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Cash Check VIAuthCode! SlgnewreofdtivarRd"IngCash: . Cash Received: I Total CODOtdorMfeuotZcalkti
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WA1'ERADDEU GAL YARDS IN DRUM'
WHEN ADDED.
CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST;
SIGNATURE
CO CRETE DISPOSAL FEE sIMMO
PARTIAL FULL 'LOAD ILYARDe Ll LOAD. WASTESTED BY:
Notica: }}',ur drivers will make every offort to Ploca matorfels whom ft aastomor doslonatoa, but the SPECIALTERMS: Anywatoradded Is atcustomorsawn risk, Ifwaterfs added on job, concreteatfettgth
con�ar�aeaumes no reapbnslDlllty for damages Inside curb ar property Ono. Customer agrees to the Is no ►ongar guaranteed. WA Ct may cause akin andforeye Irritation, CAUTION: Malarial
tomr. of °sake and dalivory and aecapts Canomto as U. Duo to hOpOdant faCtom which ato out of our flay be hOzaai r safety and ha Ptooso rotor to the backsldo oft th wt for Important
control e�tordelivery, fhlsCompany will not accept any reoW%ibliltyforthe finished raoulta, Nocrodltfor safety handling• odon,andto tedalsafetydatasheoisforaddW ormatmn.
rotumod 0, MCM6, Buyers exCeptlons and claims shall be deemed waved unless made to us In wdting AUTHO
within anb business day after thoreceipt ofruatodats. 0
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PREV TRK9 PLANT LOAD WH
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Plant'I'
Begin Loading:
To -Job:
Arrive Job:
Start Unload:
Finish Unload:
Leave Job:
Return Plant:
-
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Customer Code:.'
Customer Name: Customer Job Number:
Order Code / Date:
1 Protect Code: ` ,
t: Project Name:.. Project P.O. Number.
;, Order RO. Number.
Ticket Date:
Delivery Address:
Map Page: Map/Row/Column:
,
Delivery Instruct)
ns:. _
Dispatcher:
' �•
a,
Ticket Number
° A
Due On Job:
i
Slump:
Truck Number.
Driver Number:
Driver Name:
End Use:
LOAD
QUANTITY I
CUMULATIVE
QUANTITY
ORDERED
QUANTITY
MATERIAL CODE
PRODUCTION DESCRIPTION
UOM
UNIT PRICE
AMOUNT
\J
' r
tt
,
_ r t<
' Cash
I�Check# I Auth Code;
Signature of Driver Receiving Cash; \
�
Cash Received:
t
Tota1'COD Order Amotl to'C6iy'ect '
Without Standby CNFt�'
Check
'+_
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,il
Charge
Comments:
WATER ADDED:. GAL
YARDS IN DRU?
A
• {�—
CURB LINE CROSSED AT OWNER'S/AGENY'S REQUEST:';-' z '
AN
El LOAD WAS TESTED BY:
Notice: Our driv
Company
rs will make every.effortfo place materials where ,the customer desi nates but the,
',no
SPECIAL TERMS: An water added,is at customers own risk. If water is added on job, cwncrete`stren
eye Irfitation. CAUTION � ria,\
assume
terms of sale and,
responsibility for damages inside curb or property line. Customerr agrees to the
delivery and accepts concrete as is. Due to important factgrs which arb out of our
isno longer guaranteed. WARNING: Prodbctma cause skin and/or
:may be hazardous to our safety and health. Please refer to the backside of this ticket for Importanh
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",,dayafter
the receipt of materials.
✓'
68UNIVERSAL''hl
�:3%:.i: r;i�
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INVOICE
This Delivety'T.icket incorporates her, y reference Buyer's previously executed dit Application, if any, Selleri's Standard
Terins and Conditions-, Seller's Quotas _ _. rf any, and ,Seller's Order Confirmation (i ding limitations of warranties), as i*� fully
, eO' orth,on tl s llelivcry'l 7c*,(1if'Agreement"). Seller will provide the Standard Termls�irid Conditions upon request. Buffer agrees
tlis�t, Yttlicss otht rhise`noteil on tMe front hereof, all quantities and items were delivered as indicated and further expressly agrees to
pay, fif.�ccordduc"e with,the Agreement.
