojos y contacto prolongado con la piel. Use guantes, protecci6n en los ojos y ropa Primeros adecuada para protecci6n. LavCse las manor con jab6n suave y agua despues del manejo de materiales. Evite inhalar auxilios: polvos. Si se expone a polvos r as de los limiter recomendados, use protecci6n respiratoria. P.rimeros auxilios: En caso de c ontacto en los ojos, inmediatamente fluya agua en la parte afectada por 1.5 minutos. Si se inhala polvo, exp6ngase 1 ai.re fresco. Si el cemento fresco ti.ene contacto con sus ojos, .lave.los a fondo con agua. Acuda a atenci6n medica immdiatamente si la irritaci6n continua. CEMEX, Memorial Hermann Tower 10100 Katy Freeway, Suite 300 V8 combinado Houston, Texas 77043 01/17 Para mas informaci6n visita www.cemexusa.com.