HomeMy WebLinkAboutCEMEX CEMEX , 6 10 J
I,
Plant: Begin Loading: To Job: Arrive Job: *tart Unload: Finish Unload: Leave Job: Return Plant;
Customer Cade: I Customer Name: — Customer Job Number: Order Code 1 Date:
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1 f !. -i.
Project Coder .,Project Name: i Project P.O.Number: Order P.O.Number:-
Ticket Date: Delivery Address: Map Page:'-.`•.`Map/Row/Column:
I•rDelivery Instructions! ° Dispatcher:'.
j} ° TickefNumber:'1•-
I
j 7DueOnb: Slump: Truck Number: Number: Driver Name: End Use:
.�-. •d R�r'yl4yr, [,Driver
��-• I
i LOAD CUMULATIVE ORDERED MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT
QUANTITY QUANTITY QUANTITY
1
I
i
Cash Check#/Auth Code: Signature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect
Without Standby Charges:
,Check �I
Charge
Comments: t �
l WATER ADDED: -'L GAL YARDS IN DRUM:
WHEN ADDED.
J
SIGNATURE
I �
I' CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST:
O I f t 'l;t"' ,° 1-y1 y( ! r' SIGNATURE
_r-.. '• ❑ LOAD WAS TESTED BY:
Notice: Our driv rs 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 assume Ino 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 will
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 delive',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 busines day after the receipt of materials.
68UNIVERSAL 'I y;i�':j t�:: se%
INVOICE
b +
Y �, Application, if any, Seller's St�indard
Delivery Ticket incorporates herei c -;1reference Buyer's pdcrrCunf rmat o exect
o(in ding limitations of wayrranties) as if fully
arms and Conditions,Seller's Quotation, any,and Seller s Ur
�t forth on this Delivery Ticket("Agreement").bere all er wit quantitiesand rtemrovide es were delivered as ind Terms and d
icated and fprther request.
eBly agrees to
that,unless otherwise noted on the front q
pay in accordance with the Agreement. I
AGGREGATE / CEMENT / C q, CRETE PRODUCTS / FLY ASH
-aveand oi
Aggregate products are naturally occurring materials inand other
cludmasonry,limestone,dolomite,pozzolanr(Type IP),roof tilenic �,yand stucco. Concrete
siliceous materials. Cement products include Portland cement, �rarrite,volcanic rock,sand, ravel,and
products include Portland cement and aggregate products including limestone,dolomite,g
other siliceous materials.These products including fly ash,may contain more than 0.025%crystalline silica.
1
Hazards: ll
Freshly mixed wet cement and/or fly ash can cause eye irritation,skin and eye burns and allergic skim reactions.
Dry concrete and aggregate dust may 11 iu� may se irritation
tcontain silica,wrhich m/or ay carespiratory
s,silicosis anD`cancest r f inhaled.-
ng
crushing,grinding,cutting and/or drilling y
If ingested,keep warm,at rest,and drink large amounts of water.Fly Ash may contain trace amount of ammo
d irritation
nia. Moisture can cause the ammonia to be released. Inhalationlrisk dependsti
-nmoon duratrornia can Uand lese �el of ehing xposure.
or burns of the nose,throat and lungs. See physician.Health
rotective
Safety: Avoid contact with eyes and prolonged contastO11th skin.and wale ear after handl ngloves,eye pAvoid breathingrotection,and appropriate
dust rIf exposed to
clothing.Wash hands thoroughly with mild pil
dust above recommended limits (see MSDS),wear suitable NIOSH-approved respiratory protection.
ve to
First Aid: In case of eye contact,immediately flush eyes with flowing water for lei medical atnute§.Iftention ifust is hrritat nr��per, fresh
air.If wet cement contacts skin,rinse thoroughly with water.Get prop
CEMEX,Memorial Hermann Tower
929 Gessner,Suite 1900
V7 combined Houston,Texas 77024
02/1
For more information please visit www cemexus<r cOm.
Este ticket de entrega incluye como referencia at comprador (ya previamente ejecutada en su aplrcacion de con l ��, cnalqui y
termino estandar, condiciones del vendedor, propuesta l,del to'enEldor vendedor provee Orden de �a los t6rm nosee t lndenda esly l v c�ndilc,one�detal
garantias),como acuerdo total del ticket de entrega( Co )
idades
lados en caso de as.i ser requeridos.Con este docun eltmisn o Ace to pagor an elta los moinitolde acuc do a c�trato;al mend lane setidenti-
y materiales fueron entregados como se expresa e P
fique con una rota at frente de este documento.
EGADOS / CEMENTO / PRODUCTOS DE CON CRETO / CENIZAS VOLA aTE otros
AGR aranito,rota vole, g
Los productos de agregados son materiales naturales como predra caliza,dolomite' g ozzolan (ti o IP)�, azulejo de
materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albanileria, p P
azotea y estuco.Los productos de concreto inaherialcs s lieen tos Estlos producand y otos incictos uycn ten as volant sr(fldy ash)rl, cu.21 �l puede
granito,coca volcanic,,arena,Brava,y otros m
contener mas de 0.025% de silicio cristalino.
1 � 11
uemaduras en el o os,
Peligros: Mezcla de cemento fresco y/o cenizas volantes pueden causar initaci6n en Jos ojos,q P Y j y
reacciones alergicas en la peel.Concreto seco y polvo de agregados,pueden causar irritaci6n en los ojo4�,,pre1.y/o en
la zona respiratoria.Polvo del manejo en el trituramiento,pulidon orte/o p.r ocaso n serde co ten n antenerse
silicos,Jos cuales pueden causar silicosis pulmonar y enter sr s
en temperature calida,reposar y tomar g and6n del amoniacntido�I acinhde alac 6n del amoniaco puede causar loser. in itac 16n o
La humedad puede causar la lrbe
Seguridad: quemaduras en la nariz,garganta y pulmones.Acudir inmediatamente at medico. El riesgo en la saludi depende en
la duraci6n y el nivel de la exposici6n.
en Sep>uridad: Evite el contacto con Ojos y ontacto prolongado con la piet.Use gel ntes,prof cc criales�Evi�sinhalpar
adecuada para protecci6n.Lavese las mans on ab6n suave a ua des J
J y g 1
Primeros
auxilios: polvos.Si se expone a polvos mas de Jos limiter recomendados use protecci6n respiratoria. I
1.5
Primeros auxilJos: En taro de colire fresco SiJel cemento frescottiene con acto conua en la es rs`Ojos,tla epos''a fondo con
se inhale olvo,exp6ngase a
Sr P
agua.Acuda a atenci6n m6dica inmediatamente si]a irritaci6n continua.
CEMEX,Memorial Hermann Tower r f'
929 Gessner,Suite 1.900
VT coin aido Houston,Texas 77024
Para mas informaci611 visita www.cemexus,corn_.
0Z/12
ZZCE M C—X U'j 0, j 'li
Plant: j Begin Loading: To Job: Arrive Job: Start Unload: Finish Unload: Leave Job: Return Plant:
I
Customer Code: Customer Name: Customer Job Number: Order Code(Date:
Project Code: Project Name: Project P.O.Number: Order P.O.Number:
Ticket Date: Delivery Address: Map Page: Map/Row/Column:
Delivery Instructions: Dispatcher:
Ticket Number:
Due On Job: Slump: ruck Number: Driver Number: Driver Name: End Use:
1,T
d_;d/ti•`$ `%t_'i.'f a;... t,'t�i l•` .'
LOAD CUMULATIVE ORDERED MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT
QUANTITY QUANTITY QUANTITY
Cash Check#/Auth Code: Signature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect
Check Without Standby Charges:
Charge
Comments: i
j WATER ADDED: GAL YARDS IN DRUM:
i; WHEN ADDED.
