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WORK ORDER
l PLC Concrete Pum mpg3ervice Inc. P.O. Box 476, Ft. Lauderdale, Florida 33302 1�®^Work Order Date: No. a.r ��n/, _ r j C a I M 1s A Ft. Lauderdale (954) 731-6679 - Fax (954) 731-2193 BILL ADDRESS:'" SCANlC p .. SITE ADDRESS: i< Cj�JIs B St. Lucieunty O(ZPD0 T 1 , .ABOUT THE.JO OPERATOR C LETES IF BLANK) - "'U I SIZE SIZE REQS ,EMPLOYEE(S) - LOT READY -MIX-.- . r I U TYPE EST YARDS rA M' �r PO NUMBER THE TERMS AND CONDITIONS GOVERNING THIS RENTAL AS DESCRIBED ON THIS PAGE AND ON THE REVERSE SIDE ARE UNDERSTOOD AND AGREED TO. THE INDIVIDUAL SIGNING HAS BEEN GIVEN AUTHORITY TO EXECUTE THIS AGREEMENT. CONTRACTOR TO SUPPLY A QUALIFIED PLACEMENT CREW. AM Authorized Signature: Date / Time PM To be signed prior to start of work - SAFETY NOTE: ( ) POWER LINE ( ..) GROUND CONDITIONS ( ) OTHER ( ) '* IF IT'S DANGEROUS, DON'T DO IT! ADVISE THE OFFICE OF THE PROBLEM!** I'READINGS(OPERATOR COMPLETES) - - - - - TIME OF DAY - _ - FROM: GAUGES' - QUANTITIES .' Pump Hours Arrive Job: CA) 0LD Start Job Out: _ Prime: ' In: - Yards: �O Truck Miles (Hub) Pumped Finish jC� Job: Arrive Yrd: Out: In: Systems: ACTUAL CHARGES (OFFICECOMPLETES) Job Hours: Pump Hours: L Billed Hours: Trk Miles: ADDITIONAL -LABOR HOURS WORKED ,. JOB SUMMARY Empl ID Start End Hours Total Hours: — @ Total Yards : @ _ Job Code Type Explanation Mobilizations: � _ @ Prime: @ _ Other: @ _ @ _ DIRECTIONS: SYSTEM: REQUESTED: _ COMMENTS: PARTIES AGREE AS FOLLOWS: CONTRACTOR HEREBY LEASES FROM CONG M PUMP COMPANY, AT THE 5 HEREIN STATED, 'E BELOW TEO PER PROPERTY TOGETIER V CONNECTIONTHEREJ ("EGUIPMENT')ATTHE'NU INSURABLEVKUE.- CONCRETE PUMP COMPANY IE'AS 00 OR WON. ON Tj$E�jadB PugsuaNr To F.S.A. §440.1 a-4 THE ABOVE WORK VERIFIED TO BE CORRECT. CONTRACTOR CERTIFIES THATTHER PV .B �ACcIo �?s INVOLVINGANY OFTHE LEASED ' The above times and quantities are verified correct by: / l E ��L Date: // COMCIZETE "Thank you - We appreciate your business Materials for Life` - TORT TIERCE Rhl 4199 SELVIT2 ROAD Ticket no. 1f ; grmflcrete .TORT PIERCE, FL 33982 - 2B514B 10122/201B 622 1427' r ACKER', .DQU-, ' :- _ Delivery date,�DC1127 .Plant R K �`i't`VIS CONSJ°{,MTION Cry .. -: `1 -' �. Truck size Type job ' Customer n47122I Customer name 76317 Zone ITax 17 AM f Tarmac proleVt+ -12 CST LUCI(#Cu��(s6-Q�no. Order no. - code t-Charge delivered gc.O.D. Time due � 2K00 INDEISTR: AL AVE 3RD: ITerms (2-Charge M.S. 4C.O.D-F.O.B. Delivery namFaTid a` IN5RCE Lot - .Block CounTy AIRPORT** *OXEECHOf1EE RD E TO 25TH ST, N TO INDUS TRIAL" AL E 3 TL 5.00 Instructions - i } Slump 1'..I .l E - • a IY �1 r 0-1 i ;Quantt . o;". - x „• : • - :_� , ocl; : ci' sr..�- .-.._— d .. U/M W it•price Amount - H l .� jLoad i. Cumulative~.. �, Qrdered 1. EndeB DtescriptRJEL S3JRCHG L .06 . ! 1."0 1:1 If,) 13" 4 ENVIRON SURCHG I U bk VA eV+X Load 1 Amivejob site Start discharge Finish discharge leavejob site Arrive plant i Subtotal I Sales tax 1 ' TOTAL A additional water added to this concrete will reduce its strength. Any water added is at customer's risk.. Gallons of water added:_ Gallons of water added: _ Gallons of water added: _ Amt of CY Retained: I Customer Approval:✓ Customer Approval: Customer Approval: Customer Approval: .Tested Tested properly No. C�w1 (� �1 Authorized and received by Yes ❑ No ❑ Yes ❑ No 11 y_ !] S Ir 1 s 4' 9:8 I X l Safety is a constant state of mind, with every employee feeling responsible and empowered to act to cause him and others to work safely, on the belief that all accidents are preventable and , that zero incidents is the onlygoal. Lot: Block: Address: Correct Not Correct (-'ISTOMER.COPY. TITAN _�/ COIVCBtETE Materials for Life' grncrete "Thank you'- M appreciate your business I ' '. FORT -PIERCE RM - 4199SELVITZ ROAD FORT, PIERCE, . FL- 33982 ��OUI LD11•2, V C Ticket no. 285149- Delivery date I Plant ITruck Driver Truck size T70e' 7 IOl22l202Q 628 146.3 I HATCHER JR:. 1y FLATW ustomer no. -. _. ., - Customer name,_.: .; - •, .' - Zone - _ Tax CD IC 900t11?9 II R P DAVIS CDHSTRUCTZ N C I Tarmac project �n�-o 2 I Customer. P.D.no. Order no. y Terms code t Charge delivered a-C.0 D.. - Time due', [ y� 7 ../��1� ., I I2 Charge E0.B. G{D.D -FO.B: 3_ 31 AM! Delivery namg,,.�dladdrgfs�, LUC•.IE COUNTY r. Lot' ' Block .. ) County �JJ FFSS ''JJ" ii 2600,1NDDSTRIAL 'AVE 3RD. r " FT,' PII=RCE" ^t Instructions 7 ,.. t. LA :.! TL , I .Slump ( ICluan lty 11 Product umn; Unrt rice' Amount Load cumulative Ordered{ Code ; Description _ 11 22.0 360.1 0 V 2. 1,."1 10 41OHM 'Z ., FUEL: 't b !! 1• O ` 8040; 4.. EAiifMM SURCHG �k Q. ' o ' L V (Load • ' 'Arrive job site ,, Start discharge `:- Flnish-discharge . ' Leave joti site '- Arrive plant •� - I S Subtotal y� • Sales fax r; ,' _ - - TOTAL • i 7••u.uvu01 vvaanr-auuqu LR [nr5, concrete Will reauce•its strengti. Any water added is at.customer's risk.. • - - i Gallons of water adtled:. Gallons of water added: _ Gallons of water added: - •-I Amt of CY Retained: • I Customer Approval: • customer Approval: Customer, Customer. Approval: Tested Tested properly No_ Authorized and received by _• _ i Yes No Q Yes, Q No I ., ti +. •,C�3 CJl I X L - I ' Lot: 1 Safety.is a constant state of mind, with j every employee feeling,responsible Block: and empowered to act to cause him " Address: Correct . Not Correct and others to work safely,on the belief that all accidents are preventable and ' that zero incidents is the only goal.. , CUSTOMER COPY . _ _ TITAN -; �®NCRETE , Materials for Life' gWncretlit "Thank you We appreciate your business' FORT PI€RCE RH 4199 'SELVITZ'ROAD FORT PIERCE, FL 33982 ��gUILprNp o I MfMeEP Ticket no. .Delivery date Plant Truck DTruck size Type job 10/22l2010 625- Y424- .I.river I MOHR, JEFF YY FLATrd Customer no. Customer name Zone Tax CD 9000127 I R K DAVIS CONSTRUCTION C 1 Tarmac prof no. Customer P.O. no. Order no. (Terms code t-Charge delivered 3-C.O.D. Time due I L �+�IY22Y I 76317 3: 34 AM ' 2-Charge F.O.B. 4C.0.1)-f.0.13.. Delivery namtJydTaddre T LUCIE COUNTY Lot BlockXcounty I 2604 IERDl1STRItiL AV€ 3f{D FT PIEF2C€--- � Instructions Hi 1- , tt L 3 b , 1 t ifi .y slump II TL 5 . CC (,Quantity. �-•. ,� rv� �I Product -W -,-—T-------�—}—. ; UiM, Unit Price '$ -Amount Load, Cumulative Ordered Code Descrip{ion 11.00 33.C? 360.1)0 CAJ , R30 4 !'Y i Oo '' 3. 0 3 Y. 9 7 L SLIRCHG ID Y. 60 3. C j 1. 1300014EN IRON SURCHIS ID ,'\_ iLst il>♦ l.ti� IGI � ' )10J %T 22.FI.ui,"7 i L 3 FOi I PIE RCE Rid l Load ,Arrive jobsite start discharge Finish discharge Leave job site Arrive plant C J� - Subtotal II . t Sales tax 11 \dditional'water added to this concrete will reduce its strength. Any water added is at customer's risk. Gallons of water added:_ Gallons of water added: _ Gallons of wateradded: _ Amt of CY Retained: I- Customer Approval: Customer Approval: Customer App'cval:- Customer Approval: Tested Tested properly No. _ Aut and recei/ve)d b I nze Yes ❑ No ❑Yes ❑ No ((''qq ] ,�} (� 14} !. m.+ 4.9 �i 1 x Safety is a constant state of mind, with every,employee feeling responsible - and empowered to act to cause him and others to work safely, on the belief that all accidents are preventable and that zero incidents is the only goal. r 1 - Lot: TO !, Address: Correll Not Correct (" ISTOMER COPY L COSVCRE�E ' "Thank you We appreciate your; business"- -• - �' -" Materials for Life°"'°"`' M. - Ticket no.. g cete .