HomeMy WebLinkAboutCEMEX PAPPERS!
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SCANNED
BY
v C/� St. Lucie County
57893875
Plant:
Begin Loading:
To Job:
Arrive. Job:
Start Unload::
Finish Unload:
Leave Job:
Return Plant:
Customer Code:
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Customer Name:
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Ticket Date: Delivery Address:
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Customer Job Number.
Project P.O. Number
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Order Cade / Date:
1 Orar'E.O. Num6e0/011 r 15
Mep Pager Map/Row/Column:
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Due On Job:
Slump:
Track Number
Driver Number.
Driver Name:
End Use:
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LOAD CUMULATIVE I ORDERED MATERIALCODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT
QUANTITY QUANTITY QUANTITY
i11�n . 1
Cash Check #/Auth Cade:
Check
Charge
Comments:
l 'u;%',q Ei4V1iRGk!tb_NTFIL !-1HARGE
Signature of Driver Receiving Cash:
E..TI= D"l SPOSAL FEE
PARTJAL- .----_,- FULL LOAD 9-7ARDS
Cash Received:
WATER
COD Order Amount to Collect
ul Standby Charges
YARDS IN DRUM:
WHEN ADDED.
CURB LINE CROSSED AT OWNER'S/AGENTS REQUEST:
❑ 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 tayoyr safety and.. health. Please 'refer to the backside of bills ticket for important
central after delivery, this Company will not accept any responsibility for the finished results. No credit for safety handling infopnati and to the matenaIjeafety data sheets for additional information.
returned concrete. Buyers exceptions and claims shall be deemed waived unless made to us in writing AUTHORIZED SIGNATURE: J,/ '
within one business day after the recai,t,t jMaterpep i f,rai ,__j �, / t,
68UNIVERSAL
INVOICE
This Delivery Ticket incorporates her(-;- ry reference Buyer's previously execute,4 0—dit Application, if any, Seller's Standards'
Terms and Conditions, Seller's Quotat if any, and Seller's Order Confirmation 1 uding limitations of warranties), as if fully �>
set forth on this Delivery Ticket ("Agr(,,,,.,,,nt"). Seller will provide the Standard Temm 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, pozzolan (Type IP), roof tile, and stucco. Concrete
products include Portland cement and aggregate products including limestone, dolomite, granite, volcanic rock, sand, gravel, and i
other siliceous materials. These products, including fly ash, may contain more than 0.025% crystalline silica.
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 c
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
02/12 For more information please visit www.cemexusa.com.
Este ticket de entrega incluye come, referencia al comprador (ya previamente ejecutada en su �aplicaci& de cr6dito); cualquier
tdrmino estandar, condiciones del vendedor; propuestas del vendedor y Orden de confirmaci6n del vendedor (con limitations y
garantfas), como acuerdo total del ticket de entrega ("Contrato"). El vendedor proveera los tdrminos estandares y condiciones detal- r„+r++
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 contrcto; al menos que se identi-
fique con una nota al frente de este documento.
UEIVll+.AIU / FKUDUUl'US I)E l:01NUKr 1'U / UEAIGAS
Los productos de agregados son materiales naturales como piedra caliza, dolomita, granito, roca volcanica, arena, grava 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 caliza, dolomita,
granito, roca volcinica, arena, grava, y otros materiales silicios. Estos productos incluyen cenizas volantes (fly ash) la cual puede
contener mas de 0.025% de silicio cristalino.
Peligros: Mezcla de cemento fresco y/o cenizas volantes pueden causar initaci6n en los Ojos, quemaduras en piel y Ojos, y
reacciones al6rgicas en la piel. Concreto seco y polvo de agregados, pueden causar irritacion en los Ojos, piel y/o en
la zona respiratoria. Polvo del manejo en el trituramiento, pulido, code y/o perforaci6n puede contener materiales
silicos, Ins cuales pueden causar silicosis pulmonar y cancer si son inhalados. En caso de set ingeridos, mantenerse
eji temperatura calida, reposar y tomar grandes cantidades de agua. Las cenizas volantes pueden contener amoniaco.
Seguridad• La humedad puede causar la liberaci& 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 piel. Use guantes. protecci6n en los Ojos y ropa
Primeros adecuada pars protecci6n. LAvese las mans 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 15 minutos.
Si se inhala polvo, exp6ngase a aire fresco. Si el cemento fresco tiene contacto con sits Ojos, lavelos a fondo on
agua. Acuda a atenci6n medica inmediatamente si la irritaci6n continua.
CEMEX. Memorial Hermann Tower
929 Gessne AvSuite 1900
V7 combinado Houston, Texas 77024
02/12 Para mas informacion visita www.cemexusa.com.