SIGNATURE
p CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST:
SIGNATURE
❑LOAD WAS TESTED BY:
Notice: Our drivers will make every effort to place materials where the customer designates,but the SPECIAL TERMS: Any water added is at customers own risk. If water is added on job,concrete strength
Company assumes no responsibility for damages inside curb or property line. Customer agrees to the is no longer guaranteed. WARNING: Product may cause skin and/or eye irritation. CAUTION: Material
terms of sale and!delivery and accepts concrete as is. Due to important factors which are out of our may be hazardous to your safety and health. Please refer to the backside of this ticket for important
control after delivery,this Company will not accept any responsibility for the finished results. No credit for safety handling information,and to the material safety data sheets for additional information.
returned concrete;, Buyers exceptions and claims shall be deemed waived unless made to us in writing AUTHORIZED SIGNATURE:
within one business day after the receipt of materials. 0 c
68UNIVERSAL #
INVOICE
This Delivery Ticket incorporates herein eference Buyer's previously executed ( Application, if any, SelleI•'s Standard
Terms and Conditions,Seller's Quotation,it any,and Seller's Order Confirmation (.in,.,uu„ig limitations of warranties),as if fully
set forth on this Delivery Ticket("Agreement").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 expres0y agrees to
pay in accordance with the Agreement.
AGGREGATE / CEMENT / CONCRETE PRODUCTS /FLY ASH
Aggregate products are naturally occurring materials.including limestone,dolomite,granite,vc anic rock,sand,grave,and other
siliceous materials. Cement products include Portland cement, masonry, pozzolan (Type II `roof tile, and stucco. Concrete
products include Portland cement and aggregate products including limestone,dolomite,granite,volcanic rock,sand,lgravel,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 front 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 amountls 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 ekposure.
Safety: Avoid contact with eyes and prolonged contact with skin.Wear gloves,eye protection,and appropriatrl 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 IVIOSH-approved respiratory protection.,
First Aid: In case of eye contact,immediately flush eyes with flowing water for 1.5 minutes. If dust is inhaled,rp to fresh
air.If wet cement contacts skin,rinse thoroughly with water.Get proper medical attention if irritation f 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 comp referencia al comprador (ya previamente ejecutada en su aplicaci6n de credi.to), cualquier
termino estandar, condiciones del vendedor, propuestas del vendedor y orden de confirmaci6n del vendedor (con lir'�itaciones y
garantias),como acuerdo total del ticket de entrega("Contrato").El vendedor proveera los terminos estandares y condidiones detal-
lados en caso de asf ser requericlos.Con este documento,el com.prado.r acepta los mismos ya antes mencionados y que las cantidades
y materiales fueron entregados como se expresa en el mismo.Acepta pagar el m.onto de acuerdo al Contrato; al menos qli e se ident.i-
fique con una nota al frente de este documento.
AGREGADOS / CEMENTO / PRODUCTOS DE CONCRETO / CENIZAS VOLAN ES
Los productos de agregados son materiales naturales como piedra caliza, dolomita, granito, rota volcanica, arena, is vla y otros
materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albanilerta, pozzolan (tipo II'), zulejo de
azotea y estuco. Los productos de concreto incluyen cemento Portland y productos de agregados como p.ied.ra caliza, dolomita,
granito,rota volcanica,arena,grava,y otros materiales silicios.Estos productos incluyen cenizas volantes (fly ash)la, " ial puede
contener mas de 0.025% de silicio cristalino.
1CUIDADO!
Peligros: Mezcla de cemento fresco y/o cenizas volantes pueden causar irritaci6n en los ojos,quemaduras en pief y ojos,y
reacciones alergicas en la piel.Concreto seco y polvo de agregados,pueden causar irritaci6n en los Ojos,piel y/o en
la zona respirato.ria.Polvo del manejo en el trituramiento,pulido,Corte y/o perforaci6n puede contener;rrrrate.ria.les
silicos,.los cuales pueden causar silicosis pulmonar y cancer si son inhalados.En caso de ser ingeridos,mantenerse
en temperatura calida,reposar y tomar grandes cantidades de agua.Las cenizas volantes pueden contener amoniaco.
Seguridad: La humedad puede causar la liberaci6n.del amoniaco. La inhalaci6n del amoniaco puede causar toner, iri itaci6n o
quemaduras en la nariz,garganta y pulmones.Acudir inmediatamente al medico. El riesgo en la salud depende en
11 la duraci6n y el nivel de la exposici6n.
Seguri.dad: Evite el contacto con ojos y contacto prolongado con la pie].Use guantes,protecci6n en los Ojos y ropa
Primeros adecuada para protecci6n.Lavese las manor con jab611 suave y agua despu6s del manejo de materiales.Evite inhalar
auxilios: polvos. Si se expose a polvos mas de los limites recomendados,use protecci6n respiratoria.
Prmeros auxilios:En caso de contacto en los Ojos,in_mediatamente fluya agua en la pane afectada por 1.51 minutes.
Si se inhala polvo,exp6ngase a wire fresco. Si el cemento fresco tiene contacto con sus ojos,lavelos a Tondo con
agua.Acuda a atenci6n medica inmediatamente si la irritaci6n continua.
CEMEX,Memorial Hermann Tower
929 Gessner,Suite. 1.900
V7 combinado Houston,Texas 77024
02/12 Para mas informaci6n visita www.cemexusa.com.
Plant: I Begin Loading':_.r' To Job: Arrive Job: Start Unload: Finish Unload: Leave Job: Return Plant:
III• .�' �, •
�..Y";•_.i ..try .. .,,
Customer Code: Customer Name: Customer Job Number: Order Code/Date:
".�Project Code w a i Project Name '� a a y k + �x Iii,y t t i 4 Project RO.Number_ w Order P.O Number,.= ° t
Ticket Date: Delivery Address: Map Page_:,..:, Map/Row/Column:
(:Delivery Instructions: t t T• Dispatcher:
Due On Job: ;' Slump: fh Truck Number: Driver Number: Driver Name: End Use:
'^t;A•.r=.t-t 4 r tC4 fi oIzli.;}="! } .lf}z ;, r}
LOAD CUMULATIVE. ORDERED MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT
QUANTITY ,I QUANTITY QUANTITY '
' I
�R
I^r Pki
t .e.+ I ,.,>i, • -,I<'� :�•t.J�L. r;4ry_lLa$�.rt�°"Ir�?>~,'"=r�1
S 1 � ��f,a � � u.�~*'�. , `." � j J ti.t.��Itit�t�.{`tt i P••i r~.., trf"1�!•\�"^C:.
j� ,• i ry 4
Cash Check#/Auth Coder i-..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.
SIGNATURE
CURB LINE CROSSED AT OWNER'S/AGENTS,REQUEST:
( °tl �f,Ci : 1{•� I, °3 F.fjP17)G PiL. �t' ,'.' / , SIGNATURE
C=,_J!__, _ I. TIIT� _ y, !r%rJS :C) LOAD WAS TESTED BY:
Notice: Our drives will make every effprt•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_Ino 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 elivery 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 delive 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 i
68UNIVERSAL
i-'i'G:v INVOICE
r j•
I
his Delivery Ticket .incorporates herein b erence Buyer's previously executed Cr( application, if any, Seller's Stan(
Terms and Conditions,Seller's Quotation,it any,and Seller's Order Confirmation (inch......'limitations of warranties)l,as if fu
set forth on this Delivery Ticket("Agreement").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 accordance with the Agreement.
AGGREGATE / CEMENT / CONCRETE PRODUCTS /FLY ASH
Aggregate products are naturally occurring materials.including li s �;ne,dolomite,granite,volcanic rock,sand,gravel';and other
siliceous materials. Cement products include Portland cement, m_S7oiiry, pozzolan (Type IP)• roof tile, and stucco: Concrete
products include Portland cement and aggregate products including limestone,dolomite,granite,volcanic rock,sand,gravel,and
other siliceous materials.These products,including fly ash,may contain more than 0.025% crystalline silica.
CAUTION!
Hazards: Freshly mixed wet cement and/or fly ash can cause eye irritation,skin and eye burns and allergic skin''I eactions.
