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HomeMy WebLinkAboutINVOICESCANNED BY St. Lucie County Amount Paid; 174.00 1 Change Due; 0.00 Thank You User ID; WARDD ,. --- — X Comm ST. LUCIE COUNTY UTILITIES SEWER _ \ RES - P .O. BOX 728 FT PIERCE FL 3491 METER SZ. M/F NAME $ /tZ IRR ACCT# SECURITYDEP SERVICE ADDRESS SERVICE FEE Y-f ILI SAME DAY FEE OVERTIME FEE �� SUBDIVISION__!!p/ I t-//fj/j• LOT ate_ BLOCK METER INSTALL." _ BILLING ADDRESS CFC/WATER FPUA CFC PHONE # CFC/SEWER MOVE IN/CLOSING DATE_ GUAR. REV. This application hereby request and authorises the Utility to render water and/or a , served above in ces rregulations,o the swh § LATERAL rules and accordance with ch byes reference eference a made s present TOTAL the Utility prom tl a part of this cUtt'iliti cai P y for such services in accordance with the established rules a CUSTOMERS DEPOSITS ARE NON CUSTOMER / j SIGNATURE / /� NEGOTIABLE OR TRANSFERABLE. ' f SOCIAL SEC/ NAME OF SPOUSE FED ID w' SPOUSE SOCIAL SEC. DATE RECEIVED / J� ( � O� SE ONLY C�H RECEIVED BY C(Ij 585003346 RECEW 'D FEB 161016 Plant: Begin Loading: To Job: Arrive Job: Start Unload: Finish Unload: Leave Job: Return Plant: Customer Code: Customer Name: Project Code: � IProject Name: - -- • Ticket Data: OeliveryAddress: 1 Delivery Instructions:. SCANNED BY St. Lucie County Customer Job Number: Project P.O. Number: Order Code / Data: Order P.O. Number. Map Page: MapRtow/Column: Dispatcher: Ticket Number: ♦, Due On Job: Slump: Truck Number. Driver Number. Driver Name: End Use: tV:'el : `. G"VF = TF'n07 LINE-tT-j GNED LOADTY CUMULATIVE ORDERED QUANTIMATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT QUANTITY QUANTITY - -:� Y. 7 ".10tifif. Cash Check k/Auth Cadet Signature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect Without Standby Charges: Check Charge Comments: WATERADDED: GAL YARDS IN DRUM: WHEN ADDED. SIGNATURE. CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST: SIGNATURE - - —"- ❑ LOAD WAS TESTED BY: Notices: Our drivers will make every effort to place materials where the customer designates, but the SPECIALTERMS: Any water added [sat 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 andlor eye initatlon. 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. Nocreditfor 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 in writing AUTHORIZED SIGNATURE: within one business day after the recelpt of materials. O ryn 66UNIVERSAL , INVOICE This Delivery Ticket incorporates 1 n by reference Buyer's previously exec Credit Application, if any; Seller's Standard Terms and Conditions, Seller's Quoaauon, if any, and Seller's Order Confirmatiw. k.ncluding 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. AITVKL'l><AIit, / %_Jt 1VMlNI / 9-UN UKE I rKUVUl;1_J /.rLY' 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 ash can cause eye irritation, skin and eye bums and allergic skin reactions. Dry concrete and aggregate dust may cause irritation to eyes, skin, and/or respiratory tract. Dust from handling, crushing, grinding, cutting and/or drilling may contain silica, which may cause silicosis and cancer if inhaled. If ingested, keep warm, at rest, and drink large amounts of water. Fly Ash may contain trace amounts of ammo- nia. Moisture can cause the ammonia to be released. Inhalation of ammonia can cause coughing and irritation or 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 come, 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 los t6rminos estindares y conditions detal- lados on case de as] ser requeridos. Con este documento, el comprador acepta los mismos ya antes mencionados y quo las cantidades y materiales fueron entregados como se expresa on el mismo. Acepta pagar el monto de acuerdo al contrato; al menos que se identi- fique con una nota al frente de este documento. UhIV1r:IV'1'U / YKUllUUIUS JYK l;ONURKYU / Los productos de agregados son materiales naturaley como piedra caliza, dolomita, granito, rota volcanica, arena, grava y otros materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albaililerfa, 