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Customer Cod¢ Customer Name:, _ f" Customer Job Number. q ` Order Cotlel Data
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•:+Pro�eit�Co`de Cbrojevlf.l�ame.p j,�Lir Project P.O Number. �brder.P_:O:INumbe� F.s-i ?...
1 p U q Ticket Oates, peliveryAddress: � m� � 1 Mad Page: Map/Raw/Columm
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f LOAD:` «t' CUMULAT17/E ORDERED 'MATERIAL6DDE � �' " PRODUCTION DESCRIPTION Y 'U0M UNIT PRICE AMOUNT'
OUANTITV DUANTITV QUANTITY .:
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t QO i '02759 UNQVIROINIMENTAL CHARGE
Cash. C4eck#(Auth.Code:.-. Signature of Driver Receiving Cash[- ' _. CashRecerved:i TotaIC0D Order Amountta Ca11.ct
"t—t7 — - - - Without Standby.Chaiges: - ---
----c— Cj l • t.
4 Charge
Comments;.
WATER ADDED: _GAL WHENYARDDD D.
WHEN ADDED.
�� 'SIGNATURE
CONCRETE DISPOSAL_ FEE CURB LINE CROSSEp AT OWNER'SIAGE7JT'S•REQUEST:
Pi-lfiTif�L Fl1Ll._ LL)RI] _ t-1RDSf. 7' r"`
SIGNATURE
'v.
O LOAD WAS TESTED BY:
Notice: Our drivers will make every effort to place materials where the custoTar designates, but the 'SPECIAL TERMS: Any water added isatcustomers own risk._ Ifwater is added on job, boricrete strength
Company assumes no responsibility for damages inside curb or property line. Customer agrees to the is no longer guaranteed. WARNING: Product may cahswskm and/or eye Irritation. CAUTION: Material
terms of sale and deliver) and accepts concrete as @. Due to important factors which am out of our may be hazardous'to�yo0f safely a9d health Please iefer to the backside of4his ticket for Important
control after delivery, this Company will not accept any responsibility for the finished results. No credit for safety handling mfoppallo. and tolx7e material safelytlala sheets for atltlilionpl information.
returned concrete. Buyers exceptions and. claims shall be deemed waived unless made to us. in writing AUTHORIZED SI N(Tl'IRE: / u 1
within one business day after the re, , E usual >
I g�E l� L/l�LClap d,'ta
seuNIVERSAL. CUSTOMER t
Due On Job:
Stump: •
Truck Number,.
Driver Number.
Driver Name:
Ertl Use:
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UNfiS�IGNEIi
This Delivery Ticket incorporates hei ' ')y reference Buyer's previously execute ' edit Application, if any, Seller'sStandard'
Terms and Conditions, Seller's Quota if any, and Seller's Order Confirmation uding 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 II
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, gravel, and
other siliceous materials. These products, including fly ash, may contain more than 0.025% crystalline silica.
Dry concrete and aggregate dust may cause irritation to eyes, skin, and/or respiratory tract..Dustfrom 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 amgunts 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'iungs. 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 c i
clothing. Wash hands thoroughly with mild soap and %vater after handling.. Avoid breathing dust. If exposed to
dust above recommended limits (see MSDS), wear suitable 1VIOSH-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
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 cr6dito);'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"). El vendedor proveera Ins t6rniinos estAandares y conditions detal-
lados en caso de asf serrequeridos. 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
Pique con una rota al frente de este documento.
AGREGADOS / CEMENTO / PRODUCTOS DE CONCRETO / CENIZAS VOLANTES
Los productos de agregados son materiales naturales como piedra caliza, dolomita, granito, rota volc'anica, arena, grava y otros
materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de alban"ileria, pozzolan (tipo IP), azulejo de
azotea y estuco. Los productos de concrete incluyen cemento Portland y productos de agregados como piedra caliza, dolomita,
granito, rota volc'anica, arena, grava, y otros materiales silicios. Estes productos incluyen cenizas volantes (fly ash) la cual puede
contener mds de 0.025% de silicio cristalino.
Peli ros: Mezcla de cemento fresco /o cenizas volantes pueden causar initaci6n en Ins ojos, uemaduras en iel ojos, t
g Y P J 9 P y ..J Y
reaccigges al6rgicas en lapiel. Concreto seco y polvo de agregados, pueden causar irritaci6n en Ins ojos, piel y/o en
la zona respiratoria. Polvo del manejo en el trituramiento, pulido, torte y/o perf6raci6n puede contener materiales
silicos, los cuales pueden causar silicosis pulmonary edncer si son inhalados. En caso de ser ingeridos, mantenerse
en temperatura calida, reposar y tomar grandes cantidades de agua. Las cenizas volantes pueden contener amordaco.