MIGREGATE / CEMENT / CONCRETE PRODUCTS / FLY ASH E'
u' !.
Aggregate prod, rtets are naturally occurring materials including limestone, dolomite, granite, volcanic:rro& sand, gravel 'and ether
siliceous nrtterials: L4rnent. products include Portland cement, masonry, pozzolan (Type IP), roof tilt, and stucco: Concrete
products include Portland cctntInt and aggregate products including limestone, dolorite, granite, volcanic rock, sand; gravel, and
other silicc ous materials.:l1r'9jc products, .including fly ash, may contain more than 0:025% crystalline silica.
Hazards:F1'e 4111y-mixed wet cernent and/or fly ash can cause eye i.rri.tation, skin and eye burhs,.,iinid.'allergic skiri'rcactions.
Dry concrete and aggregate dust may cause irritation to eyes, skin, and/or respiratory tract: I.7ta'st from handling;
crushing, grinding, cutting and/or drilling may contain silica, which may cause silicosis and can6Wif inhaled.
If.ingested, keep warm, at rest, and drink large amounts of water. Fly Ash. may contain tracE amounts of ainrno-
nia.:Moisture can cause the ammonia to be released. Inhalation of ammonia can cause coughing an,o'd�irritatin
or br.:rns 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 appropr•tati'protective
clothing. Wash hands thoroughly with Mild soap and water after handling. Avoid breathing dust. lfi'-xposed to
(].List above recommended limits (see .MSDS), wear suitable NIOSH-approved. respiratory protect.ion.,y
�VI
First Aid.: In case of eye contact, immediately flush eyes with flowing water for 15 minutes If dust is inhaled, m6ve to fresh
air. 11' wet cement contacts skin, rinse thoroughly with water. Get proper medical attention it i rri tatio.4, persists.
CEMEX, Memorial Heimann Tower ia,
929 Gessner, Suite 1900
V7 combined I-Iouston. Texas 77b24 1
02/12 For more infonnation please visit ,vww.cernexusa.coin.
Este ticket de entrega incluyc coma refercncia al compr•ador (ya previam,tnte cjecutada en su aplicac.i.6.n de credito); cualquier
termirio esubidar, condiciones del vendedor, propuestas del vendedor y oaten de confirmacicin del vendedor (con .hitlitaeiones y
c;arantfas), Como acuerdo total del ticket de entrega ("Contrato" dFl vende'or proveei6 los termirios estdndares y condiciones detal-
ltad.os en taro pie asf scr rcqucridos. Con cste clocurn.ento, el cot��t r� clor ac, t f,'os imsmos ya antes mencioitados y que ]as cantidades
y materiales fueron entregados como se expresa ert el inismo., r\cepr 1r et fronto de acuerdo al contrato; al menos giie se identi-
fique, con una nota al frente de este docutnento,
GRECADOS / C'EMENT() / PRODUC.TO'S DE CONCRETO [CENIZAS VOLA
i-ES
:Los productos de agregados son materiales natu.rales cc
rateriales silicios. Los productos de cernento incluyen
azotea. y estuco. Los productos de concreto incluyen ce
granit«, r•oca volcanica, arena, g � rava, y ot:ros materiaes
contener ands d4 0.0251/o de silicio cristalino.
piedra caliza, do.lomita, granito, rota volcunica, arena, guava y otros
riento de tipo Portland, de albanilerfa, pozzolan (tipo IP);i;azulejo de
to Portland y .pjoductos de agregados como piedra caliz& dolomita.,
toy. Estos productos .in.c.luyen cenizas volantes (fly ash) laIcual puede
Petigros:, ., Mezcla de c6mento fresco y/o cenizas volant� pueden causar irritaci6n en los Ojos, qu.emaduras en pidl y Ojos, y
r �= reaccrones alergicas en la piel. Concreto seco )InolvO de agregados, pueden causar irritation en los ojos,i'piel y/o en
la Iona respiratoria. Polvo del manejo .en el trrr amiento, pulido, torte y/o perforaci6n puede contener;anaterrales
i silicas, Jos cu:des pueden causar silicosis pulmo.n4 y cancer si. son inhalados. En caso tic Sea 9ngerid:os rnantcnerse
en temperatura cfrlida, reposar y tomar grander cant? lades le a';ua. Las cenizas volantes pueden conteneri amoniaco.