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 volcanica, 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 irritaci6n on los Ojos, quemaduras on piel y ojos, y reactions al6rgicas on 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, torte y/o perforaci6n puede contener materiales silicos, los cuales pueden causar silicosis pulmonar y cancer si son inhalados. En caso de ser ingeridos, mantenerse en temperatura calida, reposar y tomar grandes cantidades de agua. Las cenizas volantes pueden contener amoniaco. Seguridad: La humedad puede causar la 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 los ojos y ropa Primeros adecuada para protecci6n. Lavese las manos con jab6n suave y agua despuds del manejo de materiales. Evite inhalar auxilios: polvos. Si se expone a polvos mas de los limites recomendados, use protecci6n respiratoria. Primeros auxilios: En caso de contacto on los ojos, inmediatamente fluya agua en la parte afectada por 15 minutos. Si se inhala polvo, exp6ngase a aire fresco. Si el cemento fresco tiene contacto con sus ojos, lavelos a fondo con agua. Acuda a atenci6n m6dica inmediatamente si la irritaci6n continda. CEMEX, Memorial Hermann Tower 929 Gessner, Suite 1900 V7 cornbinado Houston, Texas 77024 02112 Para mas informaci6n visita www.cemexusa.com. Plant: Begin Loading: To Job: Arrive Job: Start Unload: Finish. Unload: Leave Job: Return Plant: Customer Code: Customer Name: Customer Job Number. Order Code l Dale: .l Project Code: Project Name: Project P.O. Number: Order P.O. Number. "•Ticket Dater Delivery Address: ' r - rt Map Page: MaplRow/Column: ' t Derwery Instructions: Dispatcher: ,' ti Ticket Number: „4 I OSC,rIL Due On Job: Slump: Truck Number. Driver Number. Driver Nama: End Use: LOAQUANTITY D CUMQUANTULATNEITY QOUARDNTERITYED MATERIALCODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT Cash Check#/Auth Code: I Signature of Driver Receiving Check Comments: Cash Received: I Total COD Order Amount to Collect GAL YARDS IN DRUM: WHEN ADDED. SIGNATURE CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST: h�I FL_11 r-O"Nr) 0 YARDS SIGNATURE ❑ LOAD WAS TESTED BY: Notice: Our drivers will make every effort to place materials where the customer designates, but the SPECIAL TERMS: Any water added is at customers own risk. If water is added on job, concrete strength Company assumes no responsibility for damages Inside curb or property line. Customer agrees to the is no longer guaranteed. WARNING: Product may cause skin and/or eye imitation. CAUTION: Material terms of sale and delivery and accepts concrete as is. Due to important factors which are out of our may be hannicus to your safety and health. Please rotor to.the backside of this ticket for Important control after delivery, this Company will not accept any responsibility for the finished results. Nocreditfor safety handling infdrmation" and to the material safety data sheets for additional information. retumed concrete. Buyers exceptions and claims shall be deemed walved unless made to us in writing AUTHORIZED SIGNATURE: / within one business day after the recelt of materials. 68UNIVERSAL lr T�I! 10E INVOICE Nu�;z ': This Delivery Ticket incorporates 1 it by reference Buyer's previously execs Credit Application, if any, Seller's Standard Terms and Conditions, Seller's Quotation, if any, and Seller's Order Confirmation tmcluding, limitations of warranties), as if, fully , set forth on this Delivery Ticket ("Agreement"). Seller will provide the Standard Terms and Conditions upon request.,Bdyer 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. Hazards: Freshly nixed wet cement and/or fly ash can cause eye irritation, skin and eye burns and allergic skir3jeactions. 