Dry concrete and aggregate dust may cause irritation to eyes,skin,and/or respiratory tract.Dust froml 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 acid 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,rn.6 e to fresh
air.If wet cement contacts skin,rinse thoroughly with water.Get proper medical attention if irritationlpersists.
CEMEX,Memorial Hermann Tower
929 Gessner•Suite 1900
V7 combined Houston,Texas 77024
02/12 For more information please visit www.cemexusi.com.
Este ticket de entrega incluye Como referencia al comprador (ya previamente ejecutada en su. aplicaci6n de crdditd); cualquier
t6rmino 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 los terminos estandares y condic, es detal-
lados en caso de asf ser requeridos.Con este documento,el comprador acepta los mismos ya antes mencionados y que la s 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 rota al frente de este documento.
AGREGADOS / CEMENTO /PRODUCTOS DE CONCRETO / CENIZAS VOLANTES
Los productos de agregados son materiales naturaley como piedra caliza, dolomita, granito,rota volcanica, arena, grava y otros
materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albanilerfa, pozzolan (tipo IP),� zulejo de
azotea y estuco. Los productos de concreto incluyen cemento Portland y productos de agregados como p.iedra caliza;do.lomita,
granito,coca volcanica,arena,grava,y otros materiales silicios.Estos productos incluyen cenizas volantes (fly ash) la c ual puede
contener mds de 0.025% de silicio cristalino.
ICUIDAD01.
Peligros: Mezcla de cemento fresco y/o cenizas volantes pueden causar irritaci6n en los Ojos,quemaduras en pie],y ojos,y
reacciones alergicas en la p.iel.Concreto seco y polvo de agregados,pueden causar irritaci.6n en los ojos,piel y/o en
la zona respiratoria. Polvo del manejo en el trituramiento,pulido,torte y/o perforaci6n puede contener iateriales
silicos,Jos cuales pueden causar silicosis pulmonar y cancer si son inhalados.En caso de ser ingeridos,nantenerse
en temperatura calida,reposar y tomar grandes cantidades de agua.Las cenizas volantes pueden contener amoniaco.
Seguridad• La humedad puede causar la liberaci6n del amoniaco. La inhalaci6n del amoniaco puede causar toser, in,•itacion o
quemaduras en la nariz,garganta y pulmones.Acudir inmediatamente al medico. El riesgo en la salad 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
Primeros adecuada.para protecci6n.Lavese las manor con jab6n suave y agua despues del manejo de materiales.Evte 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 minutos.
Si se inhala polvo,exp6ngase a aire fresco. Si el cemento fresco tiene contacto con sus ojos, lavelos a, ondo con
agua..Acuda a atenci6n medica inmediatamente si la irritaci6n continua.
CEMEX,Memorial Hermann Tower
929 Gessner,Suite 1900
V7 combirtaclq,-7k, Houston,Texas 77024
02/12- Para.rids informaci6n visita www.cernexusa.com..
a%ZS ;
!
Z4/cc-M C-x
n
Plant: Begin Loading'. To Job: Arrive Job: Start Unload: Finish Unload: Leave Job: Return Plant:
Customer Code: Customer Name: Customer Job Number: Order Code/Date:
Project Code ; Project Name. I ProjectP.O Number:' Order P.O.Number:
"iTicket Date:r:'•. �^ ..'Delivery Addressal� F ., t': +r.: „u,,>.`� .T�_:{ -iM�tr•-r' _ _. h%{-+ � {'-{,`r i ''' � Map Pager--I-;Map/Row/Column:
elivery Instrucjiohs: +:` t. >m a ' Dispatcher:
D
! _ Ticket Number:I•-D
J;Due On Job: Slump:: tiJ:; 'True �.I („I t('i End Use.`„•;, l t:}4%I!
LOAD CUMULATIVE ORDERED TION UOM UNIT PRICE AMOUNT
QUANTITY '' QUANTITY QUANTITY
16
!
�i
Cash !CCheck#/Auth Code: Signature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect
Without Standby Charges:
Check
Charge
Comments: y'
WATER ADDED: < GAL YARDS IN DRUM:
r. WHEN ADDED.
SIGNATURE
I�. CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST:
' UP,)) ��� YA RUM SIGNATURE
❑LOAD WAS TESTED BY:
Notice: Our drivers will make every effort to place materials where the customer designates,but the SPECIAL TERMS: Any water added is at customers own risk. If water is added on job,concrete strength
Company assumes no responsibility for damages inside curb or property line. Customer agrees to the is no longer guaranteed. WARNING: Product may cause skin and/or eye irritation. CAUTION: Material
terms of sale and delivery and accepts concrete as is. Due to Important factors which are out of our may be hazardous to your safety and health. Please refer to the backside of this ticket for important
control after dells 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 concreterBuyers 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
This Delivery Ticket incorporates herein I ference Buyer's previously executed Ci Application, if any, Sellers Standard
Terms and Conditions,Seller's Quotation,._ -..y,and Seller's Order Confirmat.ion•(.incl Limitations of warranties),as if fully
set forth on this Delivery Ticket("Agreement").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 accordance with the Agreement.
AGGREGATE / CEMENT / C.�NCRETE PRODUCTS /FLY ASH
Aggregate products are naturally occurring materials includins,t '°stone,dolomite,granite,volcanic rock,sand.,gravel and other
siliceous materials. Cement products include Portland cement,,asonry, pozzolan (Type IP), roof tile, and stucco:_ Concrete
products include Portland cement and aggregate products including limestone,dolomite,granite,volcanic rock,sand, navel.,and
other siliceous materials.These products,including fly ash,may contain.more than 0.02.5% crystalline silica. �
Hazards: Freshly mixed wet cement and/or fly ash can cause`eye irritation,skin and eye burns and allergic skin reactions.
Dry concrete and aggregate dust may cause irritation-'16 eyes„skin,and/or respiratory tract.Dust from:handling,
crushing,grinding,cutting and/or drilling may contain silica,which may cause silicosis and cancer k 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 ex osure.
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.cxposed to
dust above recommended limits (see MSDS),wear suitable NIOSH-approved respiratory protection.
I
First Aid: In case of eye contact,immediately flush eyes with flowing water for 15 minutes.If dust is inhaled,m`"ve to fresh
air.If wet cement contacts skin,rinse thoroughly with water.Get proper medical attention if irritation ler-s.ists.
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:aplicac.i6n de cr6dito' cualquier
t6rmino estandar, condiciones del-vendedor, propuestas del vendedor y orden de confirmaci6n del vendedor (con li itaciones y
garantfas),como acuerdo total del ticket de entrega("Contrato").El vendedor proveera Jos t6.rminos estindares y condi'ones detal-
l.ados en caso de asf ser requeridos.Con este documento,el comprador acepta los rnismos ya antes mencionados y que la cantidades
y materiales fueron entregados como se expresa on el mismo.Acepta pagar el monto de acuerdo al contrcto; al menos q'11e se identi-
fique con una rota al frente de este documento.
AGREGADOS / CEMENTO /PRODUCTOS DE CONCRETO / CENIZAS VOLANTI ES
Los productos de agregados son materiales naturales como piedra caliza, dolomita, granito,coca volcanica, arena,gr'va y otros
materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albaflilerfa, pozzolan (tipo IP), azulejo de
azotea y estuco. Los productos de concreto incluyen cemento Portland y productos de agregados como piedra caliza dolomita,
granito,coca volcanica,arena,grava,y otros materiales silicios.Estos productos incluyen cenizas volantes (fly ash) la.'�ual puede
contener mas de 0.025%de silicio cristalino.
-CUEDADO!
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 p.iel.Concreto seco y pollvo de agregados,pueden causar irritaci.6n en Jos Ojos,'�iel.y/o en
la zona-respiratoria. Polvo del manejo en el trituramiento,pulido,corte y/o perforaci6n puede contener aateriales
silicos,los cuales pueden causar silicosis pulmonar y cancer si son inhalados.En caso de ser ingeridos,mantenerse
en temperatura calida,reposar y tomar grandes cantidades de agua.Las cenizas volantes pueden contener amoniaco.
