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Home My WebLink AboutCEMEX RECEIPTzzccmC-x 573^3G55 SCANNED BY St. Lucie County Plant: Begin Loading: To Job: Arrive Job: StartUnload: Finish Unload: Leave Job: Return Plant: Customer Code: Customer Name: ,.I'll •-'� I' �: _I�ir--"i+ r _ _ �,�_ i -_ " Project Code: Project Name: Ticket Date: Delivery Address: Delivery Instructlons: i Customer Job Number. Project P.O. Number Order Cade / Date: Order P.O. Number. Map Page: Map/Raw/Column: Dispatcher: Ticket Number. Due On Job: Slump:r Tm Number(l Ome�Number. O er Nemec c„r End Use: �I. LOAD CUMULATIVE ORDERED MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT QUANTITY QUANTITY QUANTITY ,' r Cash Check# /Auth Code: Signature of Diver Receiving Cash: Cash Received: Total COD Order Amount to Collect Check Without Standby Charges: Charge Comments: WATER ADDED: GAL YARDS IN DRUM: WHEN ADDED. SIGNATURE 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 credli for safety handling Information, and to the material safety data sheets for additional information. returned concrete. Buyers exceptions and dalms 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 by reference Buyer's previously executed Credit Application, if any, Sellers Standard Terms and Conditions, Seller's Quc n, if any, and Seller's Order,Confinnatii acluding limitations of warranties), as if fully set forth on this Delivery Ticket ("A _ ment"). Seller will provide the. Standard ns 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 li6aestone, dolomite, granite, volcanic rock, sand, gravel, and other siliceous materials.. Cement products include Portland cement, 1 �sonry, 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 conCain more than 0.025% crystalline silica. Hazards: Freshly mixed wet cement and/or fly ash can cause eye irritation, shin 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 bums of the hose, throat and lungs. See physician. Health risk depends on duration and level of exposure. Safety: Avoid contact with eyes and prolonged contact with skin. Wear gloves, eye protection, and appropriate protective clothing. Wash hands thoroughly with mild soap and water after handling. Avoid breathing dust. If exposed to dust above recommended limits (see MSDS), wear suitable NIOSH-approved respiratory protection. First Aid: In case of eye contact, immediately flush eyes with flowing water for 15 minutes. If dust is inhaled, move to fresh air. If wet cement contacts skin, rinse thoroughly with water. Get proper medical attention if irritation persists. CEMEX, Memorial Hermann Tower 929 Gessner, Suite 1900 V7 combined Houston, Texas 77024 02112 For more information please visit www.cemexusa.com. Este ticket de entrega incluye como referencia al comprador (ya previamente ejecutada en su aplicaci6n de crddito): cualquier t6rmino estandar, condiciones del vendedor, propuestas del vendedor y orden de confirmaci6n del vendedor (con limitaciones y garantfas), como acuerdo total del ticket de entrega ("Contrato"). FI vendedor proveera los terminos 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 fiieron entregados como se expresa en el mismo. Acepta pagan el monto de acuerdo al contaato; al menos que se identi- fique con una nota al frente de este documento. KFITAIJUJ / ULIV1LN'1'U / FKUDUU1'US 1JE UUINUKL'1'U / UkNILAa VULAN'1'LJ Los productos de agregados son materiales naturales como piedra caliza, dolomita, granito, rocs volcanica, arena, grava y otros materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albairilerfa, 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 coal puede contener mas de 0.025% de silicio crystallno. Peligros: Mezela de cemento fresco y/o cenizas volantes pueden causar irrttati6n 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 gjos, piel y/o en. la zona respiratoria. Polvo del manejo en el trituramiento, pulido, cone y/o perforaci6n puede contener materiales silicas, 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 liberacio'n del amoniaco. La inhalaci6n del amoniaco puede causar toser, irritati6n o quemaduras en la nariz, garganta y pulmones. Acudir inmediatamente al medico. El riesgo en la salud depende en In 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 despuds 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 15 minutos. Si se inhala polvo, exp6ngase a aire fresco. Si el cemento fresco tiene contacto con sus ojos, lavelos a fondo con agua. Acuda a atenci6n medica inmediatamente si la irritaci611 continua. CEMEX, Memorial Hermann Tower 929 Gessner, Suite 1900 V7 combinado Houston, Texas 77024 02/12 Para mas informaci6n visita www.cemexusa.com.