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 02/12 For more information please visit www.cemcxusa.com. Este ticket de entrega incluye Como referencia al comprador (ya prcviamente ejecutada en su aplicaci6n de cr6dito): cualquier t6rmino estdndar, 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 est tndares y condiciones detal- lados en caso de asf ser requeridos. Con este documento, el comprador acepta Ins misrnos ya antes mencionados y que las cantidades y materiales fueron entregados como se expresa en el ntismo, Acepta pagar el monto de acuerdo al contrcto; al mends que se identi- fique con una nota al frente de este documento. / UiLiVlEr IVTU / FKUI)UUIUb 0h UUNUKr:'1'U / UENILA, VULAIV'1'L+J Los productos de agregados son materiales naturalls como piedra caliza, dolomita, granito, roca vole5niea, arena, grava y otros materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de alban"ilerfa, 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 volchnica, arena, Brava, y otros materiales silicios. Estos productos incluyen cenizas volantes (fly ash) la coal puede contener mds de 0.025% de silicio crystalino. Peligros: Mezcla de cemento fresco y/o cenizas volantes pueden causar initaci6n en Ins ojos, quemaduras en piel y ojos, y reacciones al6rgicas en la piel. Concreto seco y polvo de agregados, pueden causar irritaci6n en los 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 ser ingeridos, mantenerse en temperatura calida, reposar y tomar grandes cantidades de agua. Las cenizas volantes pueden contener amoniaco. Seguridad: La humedad puede causar la 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 duraci6n y el nivel de la exposici6n. Seguridad: Evite el contacto con ojos y contacto prolongado con In pie]. Use guantes, protecci6n en los ojos y ropa Primeros adecuada para protecci6n. Livese his manor con jab6n suave y agua despuds del manejo de materiales. Evite inhalar auxilios: polvos. Si se expone a polvos mds de Ins 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 e] cemento fresco tiene contacto con sus ojos, lavelos a fordo 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 informaci6n visita www.cemexusa.com. -N2T b.t z 6 5hh //C'C- M C- X 585813 544 Plant: Begin Loading: To Job: Arrive Job: Start Unload: Finish Unload: Leave Job: Return Plant: Customer Code: Customer Name: Project Code: Project Name:' I' Ticket Date: Delivery Addl -. f'"DeliveryInstructions: r LOAD CUMULATIVE ORDERED MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT QUANTITY QUANTITY QUANTITY Customer Job Number: Project P.O. Number: Order Code / Date: Omer P.O. Number. ' Map Page: MaplRow/Column: Dispatcher: n Qc-r—r,*•r Ticket Number' Due On Job: Slump: Truck Number. Driver Number: Driver Name: End Use: I •-.'+ - :� i;�'=.�,r,�, c.:';•,. - r•'r3�'I' Rl rFNF_D Cash Check C/Auth Code: (Signature of Check Comments: Mi, j Cash: Cash Received: To al COD Order Amount to Collect Without Standby Charges: WATER ADDED: GAL YARDS IN DRUM: WHEN ADDED.. SIGNATURE CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST: I ' ": _ _ Jta'i'F _ 1 � _ P '..-. C�� - F i 1 . SIGNATURE T^,'_ i'_i L.Cl li) YCFii -- - -- -- --- — ❑ 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 dsk. 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 factorswhich 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 matenal safety data sheets for additional information. returned concrete. Buyers exceptions and claims shall be deemed waived unless made to us in writing AUTHORIZED SIGNATURE: within one business day after the recelpt of materials. Q 68UNIVERSAL I)FIEV Tn'j i. 1 7Ei) INVOICE I.OgD Will". -, This Delivery Ticket incorporates ;in by reference Buyer's previously exe I Credit Application, if any, Seller's Standard Terms and Conditions, Seller's Qt ion, if any, and Seller's Order Confirmat._ including limitations of warranties), askf 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. Hazards: Freshly mixed wet cement and/or fly ash can cause eye irritation, skin and eye bums and allergic skin reactions. Dry concrete and aggregate dust may cause irritation to eyes, skin, and/or respiratory tract. Dust from handling, crushing, grinding, cutting and/or drilling may contain silica, which may cause silicosis and cancer if