Seguridad: La humedad puede causar la liberaci6n.del amoniaco. La i.nhalac.i.6n del amoniaco puede causar toner,i,Jtaci.6n.o
quemaduras on la nariz,garganta y pulmones.Acudir inmediatamente al.medico. El.riesgo en .la salud d,i:pende on
la duraci6n y el nivel de la exposici6n.
Seguri.dad: Evite el.contacto con ojos y contacto prolongado con la pi.el..Use guantes,protecci6n en los(Jos y ropa
Primeros adecuada para protecci6n.Lavese las manos con jab611 suave y agua despu6s del manejo de materiales.Eyh.te inhalar
auxilios: polvos.Si se expone a polvos mas de los limites recomendados,use protecei6n respiratoria.
Primeros auxilios: En caso de contacto on los ojos,'inmediatamente fluya agua en la parte afectada par 1.5,minutos.
Si se inhala polvo,exp6rigase a aire fresco. Si el cemento fresco ti-ene contacto con sus ojos, lavelos a... ndo con
agua.Acuda a atenci6n m6dica inmediatamente si la irritac16n.continda.
N, r CEMEX,Memorial Hermann Tower
r, F 929 Gessner,Suite 1.900
V7 combinado Houston,Texas 77024
02,/12 „ .R Para mas informaci6n visita www.cem.exusa.com.
ZZCC-M
Plant: Begin Loading: To Job: Arrive Job: Start Unload: Finish Unload: Leave Job: Return Plant:
f .
Customer Code: Customer Name: Customer Job Number: Order Code 1 Date:
i
Project Code: Project Name: Project P.O.Number: `" ` Order P.O.Number:
Ticket Date: Delivery Address: Map Page: Map/Row/Column:
Delivery Instructions: Dispatcher:
Ticket Number:
Due On Job: ! Slump: Truck Number: Driver Number: Driver Name: End Use:
LOAD CUMULATIVE ORDERED QUANTITY QUANTITY QUANTITY MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT
Cash JCheck#/Aulh Code: Signature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect
Check
Without Standby Charges:
,
Charge
Comments:
WATER ADDED: f +� /GAL YARDS IN DRUM:
WHEN ADDED.
SIGNATURE
tro, CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST:
SIGNATURE
❑ LOAD WAS TESTED BY:
Notice: Our driver 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: x '
within one business day after the receipt of materials. O
68UNIVERSAL 1 t
t INVOICE
This Delivery Ticket incorporates hereir reference Buyer's previously executed f t Application, if any, Sellen?r Standard
Terms and Conditions,Seller's Quotation,it any,and Seller's Order Confirmation (in_-___n 'lim:itations of wa rantic s5 11 as if fully
set forth on this Delivery Ticket("Agreement").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 accordance with the Agreement. {,
AGGREGATE / CEMEIT / CONCRETE PRODUCTS / FLY ASH
Aggregate products are naturally occurring materials i cau�Lng limestone,dolomite,granite,volcanic rock,sand,gravel;and other
siliceous materials. Cement products include Portlan ement, masonry, pozzolan (Type IP), roof tile, and stuccol'l Concrete
products include Portland cement and aggregate products including limestone,dolomite,granite volcanic rock,sand.,ravel,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 skinIreactions.
Dry concrete and aggregate dust may cause irritation to eyes,skin,and/or respiratory tract.Dust froir hhandling,
crushing,grinding,cutting and/or drilling may contain silica,which may cause silicosis and cancer'i�f 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 anid irritation
or burns of the nose,throat and lungs.See physician.Health risk depends on duration and level of exposure. .
!'p
Safety: Avoid contact with eyesiand 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.I„l
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
l
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 cr6di.to); cualquier
t6rmino estandar, condiciones del vendedor, propuestas del vendedor y orden de confirmaci6n del vendedor (con lii�rrtaciones y
garantfas),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 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. r�
AGREGADOS / CEMENTO / PRODUCTOS DE CONCRETO / CENIZAS VOLANTES
Los productos de agregados son materiales naturales como piedra ealiza,dolomita,granito, coca volcanica, arena, grsava y otros
materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albanilerfa, pozzolan (tipo IP) j azulejo de
azotea y-estuco. Los productos de concreto incluyen cemento Portland y productos de agregados como piedra caliza dolomita,
granito,coca volcanica,arena,grava,y otros materiales sil..icios.Estos productos incluyen cenizas volantes (fly ash) la' ual puede
contener mas de 0.025% de silicio cristalino.
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 los ojos;�piel y/o en
la zona respiratoria.Polvo del manejo en el trituramiento,puli.do, Corte y/o per oraci.6n puede contener„Ilmateriales
silicos,los cuales pueden causar silicosis pulmonar y cancer si son inhalados.En caso de ser ingeri.dos,mantenerse
en temperatura calida,reposar y_tomar grandes cantidades de agua.Las cenizas volantes pueden contener,Jamoniaco.
Seguridad: La humedad puede causar la liberaci6n del amoniaco. La inhalaci6n del amoniaco puede causar toser,''rritaci6n o
quemaduras en la nariz,garganta y pulmones.Acudir inmediatamente al medico. El riesgo en la salud depende en
la duraci6n y el aivel de la exposici6n.
Seguridad: Evite el contacto con ojos y contacto prolongado con la pi.el.Use guantes,protecci6n en los" Jos y ropa
Primeros adecuada para protecci6n.Ldvese las manos con Iab6n suave y agua despu6s del manejo de materiales.E' ite inhalar
auxilios: polvos. Si se expone a polvos rods de los limites recomendados,use protecci6n respiratoria. d
�d
Primeros auxilios: En caso de contacto en los ojos,inmediatamente fluya agua en la parte afectada par .1j5 minutos.
Si se inhala polvo,exp6ngase a aire fresco. Si el cemento fresco tiene contacto con sus ojos, lavelos a fordo con
Aj
agua.Acuda a atenci6n m6dica inmediatamente si la irritaci6n continua.
CEMEX,Memorial Hermann Tower
k f` 929 Gessner,Suite 1,900
V7-cotn inado Houston,Texas 77024
02j12 Para mas informaci6n visita www.cemexusa',comm. ,;
w
cc
mcx - f l II
Plant: ,, Begln'Loading: To Jobs Arrive Job: Start.Onload: Finish Unload: Leave Job: Return Plant::
f U Jc
Customer Code: Customer Name: Customer Job Number;, Order Code]Date:
Project Code: I :?ProjectfNa me:
a i J# £ F Poleat P O Number �f 3 r^ briier P.O.Number ;,
f y ,{,'e ii ° /. '/ 4 t _r �.,� i k,e _ ., ,.. ._,.��. b '^ �, _. .r:'w s t,�,. `.., •' _..- .., ._. _,.m .
Ticket,Date ,� `'+rDeliveryAddress., ei , 1 q'_.� .-_tN• 4UJJ. dil,. >)j<t v a 2v c ?4$! MapPage.t-�rMap/Row/Column:
Deliveryli>StrL (o s r• s a„ #- Dispatcher;
e
e
a
��;..'�" .f"�.� .•.�rl' ,» » Ticket�Number;�..d
E I� F a 4 . ,•3�
Due On Job: Slump: Truck Number . Driver Number. Drroer Name End Use:
IJ• e!V A. .'L.♦J mot.. .( �J:. 1;444 t 1 ..JI —".`I 1 —.•.a a..._ i,
LOAD, CUMULATIVE ORDERED MATERIAL CODE PRODUCTION DESCRIPTION,' ' UOM UNIT PRICE AMOUNT
QUANTITY QUANTITY QUANTITY
,� h�c...}e_/ t, /io P'�1 .�a hx. 4-€;, .•.r' .ik.,W,rl.r
'�' �,- ..�" { v, . a1', i.� }.� -L� �.�+`.1 Sk.-a f-Af•#k�.�l.e � g.. s
j, ,t.. �.» .F, e r*`I ..,..'tr,} ' r�.! t�.a;',�..f.-:t y,.- �•"t tt :",�;:_ .. +
Cash,', heck#/Auth Code:. Signature of Driver Receiving Cash: Cash Received:, Total CODArder Amount to Collect
Check
I` Without Standby Charges:
I. •
Charge
Comments:
WATER ADDED: ' GAL YARDS IN DRUM:
WHEN ADDED.