.Lit humeddd puede causar la liberaci6n del amoiY� La i.tllalacion del arnoniaco puede causar toner, ii"ritaci& o
Seguridad: ctuenladuras en la nariz, garganta'y pulmones. Ac 1y- tlr;tt<diatamente it nledico..El riesgo en la salud % epende en.
t ,cfuracjein y el nivel de la exposici6n. ` N
i 'e *uridad- Evite el contacto con Ojos oontacto colon do con ]a is 1. Use uantes, rotecci6n en los o os ro a
g j Y P g P' g p �J Y p
adecuada Para protecci6n.:Lavese ]as manor con'jab6n suave y agua despuCs del manejo de materiales, Evite i.nhalar
IcI; ' po.lvos. Si se expone a polvos alas de los limited recomendados, use protection respiratoria.
' r ` -1,�)ileros alrxilios::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, lavel.Os a; fondo con
agua. Acuda a atenci6ri ni6dica inmediatamente si la irritati6n continda.
CEMEX, Memorial Hermann Tower
929 Lessner, Suite 1900
V7 combinado'`Houston, 'Texas 77024 G;
02/12-' Para mils informaci6n visita www.cemexusa.com.
Plant:
}Begin Loading:
To Job:a
" ` Ar'rive`Job: ' ;,
Start;Unload ' `
FinisFi Unload:
Leave Job:
ReturmPlant:.
CustomerCode: ,! Customer Name: Customer Job Number:, Order Code I Date:
_.310 7 G z `G 'AIEL—RY (0NS C`!..t% s 10N'.-' - icaEi 06i a :�!?.G
Project Cade: Project Name: Project P.O. Number. Order P.O. Number:
Ticket Date: Delivery Address:' ',Map;P;ge r• Map/Row/Column:
()$ /' 1 i1.S 10701 . OCEAfl DRIVE LOT- VENTURE 3 _
! Delivery 'Instructiois: Dispatcher - I
y ',it,TF COCE f SjtJ;.? ,i' �ciiCSx'iit� 1
�. Ticket Number:
Due On Job:
Slump:
I
Truck Number:
Driver Number.'
Driver Name: •
End Use:
3
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10025361-
LOAD CUMULATIVE ORDERED MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT ,
QUANTITY I QUANTITY QUANTITY
Cash
Check # / Auth Code:
Signature of Driver Receiving Cash: ,
Cash Received'.
Total COD Order Amount to Collect
WithoufStandbyCharges:
Check
I
Charge
Comments:
\
WATER ADDED: I GAL YARDS IN DRUM:
WHEN ADDED.
!I
'
SIGNATURE.
CURB LiNElCROSSED O. , ' ERVAGENT'S REQUEST:
CONCRI,
TE DISPOSAL. FEE
�
AAT
A
"� SIGNATURE
V
----�.. F!At;'!'IAL
FULL_ LOAD _..�..__ YARDS
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❑LOAD WAS TESTED BY:
Notice: Our driv afs 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 assumf s 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 an i 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 deliv4iry, 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'•1 Buyers exceptions and claims shall be deemed waived unless made to us in writing AUTHORIZED SIGNATURE:'
within one busineis day after the receipt of materials. O
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iBUNIVERSALI PREV TRH. 1o.0-23493 QTINVOICECRUZ LOAD NUNg • 2-
This Delivery Ticket incorporates lr(rein by reference Buyer's previously executed Credit Application, if any, Seller's Standard
Terms and.Conditions, Seller's Quo n, if any, and Seller's Order Confirmatio cl.uding limitations of warranties), a. if fully
set forth on this Delivery Ticket ('A_ went"). Seller will provide the Standard I �., z s and Conditions upon request. Buyer agrees
that, unless otherwise noted on the :front hereof, all quantities and items were -delivered as indicated and further expressly agrees to
pay in accordance with the Agreement.