inhaled. If ingested, keep warm, at rest, and drink large amounts of water. Fly Ash may contain trace amounts of ammo- nia. Moisture can cause the ammonia to be released. Inhalation of ammonia can cause coughing and irritation or bums of the 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 cr6dito); cualquier t6rmino estdndar, 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 t6rminos estdndares y condiciones detal- lados en caso de asf set 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. / rK0UUU'1'VS VE U01NUKE'FU / UENIZAS Los productos de agregados son materiales naturales como piedra caliza, dolomita, granito, rota 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, rota volcanica, arena, grava, y otros materiales silicios. Estos productos incluyen cenizas volantes (fly ash) la cual puede contener mas de 0.025% de silicio cystalino. Peligros: Mezela de cemento fresco y/o cenizas volantes pueden causar irritaci6n en los Ojos, quemaduras en pie] y ojos, y reactions 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, cone y/o perforaci6n puede contener materiales silicon, Jos 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. Seguridad: La humedad puede causar la liberaci6n del amoniaco. La inhalaci6n del amoniaco puede causar toser, irritaci6n o quemaduras en la nariz, garganta y puhnones. Acudir inmediatamente al medico. EI riesgo en la sa]ud depende en la duraci6n y el nivel de In 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 despu6s del manejo de materiales. Evite inhalar auxilios: polvos. Si se expone a polvos mas de los limiter 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, exp6ngasc a aire fresco. Si el cemento fresco tiene contacto con sus ojos, Idvelos a fondo con agua: Acuda a atenci6n m6dica inmediatamente si la irritaci611 continua. CEMEX, Memorial Hermann Tower 929 Gessner, Suite 1900 V7 combinado Houston, Texas 77024 02/12 Para mas informaci6n visita www.ce 'LI - /5-11 izs to Sl16 �r p 58533542 Plant: Begin Loading: To Job: Arrive Job: Start Unload: Finish Unload: Leave Job: Return Plant: Customer Code: �Projaa Codo^ Ticket Date: Delivery InsWctions- Customer Name: <Rroject Name: DeliveryAddress: Customer Job Number: Project P.O. Number. Order Cotle / Data: Older P.O,Numbec ' rh Map Page: Map/Row/Column: Dispatcher:. Ticket Number: ,Due On Job: Slump:-5r�,�, Truck Number: r_ .jrOriver Number. Driven Name;J +J�-���--�- hiv' End Useav/�_nJ iGi•��_)1 LOAD CUMULATIVE I ORDERED MATERIAL CODE PRODUCTION DESCRIPTION UOM UNITPRICE AMOUNT QUANTITY QUANTITY QUANTITY - Cash Check#/Auth Code: I Signature of Driver Receiving Cash: Check Comments: Cash Received: WATERADDED: GAL Total COD Order Amount to Without Standby Charges: YARDS IN DRUM: WHEN ADDED. SIGNATURE CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST: ["'a'ZRF TE ?)ISrPIDSal_ 7FE FULL L1.Ilai yP RT):1 SIGNATURE ❑ LOAD WAS TESTED BY: Notice: Our drivers will make every effcrt 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 initatlon. CAUTION: Material terms ofsale and .delivery and accepts concrete as is. Due to importantfactors 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. Nocreditfor safety handling Information. and to the material safety data sheets for additional informa9on. returned concrete. Buyers exceptions and claims shall be deemed waived unless made to us in writing AUTHORIZED SIGNATURE: within one business day after the receipt of materials. O 68UNIVERSAL INVOICE This Delivery Ticket incorporates h i by reference Buyer's previously execu '-relit Application, if any, Seller's Standard Terms and Conditions, Seller's Quotation, if any, and Seller's Order Confirmation lmcluding 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. Hazards: Freshly mixed wet cement and/or fly ash can cause eye irritation, skin and eye burns and allergic skin reactions. Dry concrete and aggregate dust may cause irritation to eyes, skin, and/or respiratory tract. Dust from handling, crushing, grinding, cutting and/or drilling may contain silica, which