��T g A •p. 1 b, n Delivery date 11Plant IT,uck Dnverx' x, r b of Truck size Type io 10/22/2012 626 1364 I GILCHRIST, ., :li F�FaTf ICustomer no. Customer name ^ ZT one - '! ' V000.Y2y I ,.. ,R K DAVIT CDNSax CDTRUCTIDN C : n Tarmar'projeR no , 492 21 n . - Customer P.O. no. I I order no.'b3 - I Terms code 11 Charge delivered 3 C O.o. ,3 Charge F.O.B.' 4C0.0 -F.O.S. Time due i 3: t4 AM I .Delivery namg_a6?,Vrgys, L11CIE CtioJNYY � � � - � Lot •' $lock, County } 2€00-_INDU§TRIAL AVE 3RD { FT PIERCc;. Instructions - .t *[�•"F z=L j - i.. r P _ -, H t; e' Slump i TL a • i I [ Produ� ct.; #, — w� ^. ° I Umt Unit p�lce } Amount�1 - 7 Load - Cumulative, Ordered Code Descrip ion - 21..00 44.6 3b0. 0 CA.? R 4 fiJ Y 1. 00' 4 0 1. 7 " . FUEL SURCHG I D L.00 :0 1. 0 8000 4' ENVIRDN-SLiRCHG 1 D .I ! _ I l0021 G 1'.;]I_T �� ' F!iit%.;.L7 FO PIERCE RM Load Arrive job site Start discharge, -Finish discharge Leave job site - Arrive plant i i - �' AM TOTAL yuumonai wafer aaaea to tmsconcrete wilt reduce its strength. Any water added is at customer's risk. 'Gallons of water adde - Gallons of water added: _ Gallons of water added: _ I Amt of CY Retained: Tested Tested properly No. thorized and r ceived by- ' ❑ Yes ❑ . ❑ Yes ❑ No I r' y� 15,5 ` 1 x\ i ' Lot: Safety is'a constant -state of mind, with every employee feeling responsible'' _ Block: and empowered to act to cause him.Address: Correll Not correct and others to work safely; on the belief that all accidents are preventable and that zero incidents is the oNy goal: A A f, A A Q' - . . ra ICTr1MFR C(1Pv ." —. r ;Ile Z TITAN // C®NCRETE Materials for Life' "Thank you - We appreciate your business" Ticket no. FORT, PIERtE'RM F PL irRC '339i32 205152 Delivery date lPlant Truck bri4er •'•'r Truck size Type Job Y0122l20YD �2f1 YbY4-I "SALTER, LA Y2 FLATW I Customer n�UY2% Icustomernarge DAVIS CONSTRUCTION C zone Tax CD K (i I Tarmac proj cS.no �y I Customer P.O. no. Order no. Terms cod' Z Char a delivered 3-C.D.D. Time due i �a �� 9 3:57 At1l A` , Charge F.O.B. 4GO.p -F.O.B. Delivery nam 2-15 dVT LUCIE COUNTY Lot ,Block County 2b00 INDUSTRIAL AVE 3RD j Ft PIERCE R• p InstruRions ^ - • n -.- -. ..-.Tc.c m c - � ... s . .. f i.:y. .R.. . ir. c_ Slum TL p5.00 r\ ILaadritltyProduct --�� - _ -7—i W Unitprice' 'JAmo L -Cumulative Ordered code Descrlpt�on - iY. 00 55. 0 360.10 CAJ R34 &Y I.Od 5.10) 1-10 800(47 FUEL SURCHIG RD 1.00 5, C) 1.1 iO 900014 ENVIRON SIJRCKG _ t D i r, I i Load Arrive job site Start. discharge Finish discharge .Leave jo65ite Arrive plant j 14d 33M31d I �3 f Z :H l ?Z .1010 c 10Z WOO Subtotal { � : Sales tax TOTAL WOMI duaea w mis concrete will reduce its strengtn. Any water added is at customer's risk. Gallons of water added:_�\Gallons of water added: _ -Gallons of water added: — I Amt of CY Retained: �. rested Tested properly No. C, Autho ied and received by j J Yes LJ No ❑ Yes ❑ No I t.- t� I X••� • i Safety is a constant state of mind, with every employee feeling responsible. and empowered to act to cause him and others to work safely, on the belief that all accidents are preventable and that zero incidents is the only goal. Lot: Block: Address: Correll . f Not Correct, TITAN, • // C®IWCRETE Materials.for Life' grncrete ""Thank.you -We appreciater,your business" Ticket no.. FORT PIERCE •Rht 4199 SEt_VITZ"•R4�`; FORT, PtrL. 3382 ._ 265153 ueuvery Gate 14J22/2018 Plant C.?8 Truck �`" 15.56 Driver H.`ns' µ Ih� ZEILIAISKI,I- Truck Typejob FIATFI Icustomer go,�1.� �I Custome a e Zone'. Tax CD 77 , `�c DAVI9 CONSTRUCTION 'C Tarmac prof; no,�sf �. • • I Customer P.O. no. Order no. Terms code Time due • _ .'*lfyG.l. 'S 1 [{hargedelivered 3CO.D. -4: ".� AM� L, 2{harge F,O.B. 4-C 0 D -fiO.B, - Y f Delivery name j dresS`T LUCIE COUNTY Lot Block County, ! 2600 INDUSTRIAL AVE 3RD FT PIERCE j L. T r ee h ..Instructions - --- TL Slump Load 77 ` 7:Product' ,' • _ � ,- ' + '-' '' �' U/M•' Umt price i �Amodw - i1.40 Cumulative 66.10 Ordered 360. Code .fl W2 E 4 J 5 No 1E4F y l 1.00 6. 0 I. U B000r 7 C SURCHG t D I 1.00 ' 6.0 1-(0- E040 4 ENVIRON. SURCNG t D i f � ,•j .',.. � .. it r5�i i,'af ; • y� J:•. _tip ., Load Arrivejobske Start discharge Finish discharge Leavejob site- Arrive plant I ,�• . �I•. / `/�, G�• (Z IJ Subtotal Sales tax ; ,Y� TOTAL I=UUe = 1. au=nyut. rany water aaaeu Is at customer's risk. 3allons of water acide : allons of water added: Gallons of water added: _ I Amt of CY Retained: =ustomerApprovali Customer Approval• Customer Approval: Customer Appro al ested Tested properly 3 No, I P' I dJ Authorized and receivedby Yes C)NGX ❑Yes ❑ No S� O ✓% Lot:, ' Safety is a constant state of mind,with every employee feeling responsible Block: and empowered to act to cause him. and others to work safely, on the belief Address: Correct Not Correct that all accidents are preventable and that zero incidents is the only goal. � A rl LCTnnAFt] r1nDV -- ,� TITAN • - - .. - - . � :, , �*,� ' CCDNCRETE "Thank you - We appreciate your business" i Materials for Life' Ticket no. g crete 4199 -SEWA' W, r � FDDRx PIERt ti,, F.L 33922 " `` 295154. Delivery date Plant Truck Driver 10/22/2Truck size 11 Type lob FLATW 01B GUEVAREZ, #c8 t591 Customer I n Custome - Zone Tax CD �J4UC)127 i(a `� D{�VIS,CONSTRUCT ION C Tarmac pr010T221 - I Customer RO. no, order-no..7631.ry (Terms code' C. .rge delivered 9-C.o.o.. Time due 4. 15 AP I l 2-Charge F.O.B. 4-C O.D-E0.8. i Delivery namLA5dJ.,drST LUCIE COUNTY - I.ot Block ,county 26n0 INDUSTRIAL AVE 3RD FT PIERCE r1rt. Jr 1is' P1 B r nK E Ii ro r TR17'�61 T, A f R I — - — __ -- - _ Instructions L` '-"-" ` — -" Islump r i P -_:. tt -°•.. �..-... { otluR - U/Nh, Unitprice ..,...,.:, IAmount.� .Load 1t. 00 Cumulative 77. Ordered h 364. Code GA3 Descriptio RN ' 'sa t •Y I 1.44. 7.Q 1. 7 UEL R HG tD 1.00 7.0 t. M0 2004 4 ENVIRON.SURCHG ID 4 1 ' • II I I (Load Arrive job site Start discharge Finish discharge Leave job site Arrive plant I �/ 1 i Nd 3:383Iai 4, ;Cy{H 71tjl� 7 (;'6�"" Sales tax I TOTAL � 4dditional water aqled to this concrete will reduce its strength. Any water added is at customer's risk. I Gallons of water added: 4,Z Gallons of water added: _ Gallons of water added: _ I Amt of CY Retained: Testetl Tested properly No, C, ,.t Authorized}}<eived LJ Yes LJ No ❑ Yes ❑ No _ U �,' �'.�b.}"t X Safety is a constant state of mind, with i every employee feeling responsible ' and empowered to act to cause him and others to work safely, on the belief that all accidents are preventable and that zero incidents is the only goal. Lot: Block:, Address: Correct r",(� (" ISTOMER COPY_ Not Correct '�YITAN .GOIVCIBE"fE Materials for Life' grancrete "Thank you - We appreciate your business" ' - Ticket no. FORT PIEFICE--Ffl, 4199 SE3 VIT� RflAI�L '" Delivery: date Plant' Truck Dnver " Truck size 1 Type joh 10124l2418. 6�8 Y412 I JOLLY, 7AC; 1 LATb! Customer o Custome a _ Zone, Tax CD �iE f3C7f31E'7 I ._ DAMS CCNST�t?CgIi�N C ' l • Tarmacpro'e o.` . - ' I �Ii2?1, Customer P.O, no. Order no: I Terms code t - _ I 6317 Charge delivered 3 C O D. ,2-Charge EO.B.' 4-C.OA-EO.B," ' rimed 4 -_ '23 AM I i ' - -' - Delivery nam;�5ciaddrJT-'L#1CIE_ COUNTY . • Lot � ' - Block , County, � INDUSTRIAL .AVE RD FT FIERCE,.. •. FT 16 Via- � Instructions s. . �t .r.a.c_L. ._ a ..r c1 vsT . . 1.. ,.. Slump' - + TL 5.40 r'am4Q�ti� - t: lPoduc 7,7770nni-t ' Amount , Load - i1:44 Cumulative BB:O Ordered 36n. Code CAJ Descn tion - R30�E'�`a Y . i. 06 ,B:` 1. t): B? � 7 UEL SURCHG D , i 1.00 ,B.O? 1. D Bow:4i, ENVIR,0N SUIRCHG , p 0005 2 118 Or;t 22 .