Seguridad: La humedad puede causar la liberaci6n del amoniaco. La inhalaci6n del amordaco puede causar toser, initaci6n o
quemaduras en la nariz, gar
ganta y pnlntones. Acadrrinmediatamente al medico. El tiesgo en ]a salud 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 Ins ojos y ropa
Primeros adecuada Para protecci6n. L'avese 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 Is parte afectada por 15 minutes.
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 m6dica inmediatamente si la irritaci6n continua.
CEMEX, Memorial Hermann Tower
929 Gessner, Suite 1900
V7 combinado Houston, Texas 77024
02/12 Para mas informacion visita www.cemexusa.com.
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Begin LoalinqL_1
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Arrive Job: _
Start Unload:
Finish Unload:
Leave Job:
Return Plant:
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Customer Code: Customer Name:
I
`Prolecl)Cotler t'ProjeitNeme:u In Doi,
Ticket Dale: Delivery Address:
( Delivery lnstruI !_' : `•.'l-0 CIDtll IEP'.. T(4I- C.I R. FI PfE: Rf.'fFr- HUY
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Customer Job Number Order Code/Date:
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Project P.O. Number. OrderP.O. Number.
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Map Page: MaplRow/Column:
Dispatcher.
Ticket Number:
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Slump:
Truck Number:
Driver Number.
Driver Name:
End Use:
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LOAD CUMULATIVE I ORDERED MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT
QUANTITY QUANTITY QUANTITY
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Cash Check 4/Auth Code: Signature of Driver Receiving Cash:
Check_ _—_— _—_
Comments:
WATER ADDED:
Yjty fti A 1'.�:'t
Cash Received: Total COD Order Amount to Collect
`I Without Standby Charges:
YARDS IN DRUM:
WHEN ADDED.
CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST:
T PFY PnGSAI- t-L LGRD f ARDS 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 on job, concrete strength
Company assumes no responsibility for damages inside curb or property line. Customer agrees to the is no longer guar�99t€ed. WARNING: P'duct may cause skin and/or eye imitation. CAUTION: Material
terms of sale and delivery and accepts concrete as is. Due to important factors which are out of our may bevhaz@ d s/to your saf§ty an0�alth. Please refer to the backside of this ticket for important
control after delivery, this Company will not accept any responsibiSty for the finished results. No credit for safe hart gvi�ormation,and,o theJnaterial safety data sheets for additional information.
returned concrete. Buyers exceptions and claims shall be deemed waived unless made to us in writing AU dRR ED G TORE: /Y
within one business day after the receipt of materials. X///)py
68UNIVERSAL INVOICE
This Delivery Ticket incorporates hen ' `y reference Buyer's previously execute,' "-alit Application, if any, Seller's Standard {'
Terms and Conditions, Seller's Quotat if any, and Seller's Order Confirmation i ading 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 / 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 1P), roof tile, and stucco. Concrete I'
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.
Hazards: Freshly mixed wet cement and/or fly ash can cause eye irritation, skin and eye burns and.allergic skin reactions- " I,
- 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.
i
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.
i
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 i
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 er6dito); cualquier
tErmino 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"). 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 contaato; al menos que se identi-
fique con una nota al frente de este documento.
AITKL' lTA1JV6 / UVLAMIN IV / YKV1JUl,1 VJ 1J1+
Los productos de agregados son materiales naturales como piedra caliza, dolomita, granito, roca volcanica, arena, grava 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 caliza, dolomita,
granito, roca volcinica, arena, grava, y otros materiales silicios. Estos productos incluyen cenizas volantes (fly ash) In cual puede
contener mds 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 alergicas en la piel. Concreto seco y polvo de agregados, pueden causar irritaci6n en Jos ojos, pie] y/o en
la zona respiratoria. Polvo del manejo en el trituramiento, pulido, cone y/o perforaci6n puede contener materiales
silicos, los cuales pueden causar silicosis pulmonar y cancer si son inhalados. En caso de set ingeridos, mantenerse
en temperatura calida, reposar y tomar grandes cantidades de agua. Las cenizas volantes pueden contener amoniaco.
La humedad puede causar la liberaci6n del amoniaco. La inhalaci6n del amoniaco puede causar toser, irritaci6n o
Seguridad:
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 piel. Use guantes, protecci6n en los ojos y r6pa
Primeros adecuada para protecci6n. Lavese las manor 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 ]a 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 In irritaci6n continua.
CEMEX, Memorial Hermann Tower
929 Gessner, Suite 1900
V7 combinado Houston, Texas 77024
02/12 Para mas informaci6n visita www.cemexusa.com.
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Customer Code: Customer Name:
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Customer Job Number:
Project P.O. Number.