may cause silicosis and cancer if inhaled. If ingested, keep warm, at rest, and drink large amounts of water. Fly Ash may contain trace amounts of ammo- nia. Moisture can cause the ammonia to be released. Inhalation of ammonia can cause coughing and irritation or 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 cr6dito); cualquier t6rmino est'andar, 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 ntismos 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. AUKLUAD06 / Ij! W mi pill" K01.2 Il DKOLIRL O DM-ILINKOLDI\UIrIff : Los productos de agregados son materiales naturally como piedra caliza, dolomita, granito, rota volcanica, arena, gravy y otros materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de alban"ilerfa, pozzolan (tipo IP), azulejo de azotea y estuco. Los productos de concreto incluyen cemento Portland y productos de agregados como piedra caliza, dolomita, granito, rocs volc5nica, arena, grava, y otros materiales silicios. Estos productos incluyen cenizas volantes (fly ash) la coal 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 reactions 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, torte y/o perforaci6n puede contener materiales silicos, Jos cuales pueden causar silicosis puhnonar y cfrncer si son inhalados. En caso de ser ingeridos, mantenerse en temperatura calida, reposar y tomar grandes cantidades de agua. Las cenizas volantes pueden contener amoniaco. Seguridad La humedad puede causar la liberaci6n del amoniaco. La inhalaci6n del amoniaco puede causar toser, irritaci6n o quemaduras en la nariz, garganta y pulmones. Acudir inmediatamente al medico. El desgo en In salud depende en la duraci6n y el nivel de la exposici6n. Seguridad: Evite el contacto con ojos y contacto prolongado con In piel. Use guantes. protecci6n en los ojos y ropa Primeros adecuada Para protecci6n. L6vese las manos con jab6n suave y agua despu6s del manejo de materiales. Evite inhalar auxilios: polvos. Si se expone a polvos mis de los limites recomendados, use protecci6n respiratoria. Primeros auxilios: En caso de contacto en los ojos, inmediatamente Buya agua en la 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 In irritaci6n continua. CEMEX, Memorial Hermann Tower 929 Gessner, Suite 1900 V7 combinado Houston, Texas 77024 02/12 Para m5s informaci6n visita www.ce ' - .-9 LC - 1 SSI t -U/zS L)� ZB 514� ! ', V �ZEmcx 5358354 Plant: Begin Loading: To Job: Arrive Job; Start Unload: Finish Unload:. Leave Job: Return Plant: Customer Code:Customer Name: Project Code: Project Name: .l •.1�� v- li , 'Ticket Date: � delivery Address: Delivery Instructions: Customer Jab Number: Project P.O. Number: Order Code / Date: Order P.O. Number: Map Page: Map/Row/Column:. Dispatcher. I 1—i 11 �.:, Ticket Number._ .,1, 19L15753 Due On Jab: Slump: 'Truck Number: Driver Number, Driver Name: End Use: �1, (j(J i';^. l.'- fiver: U A,,- 1(],V�D LOAD QUANTITY CUMULATIVE QUANTITY I ORDERED QUANTITY MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT Cash Check N/Auth Coca: I Signature of Driver Receiving Cash: Check Comments: Cash Received: WATERADDED: GAL Total COD Order Amount to Collect Without Standby Charges: YARDS IN DRUM: WHEN ADDED. SIGNATURE' CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST: LT-r,_ r+gPr15AL t'F_C =•r ' I f '_ _ _ JI_L L_URD __ YF�RUS SIGNATURE ❑ LOAD. WAS TESTED BY: Notice: Our drivers will make every effort to place materials where the customer designates, but the' SPECIAL TERMS: Any water added Is at customers own risk. If water Is added on job, concrete strength Company assumes no responsibility for damages Inside curb or property line. Customer agrees to the is no longer guaranteed, WARNING: Product may cause skin and/or eye Irritation. CAUTION: Material terms of sale and delivery and accepts concrete as Is. Due to Important factors which are out of our may be hazardous to your safety and health. Please refer to the backside of this ticket for Important contact after delivery, this Company will not accept any responsibility for the finished results. No credit for safely 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 In writing AUTHORIZED SIGNATURE: within one business day after the receipt of materials. 