AGGREGATE / CEMENT / CONCRETE PRODUCTS / FLY ASH
Aggregate products are naturally occurring materials including limestone, dolomite, granite, volcanic rock, sand, gravel, and other
siliceous materials. Cement products include Portland cement, masonry, pozzolarr (Type IP), roof tile, and stucco. Concrete
products include Portland cement and aggregate products including limestone, dolomite, granite, volcanic rock, sand,jgravel., 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 andeye burns and. allergic skin reactions.
Dry concrete and aggregate (lust 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 andprolongedcontact with skin. Wear gloves, eye protection, and appropriate protective
clothing. Wash hands thoroughly with mild soap and water after handling. Avoidbreathing dust. :If;exposed to
dust above recommended limits (see MSDS), wear suitable NIOSI-I-approved. respiratory protection. !
First Aid: In case of eye contact, immediately flush eyes with flowing waterfor 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 persists.
CEMEX, Memorial Hermann Tower
929 Gcssner, Suite 1900
V7 combined [10uston, Texas 77024
02/.12 For more information please visit www.cemexusa.com.
Este ticket de entrega incluye como referencia al comprador (ya previamente ejecuta.da en su aplicaci6n ,de creditb); cualqu.ier
t6rmino estindar, condiciones del vendedor, propuestas del vendedor y orden de confirmaci6n del vendedor (con limitations y
garantfas), coma acuerdo total del ticket de entrega ('Contrato")• El vendedor p.roveerd los terminos estindares y condiciones detal-
lados en caso de asf ser requeridos. Con este documento, el cornprador acepta los rnisrnos ya antes mencionados y que las cantidades
y materiales iueron entregados comp se expresa 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(:).
A.GREGA.DOS / CEMENTO / PRO.DUCTOS DE CONCRETO / CENdZAS YOLANTES
L,os productos de agregad.os son materiales natu.rales como pied.ra caliza, do.lornita, granito, roca vol.ednica, arena, grava y otros
materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, do albatiilerfa, pozzolan (tipo lP),',azulejo de
azotca y estuco. Los productos de concretes incluyen ccrr'renta Portland y productos do agregados corno piedra calizti, dolomita,
granito, roca vo.leinica, arena., grava., y otros materiales silicios. l: stos productos incluyen cenizas volantes (fly ash) la�cual puede
contener nits de 0.025% de silic.io cristalino.
Peligros: Mezcla de cemento fresco y/o cenizas volantes pueden causar irritaci6n en los ojos, quernaduras en piel y ojos, y
reacc.iones alergicas en la piel. Concreto seco y polvo de agregados, pueden causar ir•r.itacibn en los ojos,'-piel y/o en
la zona respira.toria. Polvo del manejo en el trittrramiento, pulido, torte y/o perforaci6n puede contener,niateriales
sili.cos, los cuales pueden causar silicosis pulmonar y cancer si son .inhalados. En caso de ser ingeridos, mantenerse
en temperatura calida, reposar y tomar grandes cant.i.dades de agua. Las cenizas volaptes pueden contener!amomaco.
La humedad puede causar la liberaci6n del arnoniaco, La inhalaci6n del amoniaco puede causar toser, irritaci6n o
Seguridael: quemadnraS en la nariz, g:irganta y pulmones. Acudir inmediatamente al medico. El riesgo en la salud depende en
la du.raci6n y el nivel de la exposici6n. !
Seguridad: h,vite cal contacto con ojos y contacto prolongado con la piel. Use guantes, protecti6n en los ,ojos y ropa.
Primeros adecuada para protecci6n. Lavese ]as manos con jab6n suave y agua despues del manejo de materiales. Evite inha.lar
auxilios: polvos. Si se expone a polvos mas de los lignites .recomendados, use protecc16n resp.iratoria.
Primeros auxilios: En caso de contacto en los ojos. inmediatamente fluya aqua en la parte afectada por 15 minutos.
Si se inhala polvo, exp6ngase a aire fresco. Si el cemento fresco tiene contacto con sus ojos, lavelos a,fondo con
aqua. Acuda a atenci6n medica inmediatamente si la irritaci6n continrla.
CEM.EX, Memorial Hermann Tower
929 Gessner, Suite 1900
V7 combinado Houston, "Texas 77024
02/12 Para rnas informacion visita www.CeD)exusa_com.