HomeMy WebLinkAboutCONCRETE RECEIPTMOBILECRETE
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Metered and Mixed Fresh On -Site
❑ AMEX
772.466.6070
3825 Selvitz Road, Ft. Pierce, Florida 34981
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G7 �. L Cubic yds.
ordered: `
Date: � 'fi—
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Time of Job:
Phone:
Customer Name:
Delivery Address:
City: - r
P.O.#:
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Protect Name:
YARDS
MIX DESIGN PEA ROCK PRICE
REG. UMP #57167 PERYD,
AMOUNT
USED
X50
LIS
ERI D MIX UIHMM
TIME TIME TIME DELIVERY
ON JOB STARTED FINISHED CHARGE
TRUCK
O.T. FEE
SHORT LOAD
10 Minutes of FREE
FUELSURCHARCE
unloading for every yard.
ENVIRONMENTAL
$1.00 per Minute After
SUBTOTAL I�I�
TAX
TOTAL DUE
REMARKS:
IL L.
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Purchaser assumes full responsibility for strength, slump and quality of concrete when
changing the calibration of sand, rock or water, or other material requested on the job.
I, the undersigned, will assume all responsibility for any damage where delivery is made
inside of the curb.��
Driver:
Customer X:
Truck Number.
Meter Reading
0
16vvo
SGANNED
BY
St. Lucie County
RF17FIVED V"`( 1.4 7013