Order Code / Date:
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Dispatcher:
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Slump:
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i202749 ENVIRONMENTAL CHARGE
k IAuth Code_ Signature of Driver Receiving, Cash:
C;ONCRF15MAPPtosf-i'- FbEL. LDAD fy ARDS
Cash, Received: I Total COD Order Amount to Collect
—_ .Without Standby Charges:
WATERADDED: GAL, YARDS IN DRUM:
WHEN ADDED.
SIGNATURE
CURB LINE CROSSED AT OWNER'SIAGENTS 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, lfwater is added on Job, concrete strength
Company assumes no responsibility for damages inside curb or property line. Customer agrees to the is no longer guaiaateetl. WARNII{G: Pfaduct may cause 51un and/or eye imitation. CAUTION: Material
terms of sale and delivery and accepts concrete as is Due to important factors which are out of our may be/h N s o your saf} and alth. Please refer to the backside of this ticket for Important
control after delivery, this Company. will not accept any responsibility for the finished results. Nocreddfor safe nadtljif'ig'Igfomiarlon,aq�(o the,@atenal safety data sheets for additional information.
returned concrete. Buyers exceptions and claims shall be deemed waived, nless made to us in writing Al; NO
within one business day after the receipt of materials n
66UNIVERSAL
CUSTOMER
This Delivery Ticket incorporates her ry reference Buyer's previously execute edit Application, if any, Seller's Standard'
Terms and Conditions, Seller's Quota if any, and Seller's Order Confirmation uding 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 / 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, gravel, and
other siliceous materials. These products, including fly ash, may contain more than 0.025% crystalline silica.
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
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
f 02/12 For more information please visit www.cemexusa.com. i
I
- E —'ti 'et de entrega incluye Como referencia al comprador (ya previamente ejecutada en su aplicaci6n de cr¢dito) cualquier r
terniino estAndar, condiciones del vendedor, propuestas del vendedor y orden de confirmaci6n del vendedor (con limitations y A i",>
4�.��gar�og�nffas), come, acuerdo total del ticket de entrega ("Contrato"). El vendedor proveerd los terminos estandares y condiciones detal- '
dos en caso de asfser requeridos. Con este documento, el comprador acepta Los mismos ya antes mencionados y que Las cantidades ,i
y materiales fueron entregados Como se expresa en el mismo. Acepta pagarel monto de acuerdo al contaato; al menos que se identi-
fique con una nota 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 volednica, arena, grava y otros
materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albanileria, pozzolan (tipo IP), azulejo de
azotea y estuco. Los productos de concreto incluyen cemento Portland y productos de agregados como piedra caliza, dolomita,
granito, rota voleanica, arena, grava, y otrosmateriales silicios. Estos productos incluyen cenizas volantes (fly ash) la cual 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
reactions al6rgicas en la piel. Concreto seco y polvo de agregados, pueden causar irritaci6n en Los ojos, piel y/o en
In zona respiratoria. Polvo del manejo en el trituranuento, pulido, cone y/o perforaci6n puede contener materiales
silicos, los cuales pueden causar silicosis pulmonar y caancer 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.
La humedad puede causar ]a liberaci6n del amoniaco. La inhalaci6n del amoniaco puede causar toser, irritation o
Seguridad:
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 piel. Use guantes, protecci6n en Los ojos y ropa
Primeros adecuada para protecci6n. Lavese las mans con jab6n suave y agua despues del manejo de materiales. Evite 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 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 atenei6n m6dica inmediatamente si la irritaci6n continua.
CEMEX, Memorial Hermann Tower
929 Gessner, Suite 1900
V7 combinado Houston, Texas 77024
02/12 Para mas informaci6n visita www.ce
il;,H4
1�49
57623869
'II camax
v
�Ptant:
_ __ Begin Loading_
To Job:
Arrive:Job:
Start.Unload:_I
inish Unload:_
- Leave Job,__,
Return Plant
Customer Cade: Customer Name:
: ! -t: Sh C:HARLES CPOOKS
r Project Code: Project Name:
n n.n I}I Ticket Date: Delivery Address:
IS T(I.I 't;'c��,'CJ —00 i 0i•1t4F_RCIRL CIR. FT P111RCE
6elwery Instmc5ons:
PRO OFF KINC39 1410Y
Customer Job Number.'
Project P.O. Number
Order Code / Dale:
1065 iWOE/ 15
Order P.O. Number:
Map
Page: .Map/Raw/Column:
Dispatcher:
r,lf-nv9il.o
Ticket Number.
Due On Jab:
Slump:
Truck Number
Driver Number.