-m3:5F . EO T pIERCERM lLoacl '- - Arrive job site-. Starfdischarge -'. Finish. discharge' .Leave job site Arrive plant --'• . �'! Subtotal I vaaltional water added to this concrete will reduce its strength. Any water added is it customer's risk. :Gallons of water added:_ Gallons of water added: Gallons of water added: _ Amt of CY Retained: 'Customer Approval: Customer Approval: Customer Approval .Customer Approval: I -Tested . Tested. properly -- No. 11. r�< �.� AuthQ�! ed and received I�,r/� IY I ❑ Yes ❑ No Yes ❑ No :,,1 X P- Safety is a constant state of mind, with 6eryemplayee'feeling responsible - and empowered to act tocause him and bthers,to work safely','on the belief 'that all accidents are preventable and thatzero incidents is the only goal. ' Lot: Block:- : Address: Correct Not'Correct - r:11.CTnMFR r`rlpv CONCRETE Materials for Life' "Thank you We -appreciate, your business" ,.. Ticket no, , gr�t y—p- ERCE RM i , crete 4199-SELVITZ, R9AG mac. FORT vlt�ni' .; -FL 339$? 2225156 Delivery date Plant Truck Diiver .. '-roe., Truck size Type 10t22t202B 628. 1421 I BENS, yp i FLAT17 I Customer1`00Q127 ICustomeRaW DAVIS CONSTRUCTION C zone Tax CD Tarmac piol¢ctfrl at t I Customer P.O. no. order no. �) 317 I Terms code t_Charge delivered 3-C.O.D. rime due r4. `"1, '3 AM I Y S; \. Al 3-Charge FO.B: 4C.O.D •EO.B. 1 Delivery nameodjgclr?3T LUCIE COUNTY Lot Block - County 2600 INDUSTRIAL AVE -FRD I FT PIERCE TOQ a k: skrylr C M t T T TAt 1 Q t 9 `] �I Instructions A -- - " -_ _ _ . _ _ -. .. \ TL Slump 5 OD 1 A 4 WM. Unrt,price, ( Amount Load - Lumulati rdere de tr V ����^'^_-- 11- 0b 4t).. o J60. cad l � 5 Y = 1.00 9.W 1.00 B000 7 FUEL SURCNG 1.00 9. 0 J 1.(10 8004: 4 ENV IRON SURUIG , t .D l 'Load - Arrive job site Start discharge Finish discharge Leaveloli site Arrive plant � 'LI U I Sales tax ! TOTAL � 4dditiorial water dried o this concrete will reduce its strength. Any water added is at customer's risk: j Gallons. of water added _// vv Gallons of water added:._ Gallons of water added: _ I Amt of CY Retained: CustomerApproval: Customer Customer Approval: Customer Approval: 1 Tested Tested properly No, 8r„ 15 �, AuthorizeO 6 Ix d d receivIbp - - I Yes ❑ No ❑Yes ❑ No Safety is a constant state of mind, with every employee feeling responsible _ and empowered to act to cause him and others to work -safely, on the belief that all accidents are preventable and that zero incidents is the only goal. Lot: Block: Address: Correct Not Correct (" IST(�MFR ROPY TITAN - ;�/ CORiCREYE Materials for Life" gr"Crete "Thank you - We appreciate your business" Ft7R7~��• �if1 ' 4199 SEt_VIIi ROAD- FPRT -PIEK, FE: ��OU,ILDr1;C ¢ o N = MfMeE� Ticket no. Delivery date t0/2212018 plant 'Truck G2B i5t,5 Driver `-"�• I .TAMES, CAR Truck Type job' -FLATS Icustomer ni 000� . I CustomeRia a DAVIS CONSTRUCTION C `. zone" ITax CD ITarmacproarc�mqt ,� - • - I Customer P.O.no. - Order no. 7,6317 (Terms code t-Charge delivered a C.O.D. ,={harge Time due 4: 31 AM I - F.O.B. '_4CO.D-F.O.8, - DeliverynamEftc@d,CzT LUCIE COtjNTY -. Lot Block County- { 2600 INDUSTRIAL AVE 3RD FT PIERCE a o *+ vcc n t s_4Ta' a i T ®i a 7 14 -Instructions 3 �. TL. - slump s LQuantlty } I Product i UJM; Unit price Amount ' T'� Load CumulaLO, 0Ordere 6Q. �de Aaa21.00 d2: Y 1.00 10.0 1. 4 20 ? FUEL SURENG I D 1.00 10.0) 1. 00 13000" 4 ENVIRON SURCNG ID I Load Arrive job site Start discharge Finish discharge Leave job site Arrive plant I ' Subtotal _ - Sales tax ' TOTAL +vur uuuas waanr auueu w uns concrete win reauce its strengtn. Any water added isat customer's risk. , Gallons of water added:_ Gallons of water added: Gallons of water added: _ I Amt of CY Retained: Customer Approval: Customer Approval .Customer Approval: Customer Approval: Tested ITested properly I No. 5 I Authorized and received by ❑ Yes No ❑Yes ❑ No "' - `'`s 0 `m' X ' Safety is a constant -state of mind, with every employee feeling responsible and empowered to act to cause him and others to work safely, on the belief that all accidents are preventable and that zero incidents is the only goal. Lot: Block: Address: Correct C;uSTomFR.CQPY Not Correct TITAN C0NCRETE Materials for Life' "Thank you - We appreciate your business" �Yy (Ticket no. t19r SEEM KR g crete 4Z99 SELVI7Z RC1A'- FORT PIEF{CE; 225152 _FL--zl2g _ • .. "� Delivery date I Z4122/20L8 Plant Truck 15D�` Driver RYG�IEY, Cif Srucksize Zl T e ob ELATW Customer r9l1 00127 ICustomegaR DAVIS C0NSTRUCTION C Zone - Tax CD I.Tarmac prof ya2D - Customer P.C. no. Order no. 7♦5317 Terms [ode t{harge delNered 3-C.O.D. _ ' 3-Charge F.O.B- 4C.O.D-EO.B. Time due 4: 30 AM 1 Deliverynam&DDQandr&T LUCIE. COUNTY Lot county I 2600 IRCESTRIAL AVE 3RD JBIock FT PIERCE0T�, PnPTxi+x: nWPFr NnRG[ RD P Tn PSTH qT M T/l TNI)II� TRTA9 AlF Instructions TL -- slump - 5.00 j x - - _ " '_ 'W U/Nli Unitpr•ice '.!rAmountA� Load 11 00 Cumula -vel 0 Yrdered�0 deCAJ . WA O .Y 1.00 1i.0 1.a 0 9004 17 FUEL SURCHG E D 1.00 II. C 1,. O 12100014 EAIVIR0N SURCHG I.D I .'Load Arrivej bsi�e`� I I Start discharge Finishdischarge Leave job site Arrive plant J_ �'W�.r 1j0 $ ijr 9rifril sales tax I TOTAL 4dditional water added to this concrete will reduce its strength. Any water added is at customer's risk. Gallons of water added:_ Gallons of water added: _ Gallons of water added: _ Amt of CY Retained: Customer Approvals Customer Approval: Customer Approval: Customer Approval: t I r Tested - Tested properly P P Y No. yr1� }rq� - r Authorized_ and received by Ix ❑ Yes ❑ No -. ❑-Yes ❑_No._-- -I _ "' �' `+`�' .. I Lot: Safety is a constant state of mind, with - every employee feeling responsible Block: and empowered to act to cause him Address: Correll Not Correll and others to work safely, on the belief I1 that all accidents are preventable and I that zero incidents is the only goal. ; i .� TITAN, C"NCET Materials for Life grncrete . .Thank you - We appreciate'your business". ._ —�.. Ticket no. FORT PIERCE .RM _ 4*199 SELVUZ., FORT .PIERQF.„ FL_ 339R2 295159 Delivery da • Plant b29 Truck 1438 Dnver ' '.DILLARD ^1j"`- ITruck size 41. TYPejob' FLATO O122/20ii3 l V Customer n9+ 60121 I CustomeRarke VAV IS CONSTRUCTION, C � ' -' +; - one:,.,- ., - . Tax CD Tarmac p1oLaigri7221 I Customer RO. no. order no. 'I631T (Terms cc a +-Charge delivered 3-C.O.D. 4 3-Charge F.O.B. 4C O.D -F.O.B.. Time due 4: 58 AN I Delivery nam t-Qdr5--AT LUCIE COUNTY ,.- Lot Block County 2600 INDUSTRIAL AVE 3RD = FT PIERCE A) PRORTT*W*OvccrunPEE RD F Tn P-UP AT 'N Tn MnIIc TRTAI' At F 'i Instructions, TZ - Slump 5 �Product _ I - ° ' " "' '`"` .•d U/M- ICI Unrt pace° '; I _r� 8 Amount Load 11.00 CumulaIive-„' Ordere ��. CodeCAJ ReWp Y' I 1.00 12.0 1'. 0 8000G7 FUEL SURCHG l D 1.00 12.0 -t 0 tO000-4 F-NVIRON SURCHG I D• 00072 1 8 OCT Afe�:3 FOI T ?IERCE Re l f + Lodd Arrive job site Start discharge Finish discharge Leave job site Arriveplant ': ? ] _ Subtotal TOTAL l Additional water added to this concrete will reduce its strength. Any water added is at customer's risk. Gallons of water added:_ Gallons of water: added: _ Gallons of water added: _ Amt of CY Retained: Customer Approval; Customer Approval: Customer Approval: I Customer Approval: _ Tested .Tested properly Authorized and received b ❑ Yes ❑ No ❑ Yes ❑ No I =� ` et X 1 AYA !� - Lot: Safety is a constant state of mind, with every employee feeling responsible Block: _ and empowered to act to cause him Address: Correct. Not Correct and others to work safely, on the belief that all accidents are preventable and that zero incidents is the only goal. 1AA D !