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4`4 101 MO
TEbkhol'LclldE
.Metered and MixedFre
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772A66:566::",
3825 Selvitz Road, Ft Pierce, I
Date:
. Time of job'
Cust
omer
e iyery Address:
Cityec : z
Protect Name.
YARDS MIX DEN IN 4.�_RQCK�� 10F
i IR PEUMW:#57/67 'PE
_6
F51'BE ;I) AD: MIX OTHER„:
':TIME TIME-, TIME, 1%L
ON. JOB - 'STARTED, I FINISHED. CHI
TR
6T
SHOR
.`10 MinUjes of FREE FOECSIJ'
Unloading for everyyard''
-_ ENVIRb
$1.00;per M1fiut6.Aft..
I suer
REMARKS:.'
Purchaser assumes full responsibility. foi;strdngth, sld
changindAhe-call . bration of . sand rock or water, Or 6thi
1, the undersigned, will assume all responsibility
inside of the curb.
C'us'torne'rX:
Meter Reading:,
SCANNED
BY
St. Lucie County
tNjef.)
0 ZtI4
,IT-Vq4G
, County, FL
MOBILECRETE
1513 TECHNOLOGIES MC'
s` ` " ` ' MOBILECRETE .
Metered and Mixed Fresh OnSStte VfSA
�'J TECHNOLOGIES'
772.466 5070, `, O AMEX
Metered and Mixed Fresh On Sde -
3825 Selvitz Road, Ft Pierce'Flonda31o81'
,
772.466.5070 - OAMEX
5.- .y(�t Cubicyds o[dered � '
�
3825 Selvitz Road, Ft. Pierce Flonda-34981
1�// •' `'
Date - Cubm yds brdeted,
I lob:
erName: J011A 91. "Phone.
Time of job:
:5.".
.
�.
Customer Name: a �� 7 ..r Ph d�%p-^ �zgVr
P
Delivery Address: ...
Ar}.
City:Na Fe r F wceSOI�
-
:.
..
Project Name: P.O #
2D'.;
MIX.DESIGN'
EA RO
'PRICE
`, ' ,
ED
REG.1P
#57167
PER YD
,
AMOUNT
YARDS
USED
MIX DESI N
P -R9G
PRICE
p ,
REG.lF�LM�
#57l87
PER YD ,
; AMOUNT
/AD MIX ^.
OTHER'
}
l
,
NE
TIME
'TIMEOELIVERY
�` `
.SAD MIX, .
OTHER
•'�
Lti
6 Counts
JOB
-STARTED, •
FINISHED; ,
CHARGE;±',
+
I" `
TIME
'TIME
TIME
DELIVERY'
'. TRUCK,",
'� 5 `
�'
ONJOB'
STARTED
FINISHED
"CHARGE,,,
_
-
,..
::,
TRUCK
_ ®
p p
SHORT LOAD
,
'-
OT.FEE
�;'�87��
1,
•„'
-
•, 10 MinuteS Of FREE
FUEL.Sl1RCHARGE
,..1' ,,}
;,,.,
.. ,_
SHORT LOAD•
q
Inloading for every yard.,. �.
ENVIRONMENTAL
I
�.10 Minutes of FREE ',
FU I -SURCHARGE
JUIN
O" L014
$1.00 per Minute After r..
I
unloading for every yard.
ENVIRDN'ENTAL
•�
y
TCtNG
• .. -
SUBTOTAL
`
$1.00' per Minute After
o ! Wcie
,n`�1n"r• PI -
' TAXx
, �_.,a
•.:, `'�
I _
... .
SUB TOTAL
'TOTAL DUE
r , .-..
a .. ,
,...
TAX
TOTAL DUE'•.
I.
..._.
RKS:
'REMARKS:
ser assumes. full responsibility, for strength, slump and quality nt` concrete when
-
ig the calibration of sand rock.or water, or other material requested on the lob
Purchaser assumes full responsibility for strength,'slump and ,;
..
-
giiaLty of concrete when
changing the calibration of sand, rock or water, oP othermatenal.requested
- the
ndersigned, will* assume all responsibllity for any dAmage where delivery is made i
on fob
,. _ ,
if -the curb. e ;
>
I, the undersigned will assume all responsibilityfor any danlag where delivery is
' 1 . •�P�.�rg
X: Driver
inside of the curb j ,
ier
•.' C.y gs'
i ,L. �j ��
Customer X: Driver. KV
`
leading:Number �. 6 •,
_ - -
''. : ' -� +
Meter Reading: ""'�� Tntck Number -
+`-4
_ - ,