68UNIVERSAL P^_V .I''.:� ltlir_.;.i �Y�;J LOAD Ntlrl: [- INVOICE This Delivery Ticket incorporates hJR, by reference Buyer's previously executW'red]t Application, if any, Seller's Standard Terms and Conditions, Seller's Quotation, if any, and Seller's Order Confirmation (including 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. Hazards: Freshly mixed wet cement and/or fly ash can cause eye irritation, skin and eye burns and allergic skin reactions. Dry concrete and aggregate dust may cause irritation to eyes, skin, and/or respiratory tract. Dust from handling,. crushing, grinding, cutting and/or drilling may contain silica, which may cause silicosis and cancer if inhaled. If ingested, keep warm, at rest, and drink large amounts of water. Fly Ash may contain trace amounts of ammo- nia. Moisture can cause the ammonia to be released. Inhalation of ammonia can cause coughing and irritation or 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 wv Este ticket de entrega incluye como referencia al comprador (ya previamente ejecutada en sit aplicaci6n de cr6dito); cualquier tdrmino esOmdar, condiciones del vendedor, propuestas del vendedor y orden de confhanaci6n del vendedor (con limitations y garantfas), como acuerdo total del ticket de entrega ("Contrato"). El vendedor proveera Jos tdrminos est indares 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 nionto de acuerdo al contrcto; al menos que se identi- fique con una nota al frente de este documento. RA- 411"1Cl.11gIQ / UEINILAb V ULAIN l'EN Los productos de agregados son materiales naturales como piedra caliza, dolomita, granite, 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, granite, roca volcanica, 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: Mezela de cemento fresco y/o cenizas volantes pueden causar irritati6n en los ojos, quemaduras en piel y ojos, y reacciones al6rgicas en la piel. Concreto seco y polvo de agregados, pueden causar irritati6n en los ojos, pie] 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 s] son inhalados. En caso de set ingeridos, mantenerse en temperatura calida, 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 In nariz, garganta y pulmones. Acudir inmediatamente al medico. El riesgo en ]a salud depende en la duraci6n y el nivel de In exposici611. Seguridad: Evite el contacto con ojos y contacto prolongado con la piel. Use guantes. protecci611 en los ojos y ropa Primeros adecuada para protecci6n. Lavese Ins manos conjab6n suave y agua dcspu6s del manejo de materiales. Evite inhalar auxilios: polvos. Si se expose a polvos mas de los limites recomendados, use protecci6n respiratoria. Primeros auxilios: En caso de contacto en los ojos. inmediatamente fluya agua en la parte afectada por 15 minutos. Si se inhala polvo, exp6ngase a aire fresco. Si el cemento fresco tiene contacto con sus ojos, lavelos a fordo con agua. Acuda a atenci6n medica inmediatamente si la irritaci611 contintia. CEMEX, Memorial Hermann Tower 929 Gessner, Suite 1900 V7 combinado Houston, Texas 77024 02/12 Para mas informaci6n visita www,cemexusa.com. 535J13540 Plant: Begin Loading: To Job: Arrive Job: Start Unload: Finish Unload: Leave Job: Return Plant: Customer Code: Customer Name: Customer Job Number: Order Code /Date: . ._14=1,I,71 ri. ,)''. `...t;}�. :� t_'I' l.., C'_•. I.,, i, Project Code: Project Name: Project P.O. Number: Order P.O. Number. i , f , t Ticket Date: Delivery Address: Map Pager Map/Row/Column: Delivery Instructions: Dispatcher. ,r TicketNumber, ..,,11 �,'0�1 1 M Due On Job: Slump: Truck Number. Driver Number: Driver Name:, End Use: 7. i,rl till±r':;; r't;: ;. ^.9rtil Jam; F t'JE_ D LOAD CUMULATIVE QUANTITY QUANTITY QUORANTDEREDITY MATERIALCODEPRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT Cash Check W /Auth Code: Signature of Driver Receiving Cash: Cash Received; Total COD Order Amount to Collect Check Without Standby Charges: Charge Comments 11r-JI_f_ LLJI-311 WIR[ WATER ADDED: GAL. YARDS IN DRUM: WHEN ADDED. CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST: ❑ LOAD WAS TESTED BY SIGNATURE SIGNATURE 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. 