- ' ' TITAN p �/ CONCRETE "Thank you VVe_�appreciate,your business" I . Materials for Life'° y I r Ticket no FORT PIERCE, AM j. g, Crete4299 'SELVITZ ROAt.-' FORT-PIERCE'.'SfL° 1306i2 205260 •I Deliveryda 0/22'2018. Plant �g (Truck ZSi3 Driver ; MATTNEWS, Truck size 11 Type job FLATW iCustomerrw1400i29 CustomeRaTe DAVIS-CONSTROCTION C / zone. .... Tax CD . j Tarmacproj$}rtJr - t Customer P.O.'no. Order_no. -7 f 17 T code�C alf"rge ddhvered a C.O.D. Time due 5:'02 AM 7� -- �� -. I - . . .. -. I .. , • �2-Charge F.O.B. 4-CO.D-f.O.B.` : Deliverynarrr-k2El&rrWT LUCIE COUNTY Lot Block 2660 INDUSTRIAL AVE 3RD ..FT -PIERCE ;. - I.Lot 41TRPnRT>k**nkFFr,"0QFF Rr) F TO, 29TH ST, 111 TO TtdC�J-TRTAI Al 3 i Instructions ,Tt- Slump 5.00 [—Quantity,+ 7z �;�" I � Prddud, . \tnv.�,. �, ;�� <<' i U%M, Unit,p�iCe '� Amount , • Load ` L2. 00 cumulain.,., 0 Lin. rdered_60.. d deCA T i t'o Y ` 1. 00 . 0 I. � . +8 7" a- D ; 1.00 13-0 1. ' 8000.4 ENVIRON SURCHIS dD Load ,Arrive job site Start discharge Finish discharge Leave job site Arrive plant �. Subtotal l/1 �� Sales,tax Addi Tonal water added to this concrete will reduce its strength. Any,water added is at customer's risk. iGallons of water added:_ Gallons of water added: — Gallons of water added: _ Amt of CY Retained: I Customer Approval. Customer Approval: Customer Approval Cu pproval: I Tested . • Tested properly No. .3+ Authariz nd received t;y ❑Yes ❑No r.❑Yes- ❑-Nq._ ;yry epyr .l Lot: Safety is a constant.state of mihcl, with every employee feeling responsible Block: and empowered to act to cause.him Address: Correct Not Correct and others to work safely, on the belief that all accidents are preventable and that zero incidents is the only goal.�� - e®Ne��T� I "Thank you We appreciate your business" Materials for Life' 1 Ticket no. crete '� 4199 sELVITX '&AD' FLIRT PIER(, FL 3348 285i6i Delivery tlatea122y20ie plant �2b j Truck t434 Dnver, ADAMS, PR Truck size I t Typejob I CE'TIIt�! ustomer:rfr.E3j�-� `I CustoineT.(lalp , Dr1VIS,'CUt3Sf'S C U .. .., Zone Tax CD I , p le n (Tarmac ro jriv�si :' Customer P.O. no. •` I order 6 i7 code i-Charge delivered 3-C.O.D. Time due 5: 20 AM b' v'. i - �. (Terms '2{harge F.O.B.. 4C.O.Df.0.B. j Delivery nam&jDddadrgcs, T LUCIE COUN I Y. Lot Block , . .County, , 2604 INDUSTRIAL MIE•3RD ; FT. PIERCE '.'T A rlcrinkn F . n c;F n AT A 1. AT V il + Instructions TL'r .14 Slump i-�Produd � a-- w.• ..., -. r-E': €:.^:.—I. UrTA! unit price =: Amount ° ' Load ;ti Cumula l e -0rdere ba £ode_Aj Ae�s�rp LS,t �y'�'*-� r^ �.K,4, Q � d3 - Y 2.00 14.0 1.(0 80 y 'FUEL SUPCHG 1 OCs 14. 3 I. 00 8000' 4 ENVIRON SURCHIG t D Load- - Arrive job site . Startdischarge Finish,dischaige. . ' Leave job site - Ar'rive plant = -- - I —I, �� • Subtotal selestax I - I - I I 111 J Naamonai water added to tuts concrete will reduce its strength. Any water added is at customer's risk. ' Gallons of water added: Gallons of water added: _ Gallons of water added:_ I Amt of CY Retained: - CustomerApprdval:Customer Approval:- Customer Approval: Customer Approval: Tested - Tested properly / No. �, ,� Authorized and received by Q Yes ❑ No ❑ Yes. ❑ No I '� I X Safety is.a constant state of mind with ; every employee:feeling responsible -- Blocks ' and -empowered to act to cause him - and others to work•safelyrpn the belief _ Address: correct ,, Not Correct that all accidents are preventable and ' that zero incidents is the.only goal. _-- _CUSTnMFRr:nPV-- TITAN _�/ CONCf3ETE "Thank you..- We appreciateyourbusiness" Materials for Life' gr creW 99 SELV I T4 -RQAt-- FORT PIERCE, FL 339H2 SUILD,,t,C o U C MFMBE� 285162 1 Delivery datea122`2D.LB plant 6�S Truck 1(�7 Driver ACKER, DOU Truck size Y1 IType job FLATW� LL � I 1� L Customer n°J00(i.12% ICustome filar, DAVIS CONSTRUCTION C zone Tax CD- j ,Tarmac projecT?rio221 * ' I Curtomer P.O. no. Order no.'{ ]-'� I Terms code t-Charge delivered 3-C.O.D. Time due 5 : 23 AN 4 , 2-Charge F.O.B. 4C OA -F.O.B. �Deliverynama'artita driST LUCIE COUNTY Lot Block County 1 ?_600 INDUSTRIAL AVE 3RD FT PIERCE I � A At ATRp(1RT>fr>#*nkrpf;}1npPP Rn r TO 251H ST. N T0-TN"115 RT t r -1 Instructions TL slump 5.00 Y I QuantiTy - ,.,._.-...-,..,...-... .y � Product - . d _.... U/M, ..-..n..,-.-..� Unit price : �Anount�~'� Load _11 00 CumulaSi)SS 0 �ordere�A6D I,CydeGA1 . ,Di-�`+�PtOu c . I Y..I 1. fl0 15. C 1. 80 1.00 15..0 1. TO 8000 tr ENVIRON SURCHG D- II - i _ I i Load Arrive job site •Start discharge Finish discharge Leave job site Arrive plant - — i i I I Subtotal I r Sales tax `� I Additional water added to this concrete will reduce its strength. Any water added is at customer's risk. Gallons of water added:_ Gallons of water added: Gallons of water added: -- I Amt of CY Retained: Customer Approval: Customer Approval: Customer Approval: Customer Approval - ! Tested Tested properly No.. ra I Siv�Q'+12 Authorized and received by I ❑Yes ❑N❑❑ o Yes No X, 4•`�� Safety is a constant state of mind, wyth every employee feeling responsbie clock: and empowered to act to cause/him, Address: correct Not correct and others to work safely, on trhe belief that all accidents are preventable and that zero incidents is the only goal. r r 10 TITAN Materials for Life° "Thank)you - We appreciate your business" g ncrete t_ .4°99:s9LV1zrz�8QAV•' r . FLIRT PIER , ;:L 33982 Delivery dai012212018 Plant622 Ir k 1463. Drive ATC2iER JR a, I Ticket no. - i Truck size J.1 Typejo-,k .SLA TW Customer n4,004I27 ,, .I CustomeRarKp DAVIS CONSTRUCTION C ��% � zone •` � Tak CD i r' Tarmac proi�c lc221 pp •• X- - Customer P.C.no. I, _, ? Order no. 763•Z f- Terms code t-Charge delivered 3{ ,D. I - ,2-Charge FO:B. 4C0D-F.O.B. Time due : 34 Ai'j•i Delivery namR±Tlc1 dr@ssT. LUCIE COUNTY Lot . Block. - County 2600 INDUSTRIAL-AVE 3RD' I ET PIERCE ' Instructions - TL Slump . KJ. 00 i .Quantity . ,.: ,. . i ITrodud-. :.. • a .' t U%M .. r"`..---..-.-.-,..-...� Unit price-j-lAmount .Load .; 11. ()Q t� CumulaLv%�i. r�, ordere'd460, C G &deCA ,Bes r-i.oc,+�p->furS'T - �° • . 1_.00 16.0. . , 1. i 0 R600< 7 FUEL SURCHG.. 1. 00 36.0 1..3 0 -8000] 4 ENVIRON .SURCHG tD !' - I i Load Arrive joh site .Start discharge Finish discharge Leave job site Arrive plant • ! ' • _ Subtotal - �� Sales tax I TOTAL Additional water added to this concrete will reduce its strength. Any water added is at customer's risk. Gallons of water added:_ Gallons of water added: _ Gallons of water added: I Amt of CY Retained: Customer Approval Customer Approval Customer Approval .Customer Approval: Tested Tested properly IJo. Yes -^&No ❑ Yes Q No Safety.is a constant state of mind, with every:employee feeling• responsible., and empowered to act to cause him and others to work safely, on the be that all accidents are preventable and that -zero incidents is the only goal. 8 0151 513 Lot: . Block:' Address: Correct n. 10rr L ¢n r ^M%/ TITAN . // CORICRETE Materials for Life' ' _.."Thank you - We appreciate your business" FORT PIERCE RM 4199 'SELt1I RtM -'• FOFtT_1°L r E _FL 33922 ��gUlLe�nc 2 7 n M£MBEt+ Ticket no. 285164 i 1 Delivery date • Plant Truck Driver - Truck size T FLAT iU122/2018 620 2424 MOHR, IEFF . 11 vpejob Customer n9000127 CustomeRtarge DAVIS CONSTRUCTION C zone - -Tax cD - Tarmacpr-*gn_o22I Customer P.O. no. Order no. 76317 Terms code Time du t{harge delivered 3 C.0.0. �: ,� AM �_ I , 2{harge F.O.B. 4-C.0.0:F.03. 4 Delivery nama'aMre`sa I LULIE COUNTY Lot Block County 2600 INDUSTRIAL AVE 3RD FT PIERCE " I AIRPORT***OKEECHOBEE RD E TO 25TH ST, N TO IN�DU TRIAL AtE .3 Instructions TL slum p 5.00 ' f rQuantity a-. ., '. , :Product -` - =-•• - j U/M, —_ __ Unit price ":` Amount Load 11: 00 CumulajV7 G rdere�jAO deCA.Icl° s Y 1. 