Driver Name:
End Use:
5 ptj 1DOc5
�,();:; i09c5i)
FLLRICI-i
JERRI—LifiR4'
UNASSIGNED
LOAD CUMULATIVE ORDERED MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT
QUANTITY QUANTITY QUANTITY
..), flu "tJ, Ut-1 cU. U, 1'_J1' 1: �:if'Al I%.Ir li t;ir!Y.•t:K hIUNU—I-3H 1'Uc:
Gt L�`r.'E3t F-'JEt 81J'tCf-t4tzr;S
?V 2c'ft'?•' ". CNN I RONPi ENTAL CHARGE'
Cash Check #/Auth Code: Signature of Driver Receiving Cash: Cash Received:
Check
Charge
f rComments: f
C ONCRE;TE DrSPOSAL. FEC
I PR TTfII- -- -- FULL. LOAD _ YARDS
Total COD Order Amount to Collect
Without Standby Charges:
t.
IN DRUM
ADDED.
�s (" — v - I SIGNATURE
CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST:
SIGNATURE
❑ LOAD WAS TESTED BY: I '
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
1 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
i 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 adtlitional information:
returned! concrete. Buyers exceptions and daims shall be deemed waived unless made to us in writing AUTHORIZED SIGNATURE:
I wilhin one business day after the rec.iot.f materials_.. _ _ _ _ _
i
68UNIVERSAL INVOICE
This Delivery Ticket incorporates herein by reference Buyer's previously executed_ Credit Application, if any, Seller's Standard
Terms and Conditions, Seller's Quotati f any, and Seller's Order Confirmation ( iding limitations of warranties), as if fully
set forth on this Delivery Ticket ("Agre nt"). Seller will provide the Standard Ter nd Conditions upon request. Buyer agrees s
that, unless otherwise noted on the front hereof, all quantities and items were delivered as indicated and further expressly agrees to I �,
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 a .,
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.
Hazards: Freshly mixed wet cement and/or fly ash can cause eye irritation, skin and eye _burns and allergic, skin.reactions. _�--
-- — 'Dry=doncrete-and`aggregate`dust may cause iiriCation _fo eyes, skin, en spiratory 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 j
or bums 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 ypl
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 1IIOSH-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
02/12 For more information please visit www.cemexusa.com.
Este ticket de entrega incluye come, referencia al comprador (ya previamente ejecutada en su aplicaci6n de cr6dito); cualquier {
termino estdndar, condiciones del vendedor, propuestas del vendedor y orden de confirmaci6n del vendedor (con limitaciones y
garantfas), come, acuerdo total del ticket de entrega ("Contrato"). El vendedor proveerd los t6rminos-estdndares 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.
/ YKUUUU I'UJ 1)h UUINUKKY0 / UJr NIZA,
Los productos de agregados son materiales naturales como piedra caliza, dolomita, granito, roca volcdnica, arena, grava 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, roca volcanica, arena, grava, y otros materiales silicios. Estos productos incluyen cenizas volantes (fly ash) In cual puede
contener mas de 0.025% de silicio cristalino.
Peligros: Mezcla de cemento fresco y/o cenizas volantes pueden causar initaci6n en los ojos, quemaduras en piel y ojos, y
reacciones al€rgicas en la piel. 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, cone y/o perforacion puede contener materiales
silicos, los cuales pueden causar silicosis pulmonar y edncer 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 ]a liberaci6n,del amoniaco. La inhalaci6n del amoniaco puede causar toner, 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 piel. Use guantes, protecci6n en los ojos y ropa
Primeros adecuada para protecci6n. Ldvese las manos con jab6n suave y agua despues 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 Ins ojos, inmediatamente fluya agua en la pane afectada por 15 minutos.
Si se inhala polvo, exp6ngase a afire fresco. Si el cemento fresco tiene contacto con sus ojos, ]dvelos a fondo con
agua. Acuda a atenci6n medica inmediatamente si la irrtaci6n contimia.
CEMEX, Memorial Hermann Tower
929 Gessner, Suite 1900
V7 cornbinado Houston, Texas 77024
02/12 Para mds informacion visita www.cemexusa.corn.
P 144
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IX B
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zzcC-mcx
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Ir
57823869,
t,°r"�"Plant'""Begm
L"oadln'g,y
r4'-To�`Jtib�,,,;
Arrive Job,uti,.,t�Sfart
Unload e"",€Flms�i`'Unload
uLeave Job °°
Return Plant;-
C
Customer Code:
Customer Name:
i lrz ta9
CHRRI—ES CROOKS
Project Code;
Project Name:
Ticket Date::
Delivery Address:
3.0/06;15
7300 C17IMMERCIAk_ GIR.r PT PIERCE
Delivery lQructions:
PRf C,'SUrE
PRO OFF `r<INGS 11WY
:Customer Job Number. Order Lode I Date:
Jt1Ea W Ol9
Project P.O. Number. Order P.O. Number, ,
Mapp
Page: Map/ROW/Column
272 272880;c 3
Dispatcher.
i[jJ D't: 0 t,
Ycke[Number330792,59
Due On Job:
Slump:-
Truck Number.