SIGNATURE
CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST:
NC RETEI�DI PIES L. FEC, I SIGNATURE
PARIlllllll1AL F=LILL".'Lt.lfAD _ YIAR1)8 Q LOAD WAS TESTED BY:
Notice: -Our drive i 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 ro 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 J elivery 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 deliver'„this Companywill not laccept any responsibility for the finished results. No credit for safety handling information,and to the material safety data sheets foradditional information. r
returned concrete...IPuyers exceptions and claims shall be deemed waived unless made to us in writing AUTHORIZED SIGNATURE: ,
within one businessay after the receipt of materials. O e �*
d1�
68UNIVEFISAL
I:, VIRC'V `FI, ;3.`0f)22&a -INVOICE 4; "•'
This Delivery Ticket incorporates herein by reference Buyer's previously executed Credit Application, if any, Seller's Standard
Terms and Conditions,Seller's Quotatic any,and Seller's Order Confirmation.(i. ling.limitations of warranties,),as if fully
set forth on this Delivery Ticket("Agree t").Seller will provide the Standard Terr. d Conditions upon request.Buyer agrees
that,unless otherwise noted on the front hereof,all quantities and items were delivered as indicated and further expres4 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;'�ravel,and
other. siliceous materials.These products,including fly ash, .nay 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 froi', ihandling,
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.'F1y Ash may contain trace amount3 of ammo-
nia. Moisture can cause the ammonia to be released. Inhalation of ammonia can cause coughing d irritation
or burns of the nose,throat and lungs.See physician.Health risk depends on duration and level of e'posure.
Safety:, Avoid contact with eyes and prolonged contact with skin.Wear gloves,eye protection,and appropriat protect.i.ve
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.I:f dust is inhaled.,m ve to fresh.
air.If wet cement contacts skin,rinse thoroughly with water.Get proper medical attention if irritatior 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 incl.uye corno .referencia al. comprador (ya previamente ejecutada en su aplicaci6n de credit cualquier
termino estdndar, condiciones del vendedor, propuestas del vendedor y Orden do confirmacicin del vendedor (con li' ii.taciones y
garantfas),como acuerdo total del ticket de entrega("Contrato").El vendedor proveerd los t6rminos estdndares y condi tones detal-
lados en caso de asf ser requeridos.Con este documento,el co.mprador acepta los mi.smos ya antes mencionados;y que 1 si cantidades
y materiales fueron entregados como se expresa en el mismo.Acepta pagan el monto de acuerdo al contaato; al menos e se identi-
fique con una nota al frente de este documento.
AGREGADOS / CEMENTO / PRODUCTOS DE CONCRETO / CENIZAS VOLAIyTES
Los productos de agregados son materiales naturales como piedra caliza, do.lomita,granito,coca volcdnica, arena, gi; va y otros
materiales silicios. Los productos de cemento incluyen Ceniento de tipo Portland, de albantlerfa,pozzolan (tipo IP) azulejo de
azotea y estuco. Los productos de concreto incluyen cemento Portland y productos de agregados como p.iedra caliz• , dolomita,
granito,.roca volcanica,arena,grava,y otros materiales sil.ic.ios.:Estos productos incluyen cenizas volantes (fly ash) M1,11cual puede
contener mds de 0.025%v de silicio cristalino.
1CUIDAD01.
Peligros: Mezela de cemento fresco y/o cenizas volantes pueden causar irritaci6n en los ojos,quemaduras en pier] y ojos,y
reacciones alergicas en la piel.Concreto seco y polvo de agregados,pueden causar irritaci6n en los ojos;; iel y/o en
la zona respiratoria.Polvo del manejo en el.trituramiento,puli.do, corte y/o perforaci6n puede contener;lnateriales
sil.icos,Jos cuales pueden causar silicosis pulmonar y cancer si son inhalados.En caso de ser ingeridos,mantenerse
en temperatura calida,reposar y tomar grandes cantidades de agua.Las cenizas volantes pueden contenec amoniaco.
Seguridad: La humedad puede causar la liberaci6n.del amoniaco. La inhalaci6n del amoniaco puede causar toser, irritaci6n 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 pie].Use guantes,protecci6n en los Ojos y ropa
Primeros adecuada para protecci6n.Uvese las manos con jab6n suave y a-Ua despues del.manejo de materiales.Evi,te in.alar
auxilios: polvos. Si se expone a polvos mds de los limites recomendados,use protecci6n respiratoria.
P.rimeros 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 aire fresco. Si el cemento fresco tiene contacto con sus ojos,ldvelos a;,fondo con
agua.Acuda a atenci6n m6dica inmediatamente si la irritaci6n continua.
CEMEX,Memorial Hermann Tower
Y 929 Gessner,Suite 1.900
V7 combinado Houston,Texas 77024
02/12 m Para mds informaci6n visita www.cemexusa.com.
ZZCC-Max. 1'e')5 83s0 cn
' ill i
Plant: Begin Loading: To Job: Arrive Job: Start Unload: Finish Unload: Leave Job: Return Plant:
Customer Code: I�. ' Customer {- t n r R Customer Job Number:
'Order Code!Date:
`.�i f::b-,.�.�- R 'I i:! �...��?i'�1} �1 rr^�k,+1 �_�14..~s _lY>Y.j Fi u`6 3 I X 0M ?.C?E: L R 5 PULG:.
Project Code: 1, Project Name: Project P.O.Number: Order R.O.Number.
Ticket Data: Delivery Address. A _ Map Page: Map/Row/Column:
t.ie.,.:' ,..i._ r .j ri rr=s :ice• !�� e-0.� �' �..FZ�I� �'+� ,
Delivery Instructio s: � �� _ Dispatcher:
i Ticket Number: -
11Due On Job: Slump: Truck Number: DriverNumber: Driver Name: End Use:
4. 17 < o �3 Zfa J �� `25 1 ?L.Lrali�,Ni � i'�i--f ARY Cltdt�a����l�13
LOAD- CUMULATIVE ORDERED MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE "AMOUNT
QUANTITY QUANTITY QUANTITY
-o so II � ts�. tf� ��� �9:�1�(': k E7G/HR/F L'0'3 f§d�li���_ °� l
Cash heck#/Auth Code: Signature of Driver Receiving;Cash: Cash Received: Total COD Order Amount to Collect
Check Without Standby Charges:
Charge I,
Comments:
I .WATERADDED: ' GAL: YARDS IN DRUM`
WHEN ADDED.
SIGNATURE
CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST:
C ONCRETE ,''I1)1SP0cS,AI F"I�E .
pinFP; IA;. ' Fr�.GLL LOAD YARDSSIGNATURE
❑LOAD WAS TESTED BY:
Notice: Our driver"!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 o 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 Slivery 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 delive :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, uyers exceptions and claims shall be deemed waived unless made to us in writing AUTHORIZED SIGNATURE: �n3
within one business ay after the receipt of materials. O „
68UNIVERSAL PRE:U TRK 1CK.)e?'5 7 1,5 ''kl
INVOICE
very Ticket incorporates herein reference Buyer's previously executed I it Application, if any, Seller''s Standard
Conditions,Seller's Quotat.ioi.,__ any,and Seller's Order Confirmation (in,,,uuing limitations of warranties)ll as if fully
�this Delivery Ticket("Agreement").Seller will provide the Standard Terms and Conditions upon request.Bilyer agrees
Ss otherwise noted on the front hereof,all quantities and items were delivered as indicated and further expressi, agrees to
,gay=m 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,l avel,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' eactions.