00 17.0) 1. 0 00001,7 E GHG E D 1.00 ,I 17.0) 1. 00 9000: 4 ENVIRON SIJRGHG A D 001J.'`IIlQOi,t22i? 5:( FD TlPIERCE RH ; I I Load Arrive job site Start discharge Finish discharge Leave job site Arrive plant C � Subtotal. i . � Sales tax ! 'TOTAL admtional water added to this concrete will reduce its strength. Any water added, is at customer's risk., Gallons of water added: Gallons of water added: _ Gallons of water added: I Amt of CY Retained: •Customer Approval: Customer Approval:- Customer Approval. Customer Approval: j Tested - Tested •properly No. f 5��y .v9 Autfiorie and receive b Yes ❑ No 'Q Yes ❑ No I L 15 S 1 4 � �� I Safety is a constant state of mind, with every employee feeling responsible i and empowered to act to cause him - and others to work safely, on the belief that all accidents are preventable and that zero incidents is the only goal. Lot: Block: Address: I I Correct t Not Correct - -- - - (" ISTOMER COPY_- - TITAN Materials for Life* ' "thank you - We appreciate ydur business gwwrete - 4199 SLLVITZRRROAB..,� FORT PIERCE.,,E"3982 Delivery da�0f22l2019 Plant ^3 Truck 1364- Driver _ .GIL WRIT. i Ticket no. I - 28SY65 ----,..ITrucksize - ,]-1,ITYP,ejpb FLAT Cu5tomer.rf0,.VV )J-Cf,/, - VAVLS LOWS CHLIL:-I'LON (: .Zone -' Tax CID ICustomettia5e - i Tarmac projQ&&&21 Customer P.O. no.. - Order no, '76:417 Terms code t-Charge delivered a CO.p. Time ue; 49 A '' d r I. I ,2-Charge F.O.B.-d{O.D'E0.6. i ii�� DeliverynamWJRdr&l, LUCIL C0 . r Y Lot Block County- 2600 INDUSTRIAL-AVE 3RD FT PIERCE •. AIP.PORT***OKEECHOBEE RD E TO 25TH ST, ,,y TO IA1DU ¢ 3 ? Instructions TL slump - i -`--ty .; - - ]�ProduR IQTt3 .-^r ^r�•c—..„s• +--^:,;— �.---�•r.^-e-yr^—°r•;'� n -v^—��-�:'�--^ ^.^r^-*a I Load 11 00 Cumulafgya 0 rderedq6o ycDd et:F13 pttn s ' - Reba .�?t7E,a Y i 1.00 18.0- 1.(0 800 7 FUEL SURC14G D- 1. 00 19.0) 1.(0 1300014, ENVIRON SURCNG t D _ i i I 00f,7r ii• •_, OCT 22AKE,: j - FQ.d FIERCE RH 'I - i I j Load Arrive job site Start discharge Finish discharge Leave job site Arrive plant (0 - Subtotal- i v: p f,,: .- Sales tax • TOTAL , . t Additional wate�dded-to this concrete will'reduce its strength. Any water added is at customer's risk. Gallons of water added:_ Gallons of water added:-_ Gallons of water added: Amt of CY Retained:- Customer AoDroval: Customer Aooroval- Customer Annrnval- I nianmpr Annrnval- - Tested / Tested properly No. " G' 'Authorized d received by Yes ❑ No ❑ Yes ❑ No `•`c` �'l"_ ,X Lot: Safety is a constant state of mind, with everyemployee feeling responsible Block: and empowered to act to cause. him Address:, correct Not correct and others to work safely, on the belief that all accidents are preventable and that zero incidents is the only goal. A K G\ n 11.11. 11r 1111 TITAN . C40MCRETE Thank you - We appreciate your business" Materials for Life` ,ITicket no. Inc, nr 1 gr crete 4199= Va=��R�A� . 1 FORT PIERCE, ,FL 33982 2851" Delivery •da20/22/2012 Plant" (fig Truck 1 7{ IO�ive TER (-� Truck size P1 ITypejob FL.ATW customerno000127 ICustome,%arjrT; DAVIS CONSTRUCTION C zone Tax CD f I Tarmac profe2�'r�';?21 - Customer P.O. no. - 112-Charge Order no. 7 317 Terms code 1Charge dermered. a-GD.o, Time due 6: (� F.O.B. 4C0.6 -E0;6. _ Delivery names a t re' L LE UJ 7N l Y Lot Block County 2600 INDUSTRIAL AVE 3RD I FT PIERCE AIRP8R1***0KEEGHQPEE RD E TO 25TH ST. N TO INDi)� TRIAL AC E 3 I _ Instructions TC slump Quantity Load 11. 00 cumulatilg9. 0 5)cdered�60. deCAj ��Cr pti ,ell ` y 1.00 19.0 1. 0800+a �7 IUEL HG ° D 1.00 ' 19.0 1, 0 800014 ENVIRON SURCHG i D I II I I i { I I :Load Arrive'ob site EA start discharge Finish discharge Leave job site -Arrive plant WN,33'd3Td 7T:' wV 7IDO 8 TO" CTIJJ S LF Subtotal 'Sales ' _ tax _ �J• TOTAL 4dditlonal water added to this concrete will reduce its strength. Any water added is at customer's risk. i Gallons of water added:_ Gallons of water added: Gallons of water added: Amt of CY Retained: { Customer Approval: Customer Approval: Customer Approval: I Customer Approval: 1 Tested Tested properly No. I ,.m 'r^-t �Pn� i-' Author'i}Z/-e'd' and re/<�/ived by I ❑ Yes ❑ No ❑ Yes ❑ No `•' `'+ X l f�i/// 1/ i Safety is a constant state of mind, with every employee feeling responsible and empowered to act to cause him i and others to work safely, on the belief that all accidents are preventable and that zero incidents is the only goal. Lot: Block: Address: Correct Not Correct YNYAN � c�rNca�lE-rE Materials for Life' grncrete --"Thank you -We appreciate your business" Ticket no. . FORT PIERCE PH 4149 SIELVITZ RDA_C F FORT PIERCE.."FL 33982 2051-67 Deliverydatleo` 22/2419 .. Plant 62g Truck � + ��" rDrrver ,ZE I�i( I II Truck size TyPe lob FAA S _li Customer1rl'dj{3(3L—"/ ICustome`rParpf^i+Ol�il'i�i.(,J. -' - Zone ._ ' Tax CD Tarmac pro Eci?�-12Y • ! . Customer P.O. no. - Order no. ` I% Terms code 7 Charge delivered &C o D. I • ,2-Charge F.0.0.'- 4C O.D fiO.D.' Time due 6: XI AM! -1 Delivery namWr'l2dr�'ssT LfJCIE.c.�sl.►NiY, , • Lot Block County 2600 INDUSTRIAL FIVE 3RD ; FT PIERCP AIR PORTS***0KEECNQDU RD' E 10 25TH ST, N Tb INDUS TRIAL AlL l Instructions TL slump _ Quantity _.._ u_ _ _ _: _ 77 _ -.7 — Y^ _'"; � 3 Product ' �„= lJlM s_�w Umt price. 't (Amount _ ..-'; Load :1,1 0U- Cumulati2o.0prderedj6¢. CodeCAJ M pt'+?.FA � 55i� Y - Y 00 20.' 0 -i.' t3 9000{ 7 L S1IRCHG t D ` 1.00 20: 0 X 1.(0 e000 4 - Et VIAON SURctiG - t D. -. .i ' Arrive job'site start discharge Finish discharge Leave'joti site ', Arrive plant . �t/ - Additional water a tothis concrete will reduce its strength Any water added is at customer's risk. l :Gallons of water add :��, ,,Ions of water added:_ Gallons of water added: Amt of CY Retained: i Customer Approval• Customer Approval: _ Customer Approval Customer Approval: ' Tested . ' Testedproperly - // No. -@@`` 5h7 I Authorized and received by ,,��,, rr��I, Yes U�M1. ❑ Yes U No X I: L f Safety is a constant state of mind, with every employee feeling responsible and empowered to act tacause him and others to work safely on the belief that all accidents are,preventable and that zero incidents is the only goal. I TITAN CONCRETE. , --'Thank you'- We appreciate your business" j Materials for Life' • T Ticket no. FORT PIERCE gr mcrete 41199 SEL.VITZRROAD FORT PIERCE;--FL_-,33qe2 225162 Delivery dalo/221201B Plant 62B Truck 15'�1— uve— ' _ QREZ, Truck size 10 Type job F�.��b! 1 Customer n .tiLi Y�J.. Curtome�nam"'eome�nani'e DAVIS ..'�1Zone Tax CD "> i Tarmac pro ect noL I Customer P.O. no. Y Order no. / I Terms code 1-Charge delivered 3-C.O.D. Time due {3: i�7��iS HI9 i • ' '• '3-Charge EO.B. 4-C.O:D-F.O.B., I Delivery name ` resss Lot Block County i 2600 INDUSTRIAL AVE. 3RD t i FT PIERCE AIRPORT'+**OKEECHOBEE RD E TO 25TH ST. N TO INDU TRIAL AlE 3 i Instructions i_ - Slum .7, UO P Load 1n, CJQ Cumulag@O. rderedj6o, deCAJ jr I.00 21. 0 ) 1. 6 eoo0 7 —Pb0L--SURMr ID 1.00 21.0 1."0 0000 4 ENVIR0;1 SURCHG 1 D !I I load A@Qjo}f site Start discharge Finish. discharge Leave job site Arrive plant t' I . .� Subtotal Sales tax Additional water aided to this concrete will reduce its strength. Any water added is at customer's risk. •Gallons of water added: .Gallons of water added: _ Gallons of water added:._ Amt of CY Retained: I (Customer Approval: Customer Approval: Customer Approval: I Customer Approval: I QrtYesTeed Tested pr[J I No. .