Driver Number.
Driver Name:
End User.
.5`s
5a0G
Ti
t±F3
092,50 FL.LRIC-i
.JEAN—MARY
UNASSIGNED
LOAD CUMULATIVE I ORDERED MATERIAL CODE PRODUCTION DESCRIPTION 'UOM UNIT PRICE AMOUNT
.QUANTITY QUANTITY QUANTITY -
tV.-iy C-U.()V - CV. L'1 iit51`:bt "'Ui,1V fl=u-U/ 1.Yt.K P0.JIV U "f'1 b , ,-,
Codec_.
'Comments;
a ';'ZY• .;'. FUEL. £:URCHARGF
',-:02'7=E9 f=r1'JIRONR'04TAL C;-IARCE
Cash Received:
YARDS IN DRUM:
WHEN. ADDED.
Amount to Collect
Charges:
SIGNATURE
IDPJCRC-.7F. GLSF'.C3 ill, FEL; JCURRBLINECROSSEDATOWNER'S/AGENT'SREQUEST:
_�_ r-irlRTrr�I_ •_-_ _ FULLLL7aD _ v�rRDG
SIGNATURE
❑ LOAD WAS TESTED BY:
Notice: Our drivers will make every effort to. place nationals where the customer designates,'. but the SPECIAL TERMS:, Any water added is at customers own risk. Ifwater is added on job, concrete strength
Company assumes no responsibility for damages insidecurb or property line. Customer agrees to the is no longer guaranteed. WARNING: Product may cause stun and/or eye irritation. CAUTION: Matedai
terms of sale and delivery and accepts concrete as is. Due to important factors which are out of our maybe 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 me material safety data sheets for additional information.
retuned concrete. Buyers exceptions and claims shall be deemed waived unless made to us in writing AUTHORIZED SIGNATURE:
within one business day after the reegi t t matenela.. r Y " 1, C _s - I ,v
P<i e , �,ii 1l1. �., O LOAD ','UM,, ,-
68UNIVERSAL
i
CUSTOMER
This Delivery Ticket incorporates herein by reference Buyer's previously executed Credit Application, if any, Seller's Standard
Terms and Conditions, Seller's Quotal if any, and Seller's Order Confirmation uding limitations of warranties), as if fully
set forth on this Delivery Ticket ("AgrL.___ nt" ). Seller will provide the Standard Te 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. .J
/ 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, gravel, and
other siliceous materials. These products, including fly ash, may contain more than 0.025% crystalline silica.
---Dry concrete an -aggregate 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
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
02/12 For more information please visit www.cemexusa.com.
hi
Este ticket de entrega incluye Como referencia af comprador (ya previamente ejecutada en su aplicaci6n de cr6dito); cualquier
t6rmino estandar, condiciones del vendedor, propuestas del vendedor y orden de confirmaci6n del vendedor (con limitations y 1
garantfas), Como acuerdo total del ticket de entrega ("Contrato"). El vendedor proveerd los t6rminos estindares 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 contaato; al menos que se identi-
fique con una nota al frente de este documento.
UUINUKE10 / UJEINIZAS VULAINTES
Los productos de agregados son materiales naturales como piedra caliza, dolomita, granito, rota volcdnica, arena, grava y otros
materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albaf ileria, pozzolan (tipo IP), azulejo de
azotea y estuco. Los productos de concreto incluyen cemento Portland y productos de agregados como piedra caliza, dolomita,
granito, rota volcdnica, arena, grava, y otros materiales silicios. Estos productos incluyen cenizas volantes (fly ash) ]a cual puede
contener mas de 0.025% de silicio cristalino.
Peligros: Mezela de cemento fresco y/o cenizas volantes pueden causar irritaci6n en los Ojos, quemaduras en piel y ojos, y
reacciones al6rgicas en la pies. Conereto seco y polvo de agregados, pueden causar irritaci6n en los ojos; piel y/o en
In zona respiratoria. Polvo del manejo en el trimramiento, pulido, cone y/o perforaci6n puede contener materiales
silicos, los cuales pueden causar silicosis puhnonar 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, irritaci6n o
quemaduras en la nariz, garganta y pulmones. Acudir inmediatamente a] medico. El riesgo en la salud depende, en
la duracir5n 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 mans con jab6n suave y agua despues del mauejo de materiales-E_vite 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 pane afectada por 15 minutos.