Dry concrete and aggregate dust may cause irritation to eyes,skin,and/or respiratory tract.Dust frond handling,
crushing,grinding,cutting and/or drilling may contain silica,which may cause silicosis and cancer ;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 an 1irritation
or burns of the nose,throat and lungs.See physician.Health risk depends on duration and level of ex osure.
Safety: Avoid contact with eyes and prolonged contact with skin.Wear gloves,eye protection,and appropriat;°protective
clothing. Wash hands thoroughly with mild soap and water after handling. Avoid breathing dust. If,'' j posed 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.,m. ve 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 l
02/12 For more information please visit www.cemexusa.com.
Este ticket de entrega incluye Como referencia al cotnprador (ya previamente ejecutada en su aplicaci6n de credito); cualquier
t6rtn.ino estandar, condiciones del vendedor, propuestas del vendedor y orden do confirmaci6n del vendedor (con li" itaciones y
garantfas),como acuerdo total del ticket de entrega("Contrato").El vendedor proveera los t6rminos estandares y condi iones detal-
lados en caso de asf se.r requeridos.Con este documento,el comprador acepta los mismos ya antes mencionados y que la•'cantidades
y materiales fueron entregados como se expresa en el mismo.Acepta pagar el monto de acuerdo al Contrato; al menos q e se identi-
fique con una nota al frente de este documento.
I
AGREGADOS / CEMENTO / PRODUCTOS DE CONCRETO / CENIZAS VOLANTES
Los productos de agregados son materiales naturales como piedra caliza,dolomita,granito,rota volcanica, arena, grava y otros
materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albanilerfa, pozzolan (tipo IP)',"I azulejo de
azotea y estuco. Los productos de concreto incluyen cemento Portland y productos de agregados como piedra caliza,dolomita,
granito,roca volcanica,arena,grava,y otros materiales silicios.Estos productos incluyen cenizas volantes (fly ash) 1a,11cual puede
contener mas de 0.025% de silicio cristalino.
;CUIDADO!
Peligros: Mezcla de cemento fresco y/o cenizas volantes pueden causar irritaci6n en los ojos,quemaduras en idl y Ojos,y
reacciones alergicas en la piel.Concreto seco y polvo de agregados,pueden causar irritaci6n en los ojos��prel y/o en
la zona respiratoria. Polvo del manejo en el trituramiento,pulido,Corte y/o perforaci6n puede conteneri materiales
silicos,.los cuales pueden causar silicosis pulmonar y cancer si son inhalados.En caso de ser ingeridos,' antenerse
en temperatura calida,reposar y tomar grandes cantidades de agua.Las cenizas volantes pueden contener,amoniaco.
Seguridad: La humedad puede causar la liberaci6n del amoniaco. La inhalaci6n del amoniaco puede causar toser,i('rritaci6n o
quemaduras en la nariz,garganta y pu.lmones.Acudi.r inmediatamente al medico. El riesgo en.la salud'" epende en
la duraci6n y el nivel de la exposici6n. 1,�
Seguridad: .Evite el contacto con ojos y contacto prolongado coal.la pi.el.Use guantes,protecc16n en los.,, jos y ropa
Primeros adecuada para protecci6n.Lavese las manos 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 caso de contacto en los ojos,inmediatamente fluya agua en la parte afectada por 5 minutos.
}
Si se inhala polvo,exp6ngase a aire fresco. Si el cemento.fresco tienc contacto con sus ojos, lavelos a Tondo con
agua.Acuda a atenci6n m6dica inmediatamente si la irritaci6n continda. III
CEMEX,Memorial Hermann Tower
• ' " fr + ..; , 929 Gessner,Suite 1.900
VTcombina4 Houston,Texas 77024 'I
02/.12 �, ° Para mds informati6n visita www,cemexusa.com.
i
r ZZCGM'CX 58.65,9921 4
Plant: y Begin.Loading: To Job: Arrive Job: Start Unload: finish Unload: Leave Job: .. Return Plant:
v
Customer Code I Customer Name: Customer Job jVumber: Order„Code/Date:
Project Code Project Name. _ i y Project P.O.Number Order P.O,Number:
r'., €'?�t'vl�.�r.. .,s.} ,t:, _.�. ...( t �'.. +..F�k„,t i+.1 �'c,4.d-T'•�} '�i.t.,.{< t, .1°.� �.li,.^ v, „"_. f
i
Ticket Date: " Delivery Address: Map Page: Map/Row/Column:
DeliverInstructions Dis a_tcher:
Ticket Number:
,
Due On Job: Slump: _ Truck Number:. Driver Number: Driver Name:,, 71Use
it_+ s»!a ,,,;l(} l,Ii:? _:•.P./� ." i }.� J:._7 '] ill'.� 'r/! !'� ,fl;�Il_+_�.C�.'t�
LOAD 't. CUMULATIVE ORDERED IT MATERIAL CODE PRODUCTION DESCRIPTION UOM UN PRICE AMOUNT
QUANTITY I'� QUANTITY QUANTITY
i
�•, a";() . , +, �' Fti t`?"Ci.Ij17'+'._'•f �i: 1- „ii it"!:. °
Cash .'Check#/Auth Code: Signature.of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect
Without Standby Charges:
Check
Charge
Comments: it
WATER ADDED: GAL YARDS IN DRUM:
WHEN ADDED.
l�
SIGNATURE
CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST:
L'°671 1 1 I t:_ 'FULL I OPD V(-aRDSS. SIGNATURE
❑ LOAD WASTESTED BY:
Notice: Our-drives will make every effort to place materials where the customer desjgNates,but the SPECIAL TERMS: Any water added is at customers own risk. If water is added on job,concrete strength
Company assume ho 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. CAUf10N: Material
terms of sale and elivery 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 delive' -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.iv "
returned concrete.J11'P.yes exceptions and claims shall be deemed waived unless made to us in writing AUTHORIZED SIGNATURE:within-one businesdaafterthereceipt of materials. •
68L1NIVERSAL I! p' Z17k! `1:` f 4 J .l (_(+ '�'4 lCr � r
INVOICE
/fhis Delivery Ticket incorporates herein eference Buyer's previously executed C : Application, if any, Seller's Standard
/Terms and Conditions, Seller's Quotation, it any, and Seller's Order Confirmation(inc.u_ag limitations of warranties),, as if fully-
r' set forth on this Delivery Ticket("Agreement").Seller will provide the Standard'Terms and Conditions upon request. B6, er agrees
1 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
Aggre°lkate products are naturally occurring materials including limestone,dolomite,granite,volcanic rock,sand,gravel,','ind other
siliceous materials. Cement products include Portland cement, masonry, pozzolan (. ,e IP), roof tile, and stucco.olConcrete
products include Portland cement and aggregate products including limestone,dolontitt granite,volcanic rock, sand, gavel, and
` other siliceous materials.These products,including fly ash,may contain more than 0.0 5%o crystalline silica. l
CAUTIONI
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 it inhaled.
® If ingested,keep warm, at rest, and drink large amounts of water. Fly Ash may contain trace amountsil'of ammo-
nia. Moisture can cause the ammonia to be released. Inhalation of anunonia can cause coughing an imitation
or burns of the nose, throat and lungs. See physician.Health risk depends on duration and level of ex Ilosure.
Safety: Avoid contact with eyes and prolonged contact with skin.Wear doves,eye protection,and a ro riat-I rotective
Y Y P g.. o Y p PP P �I�
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;ipersists.