^ I � Autho received N0 QYes pN ,�� S' ' GS X Il 10 y - I Safety is a constant state of mind, with every employee feeling responsible and empowered to act to cause him and others to work safely, on the belief, that all accidents are preventable and that zero incidents is the only goal. Lot: Block: Address: Correct Not Correct TITAN _l/ C®I�iGREiE Materials for Life` grA-crete� I "Thank you - We appreciate your business" FORT PIERCE RN 4199 SELQITZ-ROAD FORT.-PIEK- ,'FL '33r?82 Delivery daf.€U/c'2/2t31B Plant 628 (Truck. 1412 (Driver •JI1LLYs c Customer nif. J L ... I Custome a of '�eT-T!^{R.{i:1�i� i+- . JAS Truck size 11 JTypejob FLAT114 ,Zone. - 4 Tax CD Tarmac pro -rio al Customer P.Q. no. Order no. 3 - , { _ • f I - Fq harge delivered 3 C.O.D. Time doe 0- I ' 2{ha_rge F.O.B. &CAD-EO.B. II Delive narrigUi addrMs = JFJf' ry 2600 IPNDOSTRIAI AVE 3RD , Lot.Block- County i FT PIERCE AIRPORT***-OKEECH®BEE RD,E TO 25TH ST. -N1 TO IN1DU TRIAL AL .3 I Instructions lL -_-- slump ZI. ' - - ,.-. �Produd "_ - IQuantlty .v� �..., ..,_„_ ,. .. s, �l U/M, Unit: price ��Amount Load 1j_, QQ LLCumula"thpl, 0 rderedt60, acleLAJ2. 1.00 22. 0 1.(0 BOM y F L- SURC'HG D t!ta15 118 0" 2 M ' A145;a1 1.00 22.0) : 1. - 4 BOfl4� 4 ENIVIRONI SURCHG' € D FJl 9'IEfI E RN I ;Load Arrive job site start discharge'= Finish discharge Leave job site Arrive plant - i Sales tax 'TOTAL . I raaaltlonai .water apaea to tms concrete wul reduce its strength. Any water added is at customer's risk. Gallons of water added:_ Gallons of water added: Gallons of water added: — Amt of CY Retained: Customer Approval: Customer Approval: - Customer Approval: Customer Approval Tested Tested properly No. - 1 1y1 AuthotJ/' d and recei y ❑ Yes �o 'L) Yes ❑ No _ r u'°� I X t VV 11 • I Lot: I Safety is a constant state of mind, with every employee feeling, responsible Block:` and empowered to act to cause him i Address: Correct Not Correct and others to work sefely,' on the belief that all accidents are preventable and that zero incidents is the only goal.. CUSTOMER COPY TITAN .� COPYCIYETE Materials for Life' Delivery dateO Plant �i2L7/2 1 9 �1O Thank you - We appreciate your business" aV% FORT PIERCE RN 4199 SEL.VIZZ'•=ROAD FORT' "E. F'L"12922 Truck Driver i421 I i�tJS, � HER4t Ticket no. 1 I 2135170 j I Truck size 11 Type job FLATb! i Customern900012-2 ICustomeRam` DAVIS CONSTRUCTION! C zone Tax CD Tarmac proj_ec9 yoL2� ' t ' ;T I Customer P.O. no. - - Order no. �fs31: i (Terms code 7-Charge delivered 3-CO.o. ,2{har eFoe4-6.D-F.O.B.. g Time due (T: AM Delivery naman'l dr&T LUCIE COUNTY Lot Block ' County IAL AVE 2b00AIRPORTRs**0kEFCH0PEF FT PIERCE RD F TO 25TH ;ST, N TO IhlDLI.TRIAL Instructions Tf Slump - I uaaUri'tity' � � i .�I U/M. P - •f�_.._ Unit rice. :Amount ` 11.002. Cumula 've 1 rdered� P ifiii. r ode Cf4J - e �t-3N-t1� G x i ,Y � 1. 00 23. 0 _ 1.40 130mi7 UR C D 1.00 23.0.h 1. 0 200014 ENVIRON SURCHG I Load Arrive job site start discharge Finishdischarge Leave job site Arrive plant j r I / � z •J Subtotal • 7/�, •- sales tax i TOTAL I Additional water added to this concrete will reduce its strength. Any water added is at customer's risk. Gallons of water added:_. Gallons of water added: Gallons of water added: — I Amt of CY Retained: Customer Aooroval: k Customer Aonroval: Customer, .Customer Aooroval: Tested Tested properly No, t�'.� - y^�� h Authorize d received by { ❑ Yes ❑ No ❑ Yes ❑ No X Safety is a constant state of mind, with every employee feeling responsible and empowered to act to cause him and others to work safely, on the belief that all accidents are preventable and that zero incidents is the only goal. Lot: Block: Address: Correct' i Not Correct TITAN y c®e�acaz�'E Materials for Life" "Thank you'- We"appreciate your business.. FORT F1ERGF--1dn_ ..: 4199 ,SF_LVJTZ �RGAb -^-'. FflF<T FIERCE ,--G,"B2 Ticket nor' - 2E5i�1 . i Delivery dar�e0�22/2015 Plana 62/d Truck -- 3.�6rJ ',I Driver - JAPI a, CAR Truck size 11 TYPe lob 2" I '• FLATW, ... Customer wD40127 -, ..".I Customer tare DAVISCONSTRUCTION •C • ^ � Zones ; .Tax CD,. � I Tarmac pro N 2°�21 Customer P.O. no. - - I Order no. y�F317-, Terms code I 1-Charge delivered a c.o.o.. 42 -Charge FO.B. 4 C O.D: EO.B. Time due - b; 33� API; Delivery nam_cjQdr43sT LUCIE COUNTY - - _ Lot - .Block County j 2600 INDUSTRIAL AVE 3RD_ - I FT -FIERCE - A D XcskM � C11; C T C1 A �l14 C TRIM, r 2 Instructions - - TL Slump 'I1Rroduc2 _;.-.s,-`~"^ i UM. Unitprice l�Amount f Load 11. OO Cumulay63 -0rdered 60. .8pdeCAJ2 t 1. 00 24.0) 1. 0 8 % FUEL SURCHG • I D.., 1.00 24. 1. 0 .900014 "ENVIRON' SURCHG r Load Arrive jobsite 'Starf discharge Finish discharge Leavejobsite Arrive plant - Subtotal - , vaamonal water aagea to this concrete will reduce its strength. Any water added is at customer's risk. " Gallons of water added:_ Gallons of water added: — Gallons of water added:_ I 'Amt of CY Retained: { Customer Approval: Customer Approval: Customer Approval: Customer Approval:, Tested Tested properly No. I r� I Authorized and received by , ❑ Yes ❑ No ❑ Yes ❑ No X- " Lot: Safety is a constant state of mind, with" every employee feeling responsible Block: and empowered to act to cause him and others to work safely, on the belief Address:• Correct Not correct that all.accidents are preventable and ' that zero incidents is the only goal. \ h .a n CUSTOMER COPY ,� TITAN d C:"MCME>t'E "Thank you - We appreciate your business" Materials for Life' Ticket no. FORT PIERCE RM grcrete 4199 SELVITZ ROAD F48Y IERCE.� gt" 8 �" 225172 Delivery date01 i2i�1g plant �2t3 Truck s- ( D' er RI�NEy, C}.l ITruck size 3_Y Type job gLATja Customer r(a000127 ICustome(parpp DAVIS CONSTRUCTION C zone Tax CD I Tarmac projecprlpye,L I Customer p.0. no. Order no. 76317 _I Terms code 1-Charge delivered 3-C.O.D. 2-Charge EO.B.. C-C.O.D -F.O.B. Time due I - MI Delivery namsaaudtare%r LUCIE COUNTY Lot ck County 2600 INDUSTRIAL AVE 3RD FT PIERCE iR n T** FF latl c F fi TO UC RI L AlCE 3 Instructions TL - - - slump 5.00 1 1 Quantity -: �• - - . - - ; �Producf: '• -.- � U/M. Unit_ price Amount I load tt. ()o Cumula�74. {7 Ordere1,§60. €pdeGA.T ; , Snpt rJ y 1.00 25.0 1. BOM17 �CEL SiffCNG 1) 1.00 25.0) 1.1 800014 ENVIRON SURCNG €.D I - S I i l I i I Loadv; N ::,13' a3jCl y}r ob site Start d chytrg � Finish discharge Leave job site Arrive plant �i [;:1nd }, i,`_il] E � TU%/a lA! llt Subtotal "• .( (J{/_ � TOTALX 4dditionaI wqjw added to this concrete will reduce its strength. Any water added is at customer's risk. Gallons of water/added: Gallons of water added: _ Gallons of water added: _ I Amt of CY Retained: _ Customer Appr va: r) Customer Approval:- _ Customer Aooroval: Customer Anmoval: i esteo Tested properly No. Authorized and received by I Yes ❑ No Yes ❑ No , x t Safety is a constant state of mind, with. every employee feeling responsible and empowered to act to cause him and others to work safely, on the belief that all accidents are preventable and that zero incidents is the only goal. Lot: Block: Address: Correct , Not Correct TITAN Materials for Life gr Crete "Thank you. - We appreciate your business" FORT PIERCE RA 4199 SELVITZ ROAD �agUILOrte R6' o u - c d z yPM86P Ticket no' Delivery date0/:22120Lfl plant i&22 Truck ..1:438 Drver, jj, V. ITr`uck size Typejob FLATbP{ ,],t Custcmernp.000,t27 - - Cust7e,Ra*-DAVIS, CONSTRUCTION C. toga �,• TaaCD i —; Tarmac prorgZT&221 ' (Customer P.O no. ' OrdeY no. %631:% ITerrns coder -charge delivered 3-cD.D. _ ; z-charge F.O.B. 4-GO.D,;FO.B. Time due 6:55.AM; - Deliverynam2eandr&T LUCIE COL114TY BlockCoubty2660 INDU1 TRIAL AVE- 3RD- jLot FT PIERCEATPPf1RT-***OkEfCHnfIFF RV F TO NTHfiT.