Si se inhala polvo, exp6ngase a aire fresco. Si el cemento fresco tiene contacto con sus ojos, ]dvelos a fondo con
agua. Acuda a atenci6n m6dica inmediatamente si In irritaci6n continua.
CEMEX, Memorial Hermann Tower
929 Gessner, Suite 1900
V7combinado Houston, Texas 77024
02/12 Para mas informaci6n visita www.cemexusa.com.
,q '�,Nt
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57823872
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Eu�ty�JLeave
t
Customer Code: Customer Name:
3150549 CHARLES CROOKS
Project. Code:. Project Name:
Ticket Data: DeliveryAddress:
10/06/15 7300 COMMERICIAL CIR. FT FIERCE
Delivery Instructions:
PRESSURL PRO OFF DINGS HWY
Customer Job Number.Order Code / Date:
Project P.O. Number: 1 Order P.O. Number.
BA
Map Page: Map/Row/Column:.
272 27268023
'Dispatcher.
'ao�r e-IIU
Ticket Number.
33979516
Due On Job:
Slump:
Truck Number:
Driver Number.
Driver Name:
End Use:
).:.49
5.O0 1U025153
109294
CYRONE
WILFORD
UNASSIGNED
LOAD CUMUOULATIVE ORDERED MATERIAL CODE PRODUCTION DESCRIPTION UOM UUNITPRICE AMOUNT
QUANTITY ANTRV QUANTITY
t0.00 30, 00 30.06 1181967 3000 REG W/17I13E:R MONO —FIB YD3
'r 1
OC1 f, >'+781i_• FUEL SURCHARGE
t,ft^ S?02749 ENVIRONMENTAL CHARGE
I Cash =—Check L6uVh Cade_ (Signatureof Driver Receiving. Cash: I Cash Received: I Total
COD Order
Standby AmountChargeto Collect
1...__,. __ __ __ _
m Comments:
YARDS IN DRUM:
WHEN ADDED.
SIGNATURE,
ONCRETE DISPOSAL FEE_ �CURBLINE CROSSED AT OWNER'S/AGENTSREQUEST:
PA'3TIRL FULL. (_DAD YARDS
N'� y SIGNATURE
r
❑ 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. lfwater is added vnjob:,concrete strengl
Company assumes no responsibility for damages inside curb or propertyline. Customer agrees to the is no longer guaranteed. WARNING: Product may rouse skin and/or eye knhfi1oe:.�CAUTION: Mated
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 4he backside of ibis ticket for Importer
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 inwriting AUTHORIZED SIGNATURE:
within one business day after the receipt of materials. (vl
68UNIVERSAL
INVOICE
This Delivery Ticket incorporates herein by reference Buyer's previously execs Credit Application, if any, Seller's Standard
Terms and Conditions, Seller's Quon, if any, and Seller's Order Confirmatic eluding limitations of warranties), as if fully
set forth on this Delivery Ticket ("A"ruement"). Seller will provide the Standard'r erms and Conditions upon request. Buyer agrees ".• t
that, unless otherwise noted on the front hereof, all quantities and items were delivered as indicated and further expressly agrees to i J
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, gravel, 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
ury-concrete-and-aggregate-dust may —cause irritation to eyes, skin, and/or respiratory tract. Dust from handling, ! u ;
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
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
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 credito); cualquier
termino 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"). El vendedor proveer6 los terminos estandares y condiciones detal-
lidos 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.
/ PRODUCTOS DE CONCRETO / CENIZAS
Los productos de agregados son materiales naturales como piedra caliza, dolomita, granito, roca volcanica, arena, grava y otros
materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albaffilerfa, 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 volcanica, arena, grava, y otros materiales silicios. Estos productos incluyen cenizas volantes (fly ash) la coal puede
contener m6s 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, pulido, corte y/o perforaci6n puede contener materiales
silicos, los cuales pueden causar silicosis pulmonar y cancer si son inhalados. En caso de set ingeridos, mantenerse
en temperatura calida, reposar y tomar grander 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, 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 piel. Use guantes, protecci6n en Jos ojos y ropa
Primeros adecuada para protecci6n. L6vese las manor con jab6n suave y agua despues del manejo de materiales. Evite inhalar
auxilios: polvos. Si se expone a polvos mds de los linutes 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 cernento fresco tiene contacto con sus ojos, lavelos a fondo con
agua. Acuda a atenci6n m6dica inmediatamente si la irritaci6n continua.
CEMEX, Memorial Hermann Tower
929 Gessner, Suite 1900
V7 combinado Houston, Texas 77024
02/12 Para m6s informaci6n visita www.cei
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Customer Code:
Customer Name:
501 -1,
CHARLE.S C,R00e _
'Project Code:
Project Name:. -
Ticket Date;
Delivery Address:
i 1/t C; ; 5
7: r•)Ct C:OVINERCIAL Ct R. FT FIERCE
Delivery Instructions.