CEMEX, Memorial Hermann Tower
929 Gessner, Suite 1900
V7 combined Houston,Texas 77024
02/12 For more information please visit www.cemexusa.com. II
Este ticket de entrega incluye Como referencia al comprador (ya previamente ejecutada en su apl.icaci6.n de crddito); cualquier
t6rmino estandar, condiciones del vendedor, propuestas del vendedor y orden de confirmaci6n del vendedor (con frnitaciones y
garantfas),como acuerdo total del ticket de entrega("Contrato").El vendedor proveera los t6rminos estandar6s y condioiones detal-
lados en caso de asf ser reque.ridos.Con este documento,el comprador acepta los mism.os ya antes mencionados y que]as cantidades
y materiales fueron entregados como se expresa en el mismo.Acepta pagar el monto de acuerdo al contaato; al menos q&se identi-
fique con una nota a]frente de este doCumcnto.
AGREGADOS / CEMENTO / PRODUCTOS DE CONCRETO / CENIZAS VOLANTES
Los productos de agregados son materiales naturales como piedra caliza, dolomita, granito, rota volcCmica, arena, gr�iva y otros
materiales silieios. Los productos de cemento incluyen Cemento do tipo Portland, de albanilerfa, pozzolan (tipo IP),'jlazulejo de
azotea y estuco. Los productos de concreto incluyen cemento Portland y productos de agregados como piedra caliza dolomita,
granito,roca volednica,arena,grava,y otros materiales silicios. Estos productos incluyen cenizas volantes (fly ash) la;�cual puede
contener mas de 0.025% de silicio eristalino.
1 +
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 los ojos,!iprel y/o en
la zona respiratoria. Po.lvo del manejo en el triturarniento,pulido, Corte y/o perforaci6n puede conteneilljj�nater�ial.es
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 liberaci6n del amoniaco. La inhalaci6n del amoniaco puede causar toser, Xritaci6n o
quemaduras en la nariz, garganta y pulmon.es.Acudir.inmediatamente al medico. El riesgo en la salud depende en
la duraci6n y el nivel de la exposici6n. LII
Seguridad: Evice el contacto con Ojos y contacto prolongado con la piel.Use guantes,protecci6n en los Ojos y ropa
Primeros adecuada para protecci6n.Lavese]as manos con jab6n suave y agua despu6s del manejo de materiales.Evite inhalar
auxilios: polvos. Si se expane a polvos mas de los limites recomendados,use protecci6n respiratoria. ,'I
Primeros auxi.lios:En caso de contacto en.los Ojos,inmed.iatamente fluya agua en.la parte afectada por i15 minutos.
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 m6dica inmediatamente si la in-ita6i6n continua.
CEMEX, Memorial Hermann Tower
f 929 Gessner, Suite 1900
V7 combinago Houston,Texas 77024
02/12 ,. Para mas informaci6n visits www.cemexusa.com.
Woe-
A tMEX
S 8-I'V E 1)
nm ED -� APRO 2 & 2016
at.1u m`b-- '�!��fu
PE� I ING
St. Lucie C 'unty, FL
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Plant: Begin Loading: To Job: Arrive Job: Start Unload: Finish Unload: Leave Job: Return Plant:
I .
Customer Code: Customer Name: Customer Job Number: Order Code/Date:
,.. -
�l.ry,.,; r- I
a.t, h .lp, ,{ 5•
Project Code:, Project Name: Project P.O.Number: Order P.O.Number:
Ticket Date: Delivery Address: Map Page Map/1311 Column:
Delivery,Instructions: - Dispatcher:
/;i •- ' ,S' _ • • 'ram
Ticket Number:
i
Due On Job: Slump: Truck Number: Driver Number: Driver Name: End Use:'
:,y`t-j, r- c•i, .�..-; - ?�. �' .� f` ._F7,C) jt {_�.�, { -•ti-- y�.,l.:y�e` {,;/"•" I i ;.^,t:;ry p7_ 7 .
t. ,a••. A' :7—::. _/ 1'..�..1'. .wl�' �.O l.'.I•''iti i`1.•II .../�cy.....� _. VI�:1��1.2)
LOAD CUMULATIVE ORDERED MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE —AMOUNT
QUANTITY QUANTITY QUANTITY
`. .` t:� ,') `6_ir�.i `�,t I, t..n•.tt�t.;rryr� � °
1
I,
Cash Check#/Auth Code: Signature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect
Without Standb Charges:
Check
Charge r
Comments:
WATER ADDED: GAL YARDS IN DRUM: �I
WHEN ADDED.
ter. �I SIGNATURE
CURB LINE CROSSED AT OWNER'SIAGENT'S REQUES
J� :
SIGNATURE
I
❑ 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 or 7 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 irritationl. 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 tickeCfor 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 info)oration.
retumed 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 INVOICE
This Delivery Ticket .incorporates herein ference Buyer's pre•ri.ously executed (�Application, if any, Seller's Standard
Terms and Conditions,Seller's QuotationOn,
y,and Seller's Orde 'onfirmation (incMWi g limitations of warranties),as if fully
set forth on this Delivery Ticket( Agreem �ent ).Seller will proved e Standard Terms and Conditions upon request.Buyer agrees
that,unless otherwise noted on the front hereof,all quantities and it s were delivered as indicated and.further expressly agrees to
pay in accordance with the Agreement.
I1' AGGREGATE / CEMENT / CON(BETE PRODUCTS /FLY ASH
Aggregate prooducts'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 silicem�s materials.These products,including fly ash,may contain more than 0.025% crystalline silica.
CAUTION!
Hazards: Freshly mixed wet cement and/or fly ash can cause eye irritation,skin and eye burns and allergic skin reactions.
Dry concrete and aggregate dust may cause irritation to eyes,skin,and/or respiratory tract.Dust from handling,
crushing,grinding,cutting and/or drilling may contain silica,which may cause silicosis and cancer if inhaled.
If ingested,keep warm,at rest,and drink large amounts of water. Fly Ash may contain trace amounts of ammo-
nia. Moisture can cause the ammonia to be released. Inhalation of ammonia can cause coughing and irritation
or burns of the nose,throat and lungs. See physician.Health risk depends on duration and level of exposure.
Safety: Avoid contact with eyes and prolonged contact with skin.Wear gloves,eye protection,and appropriate protective
1 ';i clothing. Wash hands thoroughly with mild soap and 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 combinedl' Houston,Texas 77024
02/12 For more information please visit www.cemexusa.com.
Este ticket de j'entrega incluye comp referencia al comprador (ya previamente ejecutada en su aplicacion de cr6dito); cualquier
termino estanl'ar, condiciones del vendedor, propuestas del vendedor y orden de confirmacion del vendedor (con limitaciones y
garantfas),como acuerdo total del ticket de entrega("Contrato").El vendedor proveera los terminos estandares y condiciones detal-
lados en caso de as.f 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 at Contrato; at mends que se identi-
fique con una nota at frente de este documento.
11
AGREGADOS / CEMENTO / PRODUCTOS DE CONCRETO / CENIZAS VOLANTES
Los productos de agregados son materiales naturaley como piedra caliza, dolomita, granito,coca volcanica, arena,gravy y otros
materiales silkios. Los productos de cemento incluyen Cernento 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 Y;olcanica,arena,grava,y otros materiales sili.cios.Estos productos incluyen cenizas volantes(fly ash) la cual puede
contener mds ide 0.025% de silicio cristalino.
;CUIDADO!
Peligros: !:Mezcla de cemento fresco y/o cenizas volantes pueden causar irritacion en los ojos,quemaduras en pie] y ojos,y
'reacciones alergicas en la peel.Concreto seco y polvo de agregados,pueden causar irritacion en los ojos,pie].y/o en
!la zona respiratoria.Polvo del manejo en el trituramiento,pulido,Corte y/o perforacion puede contener materiales
isilicos,los cuales pueden causar silicosis pulmonar y cancer si son inhalados.En caso de ser ingeridos,mantenerse
en temperatura caliza,reposar y tomar grandes cantidades de agua.Las cenizas volantes pueden contener amoniaco.