- N Tfl TNT-M i4t'All;G R -Instructions ,TL - .' _ - - (Islump 55. 00 ( _._.._w-..v 4.... ._ =�. .. Quantity . ��' �•• ,-,:`- rodud .:�� .�;� r� ,�-�=.--�� ulNt` Unit 14mount Load Y1.0d CumulaIM.0 rderedjb4'., fPdeC-AT R p 3 $ Y I 1.00 26: ©� L. t . . 8 FLI L biJRCHG D . , 1 1 00. 26. C? - t. 0 8000; 4, 0401ROiy SLIRGHG ' D . I FP RM •Load - Adive�job site. Start discharge Finish discharge' Leavejbb site Arrive plant - - - r' ' Subtotal I - TOTAL : I gddnional wateTd!)CustcmerAppmval:_ o this concrete will reduce its strength. Any water added is at customer's risk. Gallons of water addeallons of water added: _ Gallonsof water added: _ ,rAmt of CY Retained customer Approval: Customer) Customer Approval. _ I Tested Tested properly - I No., p— Authorized and received by - ❑ Yes ❑ ❑ g--q ❑ No Yes No " •i ay 3 - IX.5,^1 \ Cot: Safety is a constant state of mind; With t every employee feeling responsible Block and,empowered,to act to Cause him Address: - Correct Not Correct - and others to'work safely, on the:belief. that all accidents are preventable and , that zero incidents is the only goal. 11.I IRTOMPR r:CTPV -- O�YIIMN C-40MCRETE "Thank you - We appreciate your business" Materials for Life' I Ticket no. I gremcreU 4199 SELVITZ� D FORT• RIE##��. "F6 Ete'�"' ry 205175 datje,O1L212OZ$ plant Truck -AP- ;Delivery Trucksize it Type job rLATW b28 i6i..3 Driver- MATT ICdstomer n„n00.L27 ICustomeparkt DAVIS CONSTRUCTION C zone -lax cD - I iTgrmac pro ecVV 22 Customer P.O. no. Order no. 76317 (Terms code 1{harge delivered a{.O.D. ' 2-Charge EO.B. 4-C.0.D -eO.B. Time due $r= Delivery nam n r,&j LUCIE COUNIlyLot. Block County 2� 00 FT PIERCE AIRPORT***OI«ECNOBEE RD E TO 25TH ST. N TO iNUEJj TRIAL A E 3 ,Instructions TL slump 5.00 Load ZI OO Cumulatl% O rdereUo o deCA12 - RS50ti Y i.00 27rW I. -0 600 -2 NG ID 1.00 27.-07 2. 13000.4 ENVIRON SURCHI; ID I I I i � I Load i Arrive job site start discharge Finizh discharge Leave job site Arrive plant ""') Subtotal I TOTAL i 4dditional water added to this concrete will reduce its strength. Any water added is at customer's risk. :Gallons of water added:_ Gallons of water added: _ Gallons of water added: _ Amt of CY Retained: Customer Approval: Customer Approval: Customer Approval: _ Custgmei.Approval: n f Tested Tested properly No. I t. r. a �^ 1 5 5 2 4 Authorized �faD d reced `ei b_g �L i I 0 Yes ❑ No Yes ❑ No " X t Safety is a constant state of mind, with every employee feeling responsible and empowered to act to cause him and others to work safely, on the belief that all accidents are preventable and that zero incidents is the only goal. Lot: Block: Address: Correct Not Correct TITAN Materials for Life" g crete" , "Thank you - We' appreciate your business" ' .FORT PIERCE ,FORT PIERCF, 4Q2 Ticket no. Delivery date Plant ITruck Driver Truck size • Type'ob .0122120it3 • 622 146- I ACKER,-DbU-.. ii - FLATGb 'Customer no: - -- Customer name Zone . Tax CD '• 900012% _ I R K DAVIS CONSTRUCTION-C, Tarmac project no. - Customer P.O. no. .Order no. - Terms code t{harge delivered 3 C.O.p. Time due y 2 4/i2G.t. I -.% - o s �'ht+t Jc3.2i/ I ,2{harge: F.O.B. 4{O.D -F.O.B. `' 7:, 21. AM Delivery name and address - ' dot Block '. County201B ST LUCIE COUNTY 2600 INDUSTRIAL AVE.3RD 1 II f PI RCE L Instructions AIRPORT***OXEECHOJ3EE -RD E TO 25TH ST, N TO INDUSTRIAL AVE. 2- - slump TL � 5 � 1 -" _r rProduct ,.am . .. - ' Load ,Cumulative Ordered , Code Description Tf . Oa 307.0) 360. GO CAJ ,$ ,.• Rao €�f t Y 1 I..-00 2B.0 i, 0 7 FUEL SURCHG t D. 1.00 28.0) 1. GO 6000'4 ENVIRON SURCHG '-t D I i Load " i Arrive job site Start discharge Finish discharge Leave job site Arrive plant " I Subtotal 1 . Sales tax TOTAL yuwovndl waier.auueu to tnls concrete will reduce Its strength. Any water added is at customer's risk. Gallons of water added:_ Gallons of water added:._ Gallons of water added: I Amt of CY Retained:, ` Customer Approval: Customer Approval: - Customer Approval Customer Approval:.`' - Tested Tested properly I No. " Pp} 8 ,01 ° h 5 2 Authorizedand received b'y,� " - Ix - ❑ Yes ❑ No ❑. Yes -❑ No v Lot - Safety is a constant state of mind; with every.employee feeling responsible Block: and empowered to act to cause him and others to work safely, on the belief address: correct Not Correct that all accidents are preventable and that zero incidents is the only goal. 1AA N A A A Cl 1QSnhACD CnDV T NCFZETE TAN Materials for Life' "Thank you - We appreciate your business" ��gUl Lor�,o U CC 7�n MfMBEP gwocretePIERCE -=-y-Y FORT 4I-SELVITZ RW FORT P_ F.RF_E FL �3391?a t 7 � Delivery date Plant Truck w Y Driver' '�'-``L� Truck size Type job, 10/22/2'012 `r62B 1424 I MOHR, JEFF 11 "-TLAT4} Customer no. Customer name r Zone Tax CD 9000127 I' R k DAVIS CONSTRUCTION C Tarmac project no. I Cdstomer P.O. no. Order'no. - _ Terms code 7-Charge delivered B C.o.D: Time due y .yy 471221 76317 I �1-Charge EO.B. C-CO.D-F.D.B. l:32 AM veuvery nanre anu euaress 201E ST LUCIE COUNTY f Lot I Block County I 2600 INDUSTRIAL: AVE 3RD i FT PIERCE ; ,Instructions AIRPORT***0KEECHODEE RD £ TO 25Tlk7.ST: N TO INDUS'[RIAL. AVE 3 slump TL 5.00 j i�ProduR ;•.. I U/M Unit.Price 'Amount " Loadrq ` Cumulative Ordered Code Descriptionj 00 315. 0) 360. GO CAJ2. R30 Y t''7C` 00 29.0) 1. 10 9000G7 L SURCHG 29,0 1.(0 8000" 4 ENVIRON SURCNG ID 0018 2 Jlc; OCT 22 Hrq.;t a FQ :T PIERCE kq . i i i Load Arrive job site Start discharge Finish discharge Leave jbbsite Arrive plant G Subtotal i .� . V Sales tax 'TOTAL WUI UUndl wdier auueu to tins concrete win reauce its strength. Any water added is at customer's risk. j Gallons of water added:_ Gallons of water added: Gallons of water added: _ 'I Amt of CY Retained: Customer Approval Customer Approval: Cuomer Approval: Customer Approval: -/ _ I ] Yes ❑ No ❑ Yes ❑ No No. U4.15526 Safety is a constant state of mind, with every employee feeling responsible and empowered to act to cause him, and others to work safely, on the belief that all accidents are preventable and that zero incidents is the only goal. Lot: Block: Address: Correct Not Correct —' -- -- -- -- -- - - - CIIQTnMCQ r%nDv - -- " - - _._- - ---- - - - -"' - - - -'---- *TITAN u. C01I1R9CRETE _ "'Thank you - We appreciate your business" Materials for Life' t. u' C c z � n M£M86P Ticket no. g r add 'FORT'PIERCE R► , 4199 SELV$12' anc— �Aa— -i FORT tP_ gg _ Fl, .� 3�2. •y 285172 'Delivery date Plant Truck Driver vr� Truck size Type job I 10/22/2018 b28., 5364 l GTLCHRIST, 21 FLATW Customer no. `' , - Cdstomer name "" W = - -Zone y Tax CD, 900b127'. I R i{ DAVIS COHSTRUr ION C` 1{harge delivered a:CO.D. .Tarmac project no: Customer P.O. no. - Ordegnp. +� �y Terms code Time due - �r.� t 471221 I , i ' /m ]I7 ' I; I2{harge F.D.B_. 4CO.D-EO.B. /:44 Al'1! ,Delivery name and address = , .Lot. - Block GounTy 2019 ST -LUCIE COUNTY �'- 2600 INDUSTRIAL; AVE- 3RD L FT PIERCE ,Instructions AIRPORT***gXEECHOBEE RD E TO 25TH, ST, N TO INDUSTRIAL AVE 31 slump TL . 5.,00 I — _�— ,...^^-----� [produ • " :. UiM. Unit P ice `i 'Load Cumulative - Ordered - Code Descriptioni - - - I j .1. 00 329. 0) 350.(0 CAJ R30 69OXV517 Y, � 1.,00 30.0" 1.