P>REFF;—I iRE:
PRO OFF '.INIGS H4J
Customer. Job Number,
Protect P.O. Number:
Order Code / Date:
Order P.O.. Number.
RA
Map. Pager Map/Rcw/Column:
272 272 88CIE'
Dispatcher..
ta.jr::o'�e 11E7
Ticket Number.
,'.39 7 95 18
Due On Jp6'.
Slump:
Truck Number:,
Driver Number.
Driver Name:
End Use:.
_I:0
5754 10921./'
TYRONE
14ILFORD
UNAGSIF3NED
LOAD
QUANTITY
CUMULATIVE
QUANTITY
ORDERED
QUANTITY
MATERIAL CODE
PRODUCTION DESCRIPTION
DOM.
UNIT PRICE
AMOUNT
{-J. 00
^. ljl� 30. rJo i ; Fil olrJ
3000
` EG : W/F Tt:F'R MDt`!G'-F7'ly. YT73 -
I
-
i
;ash Check If/Auth Code:. Signature of Driver Receiving Cash:
— — Without Standby Charges:.
GAL YARDS IN DRUM:
�• WHEN ADDED
SIGNATURE
CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST:
OLOAD WAS 'TESTED BY:
Noticei'. 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. Ifwater 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 cretlit for safety handling information. and to the material safety data sheets for additional informatiom
returned concrete. Buyers exceptions and daims shall be deemed waived unless mado to us in writing AUTHORIZED SIGNATURE;
within one business day after the receipt of materials.
Pads
i
68UNIVERSAL
CUSTOMER
1 4
This Delivery Ticket incorporates herein by reference Buyer's previously exec Credit Application, if any, Seller's Standard
Terms and Conditions, Seller's Qu( in, if any, and Seller's Order Con6rmati, icluding limitations of warranties), as if fully
set forth on this Delivery Ticket ("As...,ment"). Seller will provide the Standard 1 erms 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.
TE / 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, gravel, and
other siliceous materials. These products, including fly ash, may contain more than 0.025% crystalline silica.
mixed wet
ash can
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
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
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 credito); cualquier
termino estandar, conditions del vendedor, propuestas del vendedor y orden de confirmaei6n del vendedor (con limitaciones y
garantfas), como acuerdo total del ticket de entrega ("Contrato"). El vendedor proveeNd Los terminos estdndare's y conditions detal-
lados en caso de asf ser requeridos. Con este documento, el comprador aceptalos mismos ya antes mencionados y que Las cantidades
y materiales fueron entregados como se expresa en el rnismo. Acepta pagar el monto de acuerdo al contacto; al menos que se identi-
fique con una nota al frente de este documento. '
DE
Los productos de agregados son materiales naturales como piedra caliza, dolomta, granito, roca volcanica, arena, Brava'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 caliza, dolomita,'
granito, roca volcanica, arena, Brava, y otros materiales siLicios. Estos productos incluyen cenizas volantes (fly ash) la cual puede
contener mas de'0.025% de silicio cristalino.
Peligros: Mezela de cemento fresco y/o cenizas volantes pueden causar initaci6n en Los ojos. quemaduras en piel y ojos, y
reacciones alergicas en la piel. Concreto seco y polvo de agregados, pueden causar irritati6n en Los ojos, piel y/o en
la zona respiratoria. Polvo del manejo en el trituramiento, pulido, torte y/o perforaci6n puede contener materiales
silicos, Los cuales pueden causar silicosis pulmonar y cancer si son inhalados. En caso d'e ser ingeridos, mantenerse
en temperatura calida, reposar y tomar grandes cantidades de agua. Las:cenizas volantes pueden contener amoniaco.
La humedad puede causar la liberaci6n del amoniaco. La inhalaci6n del amoniaco puede causar toner, irritaci6n o
Seguridad
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 piel. Use guantes, protecci6n en los ojos y ropa
Primeros adecuada para. protecci6n. Ldveselas mans con.jab6n suave y agua despues del manejo de materiales. Evite inhalar
auxilios: polvos. Si se expone a polvos mas de Los linutes 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, exp¢ngase a aire.fresco. Si el cemento fresco tiene contacto con sus ojos, ldvelos a fondo con
agua. Acuda a atenci6n medica inmediatamente si la irritaci6ncontinua.
CEMEX. Me,riorial Hermann Tower
929 Gessner, Suite 1900 Q
V7 combinado Houston, Texas 77024
02/12 Para mas informacion visita www.cemexusa.com.
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