Seguridad: iLa humedad puede causar la liberacion del amoniaco. La i.nhalacion del amoniaco puede causar toser, irritacion o
.quemaduras en la nariz,garganta y pul.mones.Acudir inmediatamente a] medico. El riesgo en la salud depende en
la duracion y el nivel de la exposicion.
Seguridad: Evite el contacto con ojos y contacto prolongado con la piel.Use guantes,protection en los ojos y ropa
Primeros adecuada para proteccion.Lavese las manor con jabon suave y agua despues del manejo de materiales.Evi.te inhalar
auxilios• polvos.Si se expone a polvos mds de los limites recomendados,use proteccion 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, expongase a wire fresco. Si el cemento fresco tiene contacto con sus ojos, lavelos a fondo con
gua.Acuda a atencion medica inmediatamente si la irritacion continua.
CEMEX,Memorial Hermann Tower
929 Gessner,Suite 1.900
V7•combinado Houston,Texas 77024
02/12 Para mas informacion visita www.cemexusa.com.
q
III "
CC-MG-)- <`
r.
Plant:',
Begin Loading: To Job: Arrive Job:. Start Unload: Finish Unload: Leave Job: Return Plant:
f
I' Code Date:Order /
Customer Code Customer Name: Customer Job Number:l
(Pro}ect Code; Project Name !' . f -s,i e r.t.D '++; Project P.O,Number! a.°Order P.O.Number: -
Ticket Date: Delivery Address: Map'P.agei ••! Map/Row/Column:
Delivery Instructio s;. ( Dispatcher:r "
• Ticket Number:
Due On Job: Slump: Truck Number: Driver Number: Driver Name: _ End Use:
r.`c- 9 ;rzrrz( (\ir= r,gj`I FCiEtil t {i�Rt "pl:^.rr.ty
LOAD. CUMULATIVE ORDERED MATERIAL CODE PRODUCTION DESCRIPTION 'JOM UNIT PRICE AMOUNT
QUANTITY QUANTITY QUANTITY
i t
r„ .t:• '. ., ry _,`,� ,,ai r ,- ,.- _ -,;{� .;f? itt'� 1l-tr'r'. . "tI',_ . . •
.Alt',
: .l. . •.l _I,i �,i i�'. dt i�_ ��..j,y.i'�
i
I --
I r
It •
Cash Cjieck#/Auth Code: Signature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect
Check
Without Standby Charges:
� ,
Charge <<„
Comments: }
WATER ADDED: GAL YARDS IN DRUM:
WHEN ADDED.
I, SIGNATUR
I
CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST:
:i) is{ i (.��..0_. 11.7, �`! ';r!-dIil)� SIGNATUR
❑ LOAD WAS TESTED BY:
Notice: Our drivers��Ivvill make every effort to place materials where the customer designates,but the SPECIAL TERMS: Any water added is at customers own risk. If Water 15 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 del very 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 r control after delivery,t is 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. Bu Hers 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
.r
77.
68UNIVERSAL
INVOICE ' I
This Delivery Ticket incorporates•.,,� reference I uyer's previously executed t Application, if any, Seller's Standard
Terms and Conditions;Seller's Quot. any,and Seller's Order Confirmation (i. ng.limitations of warranties),!as if fully
set forth on this Delivery Ticket("Agitelnent").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 accordance with the Agreement.
AGGREGATE / CEMENT j�CONCRETE PRODUCTS / FLY ASH
Aggregate products are naturally occurring materials includ'ng limestone,dolomite,granite,volcanic rock,sand.,gravel, nd other
siliceous materials. Cement products include Portland cement, masonry, pozzolan (Type IP), roof tile, and stucco.!^;Concrete
products include Portland cement and aggregate products ilicluding limestone,dolomite,granite,volcanic rock,sand,gravel,and
other siliceous materials.These products,including fly ash. may contain more than 0.025% crystalline silica.
CAUTIONt
Hazards: Freshly mixed wet cement and/or fly ash cU.n 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'ihandling,
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 lay ge amounts of water.Fly Ash may contain trace amoun61Jof ammo-
nia. Moisture can cause the ammonia to b�released. Inhalation of ammonia can cause coughing and irritation
or burns of the nose,throat and lungs. Se;, physician.Health risk depends on duration and level of exposure.
Safety: Avoid contact with eyes and prolong contact with skin.Wear gloves,eye protection,and appropriate protective
clothing. Wash hands thoroughly w,,jth mild soap and water after handling. Avoid breathing dust. If;exposed to
dust above recommended limits (fie MSDS),wear suitable NIOSH-approved respiratory protection.
First Aid: In case of eye contact,immediptely flush eyes with flowing water for 15 minutes.If dust is inhaled,move to fresh
air.If wet cement contacts 011i,rinse thoroughly with water.Get proper ined.ical attention if irritati.on'ipersists.
CEMEY,Memorial Hermann Tower
929, essner,Suite 1900
V7 combined 146uston,Texas 77024
02/12 For more information please visit www.cemexusa.com.
Este ticket de entrega incl.uye como referencia al comprador (ya previamente ejecutada en su aplicaci6n de credi.tq); cualquier
termino estandar, condicisxies del vendedor, propuestas del vendedor y orden de confirmaci6n del vendedor (con liihitaciones y
garantfas),como acuerdb total del ticket de entrega("Contrato").El vendedor proveera los terminos estandares y condiciones detal-
lados en caso de asf ser requeridos.Con este documento,el comprador acepta los mi.smos ya antes mencionados y que las cantidades
y materiales fueron entregados como se expresa en el mismo.Acepta pagar el m.onto de acuerdo al Contrato; al me-nos 1-�e se ident.i-
fi.que con una nota al frente de este documento.
AGREGADOS / CEMENTO / PRODUCTOS DE CONCRETO / CENIZAS VOLANTES
Los productos de agregados son materiales naturally como piedra caliza, dolomita,granito,roca volcanica, arena, g '•rva 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 caliz dolomita,
granito.,roca volcanica,arena,grava,y otros materiales silicios. Estos productos incluyen cenizas volantes (fly ash) la cual puede
contener mas de 0.025% de silicio cristalino. 'I
1CUIDADO!
Peligros: Mezcla de cemento fresco y/o cenizas volantes pueden causar irritaci6n en los Ojos,quemaduras en pi'l y Ojos,y
reacciones alergicas en la piel.Concreto seco y polvo de agregados,pueden causar irritaci6n en los ojos'l piel y/o en
la zona respiratoria. Polvo del manejo en el trituramiento,pulido, Corte y/o perforaci6n puede contene materiales
si.licos,los cuales pueden causar silicosis pulmonar y cancer si son inhalados.En caso do ser ingeridos antenerse
en temperatura calida,reposar y tomar grandes cantidades de agua.Las cenizas volantes pueden contene amoniaco.
Seguridad: La humedad puede causar la liberaci6n del amoniaco. La inhalaci6n del amoniaco puede causar toser,initaci6n o
quernaduras en la nariz,garganta y pulmones.Acudir inmediatarnente al. medico. El ri.esgo en .la saludidepende en
la duraci6n y el nivel de la expos.ici6n.
Seguridad: Evite e.l contacto con Ojos y contacto prolongado con .la piel.Use guantes,protecci6n en los Ojos y r-opa
imeros adecuada Para protecci6n.Lavese las manos con jab6n suave y agua despu6s del manejo de materiales.Evite inhalar
X11iUS: polvos.Si se expone a polvos mas de los limites recomendados,use protecci6n respiratoria.
Primeros auxilios: En caso de contacto en los Ojos,inmediatamente fluya agua en la pa to afectada pori 1,5 minutos.
Si se inhala polvo,exp6ngase a afire fresco. Si el cemento fresco tiene contacto con sus ojos, lavelos;ia Tondo con
agua.Acuda a atenci6n medica inrnediatamente si la irritaci6n continua.
_ CEMEX,Memorial Hermann Tower
929 Gessner,Suite 1.900 j
7 combinadc:� Houston,Texas 77024
Para rids informacion visita www.cernexusa.co
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