(0 8000 y FUEL SURCHG D<, 1.00 30.0' 1.t0 800014 ENVIRON SURCHG I D j 1 + Ti FO .T PiEPCE RM I 'Load Arrive job site start discharge finish discharge 'Leave job sRe Arrive plant i r� Subtotal 1 � b'ar.vM ,~• ' -i � TOTACX 4.. { Additional water o this concrete will reduce its strength. Any water adcled is at customer's risk. Gallons of water added allons of water added: Gallons of water added: _ I� Amt of CY Reamed:_ Customer Approval: Customer Approval: - Customer Approval: f Customer Appoval: i Tested / Tested.properly I No. Y'�.^ y� e+ pf'p 'Authorized and received b ` ?' ❑ Yes �1'At/o ❑ Yes ❑ No ..1 'i"'Er, `'Yd '^ 7 1 11 Lot: I' Safety is a constant state of mind, with every employee feeling responsible Block: and empowered to act to,cause him Address: correct Not Correct ' -and others to work safely, on the belief .that all accidents are preventable and that zero incidents is the only goal.' rY 1CSnKACD nnOV 3. TITAN _/ . C®NCRETE Materials for Life° Ticket no. 285180 Delivery date - - i Plant _, - Truck Driver " Truck size Type job 10/22/-2018 r G2B -1556 � ZF-k 1� sla I 11 Iva I FLAW "Thank you We appreciate your business" .. 1 g Crete FORT PIERCgf RM 4199 'SELVft:Z-,AfJAL FCIRT PIEGt FL-, 982 Customer no., 9004i2',} Customer name ' Zone Tax CD R, K DAVIc COAI$TF(l�TION L Tarmac project no. Cu'sfomer P.O. no. - -0(de�no. Terms code 1-Charge delivered 3 C,0.0. Time due 4_? 221,; I y, 76337 I • 42-Charge F.O.B. 4C.O.D-60.B: %-5� A1i� Delivery name and address Lot Block County -I 2018 -ST Lour= COUNTY �. . 2600 INDUSTRIAI. AVE 3RD C FT PIERCE ' j InstruRions K K HEM TL iti r_j( , , i Fi 1 ULi i.K 1. L E.3 .slump - -1 5.00 f Quantity 1-Pr duct , :��_ Pi Unit rice. ,? I�� x r Amount-• ,v„ . Load _ Cumulative Ordered Code Description ILL.00 340.0 Mo.3.0 CAJi R30 R Y. -1. 00 31.,0 _ 1.(0 80 '7 RCHG 1. UO 31.0) . 1.(0 13000.- 4 ENVIRON SURC€iG - 2 D ' •4, - I^• I Load Arrive job site start dischargeFinish discharge Leavejo65ite - Arrive plant '� �% : fl �J % ' / :�/ - •Q, J V• � �� t st'� � __._ .�_.} Subtotal Sales,tax i � /J t� 1 � TOTAL I Additional water ada de to this concrete will reduce its strength. Any water added is at customer's risk. j Gallons of water added: Gallons of water added: Gallons of water added: Amt of CY Retained: Customer Approval. Customer Approval: Customer Approval: Customer Approval: i 'Tested Tested properly No. P5 ,! t— ((�� Authorized and received by I ❑ Yes _ ❑ Yes ❑ No 17 u v J X I Safety is a constant state of mind, with I every employee feeling responsible, and empowered to act to cause him and others to work safely, on the belief that all accidents are preventable and that zero incidents is the only goal. Lot: Block; Address:, . Correct Not. Correct 071YAN C®MCELETIE Materials for Life` gr crete a• "Thank you -re 0 FORT 4199 FORT your business" RPM ROAD FL 33952 3 Ticket no. , • 2�jS181 Delivery date Plant j Truck Driver'. • P - Truck size Type job 10/2212018 76i591 If IFVARC2. 10 y. FLATW, Customer no.-- - Curtomei name- - -Zone _ - Tax CD 9000127 I.R.k.DAVIS GOST1l TIOF! C I` Tarmac project no. 47i221 Customer P.O. no. _ de�go. Terms code t-Charge delivered a [.O.D. ;. 7f�31`7 I .. - '2-Charge FD.B:_ 4-CO.D-F.O.B. Time due - 8:01. Am Delivery nam. d dres - ��I� Lot - Block County 200 .IP6>)llSi[?IA4a AVE 3RO, FT PIERCE _ „ ,, •_ _ _ I InstructionstJ I r-'T"'' r tt r%IJ t L Q 01: t t s , 1 i' s .� 1 rf lt+•_ Slum -' TL S'• } p 5.00 ! - Product Load: Cumulative Ordered Code • Description 10.00 ' 350. y > MO. 10 CATr ,R-20 9M-, Y 1106 32. C 1, 1. 60, 0000 7, FUEL SURCHG I D Y. 00 32. C 1. 10 9000 4 FMVIRD24 ItURCHG 11) If I ' , �•�. • - .. .. 1, - .. ' - L l i �^ 31. 4d�d ' Rh"1 r N 7 6 'site Start discharge Finish discharge Leavejob site Arrive plant y I Additional water added to this concrete will reduce its strength: Any water added is of customer's risk. Gallons of water added: Gallons Gallons of water added: Gallons of water added: _ Amt of CY Retained: ACustomer Approval: r1... Customer Approval: Customer Approval: I - Customer Approval: /„�,. Tested. Tested properly I No. ,.1 p Authori a d eceived bye ❑ Yes a No ❑ Yes ❑ No IS. 1� 30 x 1 Lot: - Safety is a constant state of mind, with every employee feeling "responsible and empowered to ad to cause him . and others to work safely, on'the belief that all accidents are preventable and that zero incidents is the only goal. Block: Address: Correct Not Correct i r rnrc.• •rr. r 1111 TITAN . C"NC:RETE "Thank you -We appreciate your -business" Materials for Life` � Ticket no. gr Y�yy��,crete 4199 SELVITZRFOAD FORT PIERCE, -rL. 339192 2251B4 i Delivery date Plant JTruck Driver Truck size 10112212012 I4i?_I I PENS, HERB iSa 7ypejob =LATdJ Customer no. Customer name Zone Tax CD 9000327 I R le DAVIS CONSTRUCTION C Tarmac projeR no. Customer P.O.no. Order no. Terms code - Time due - t-Charge delivered 3-C.O.D. 7r-2�-t• I IEP3.YiI L cod; F.O.B. 4C.O.D-F.03. 9: 55 All Delivery name and address Lot Block County 20Ih1�8� ST LUCIE COUNTY I 2600 INDUSTRIAL AVE 3RD FT ?MERGE TL 1 5, 00 Quantity., - -' '} Product �J - I �� - _ ... � � ,�.. ' U/M; Unit PrICe � Af110Unt 10.00 1.00 1. 04 360.0) 360. 33.0) 1. 33.0 2. 7 FUEL SLRCHG 4 ENVIRON SUIRCHIS Load Arrive job site Start discharge Finish discharge Leave job site Arrive plant ldditional water addd'to this concrete will reduce its strength. Any water added is at customer's risk. Gallons of water adrjed. Gallons of water added: _ Gallons of water added: _ Amt of CY Retained: Customer Approval: Customer Approval: Customer Approval: Customer Approval: rested I Tested properly I tr, I'� No. X thorized�nd received' - Yes No Yes No - �' 5 3 3 I �O U � J4_I y ❑ Teop � Safety is a constant state of mind, with every' employee feeling responsible and empowered to act to cause him 'and others to work safely, on the belief that all'accidents are preventable and that zero incidents is the only goal. Lot: Block: Address: Correll Not Correct TIMAN C®NICRETE "Thank you - We appreciate your business" Materials for Life" Ticket no. FORT PIERCE RM g r crete 4199 SELV I TZ . ROAD FORT PIERCE, FL 339e2 295199 Delivery date Plant Truck Driver Truck size Type job FLATGt 10J�2/^c018 62t3 ' 1556 I ZEILINS#tI, I ,Customers - Customer a T- -Zone - Tax CID - S �JUCA127 I ,. - DAUIS_CONSRUCTION. C. _ - = ,Tarmac projgd.0o . Customer P.O. no. .. Order no. Terms code s-Charge delivered 3 C 0 D. Timedue +1�221 y63a7 I 10--11 All 2 Charge FO,a. 4C 0 D -F.O.B. Delivery name -And ja dresssr LtjC IF Coljt4TY .Lot L County 2600 INDUSTRIAL AVE 3RD- FT PIERCE Instructions TL slump ' J • t J r .. .,....-e..-- -• • : - Imo____._, .r r . ' _ .. _ '. i uiNi Unit pr � l Amount ILoad - Cumulative Ordered ' Code-Descript on'ti¢.r i 6. 00 3t-6. 0. 366. 0 CAJ2: R30 Y i I i. 0 0 34• r,> 1.(0 8000 •7 ', FU.FL SFJRCHG 1. 00 34.0) 1. e000 4 ENVIRON SiJRCHG ! D i 'Load Arrive jobsite start discharge Finish discharge ;rt Leave job site Arrive plant Subtotal I �• ! � f �l � ' j� �� 1 � ��%• �� - Sales tax r •. TOTAL J 4dditional water added to this concrete will reduce its strength: Any water added is at customer's risk. Gallons of water added: Gallons of water added: _ Gallons of water added: _ Amt of CY.Retained: Customer Approval: Customer Approval:. Customer Approval: Customer Approval: Tested Tested properly No. Authbnied and rec rved by', - ❑ Yes &ho L3 Yes Lj No I J 5 5 3 V I /� h' \ ` �,C.l �!` 1. Y / i •"�� Lot: Safety is'a constant state of mind, with every employee feeling responsible Block: and empowered to act to cause him Address: Correct Not CorreCt r and others to work safely, on the belief that all accidents are preventable and that zero incidents is the only goal. 1AA Q