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 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 in writing AUTHORIZED SIGNATURE: within one business day after the receipt of materials. 681LINIVERSAL INVOICE This Delivery Ticket incorporates he by reference Buyer's previously execul redit Application, if any, Seller's Standard Terms and Conditions, Seller's Quotation, if any, and Seller's Order Confirmation \,,,,luding limitations of warranties), as if fglly 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 quantitiesand 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. Hazards: Freshly mixed wet cement and/or fly ash can cause eye irritation, skin and eye burns and allergic skin reactions. Dry concrete and aggregate dust may cause irritation to eyes, skin, and/or respiratory tract. Dust from handling, crushing, grinding, cutting and/or drilling may contain silica, which may cause silicosis and cancer if inhaled. If ingested, keep warm, at rest, and drink large amounts of water. Fly Ash may contain trace amounts of ammo- nia. Moisture can cause the ammonia to be released. Inhalation of ammonia can cause coughing and irritation or'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:ccmexusa.com. Este ticket de entrega incluye come, referencia al comprador (ya previamente ejecutada en su aplicaci6n de cr6dito); cualquier t6rmino est£ndar, 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 proveerd los t6rminos estandares y condiciones detal- Jades en caso de asf ser requeridos. Con este documento, el comprador acepta Jos 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. Akxmjr krALV.) / %_EivmiV jL v / rtwltjUt: l u1J u V VLAN I LJ Los productos de agregados son materiales naturales como piedra caliza, dolomita, granite, coca vole5nica, 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, rocs volednica, arena, grava, y otros materiales silicios. Estes productos incluyen cenizas volantes (fly ash) la 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 pie] 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 temperature calida, 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 natiz, garganta y pulmones. Acudir inmediatamente al medico. El tiesgo en la salud depende en in duraci6n y el nivel de la exposici6n. Seguridad: Evite el contacto con ojos y contacto prolongado coil In piel. Use, guantes, protecci6n en los Ojos y ropa Primeros adecuada para protecci6n. L6vese las mans con jab6n suave y agua despu6s del manejo de materiales. Evite inhalar auxilios: pelves. Si se expone a pelves mds de los limites recomendados, use protecci6n respiratoria. Primeros auxilios: En caso de contacto en los ojos, inmediatamente fluya agua en la pane afectada per 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 nuts informaci6n visita www.cemexusa.com. L� COMOX 58582138 pxa 1,571-01zs Plant: .Begin Loading: To Job: Arrive. Job: Start Unload: Finish Unload: ,Leave Job: Return Plant: C 92/ 109E: Customer Code: Customer Name: Customer Job Number. .Omer Code/.Date: - .1-. rONSTRUCTIOIy CF_RV.ICES LLC 74-r 02/cE/ic IProject Code: Project Name: • Protect P.O.Number. Omer P.O. Number. 1 THRI, VIPI-i PU F2cc+lj 17 E ?j 9 r V<�" - t `itc.0 Ticket Date: Delivery Address: Map Page: Map/Row/Column: Y Di - Delivery Insbuctions; Dispatcher, � ! Tcket Number. i l I :,42.,0t 3n I. i Due On job: slump: S. 00 �I �I�CJmb,�.3 I�Dn�`Nui er: �Trer NaUL I T( R End Ut�LDNG: EXT SHE- G LOAD r QUANTITY CUMULATIVE I QUANTITY ORDERED QUANTITY MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT t . uit j 3G9--90 3000 BL ENDEDPRP+t I t.tab 12-7t?"_N FUEL SURCHARGE 1 . 00 12f'V:749 ENV I RONMENTAL, CHARRE f FEB 20 rm 1:01 Cash Check If/Auth Code: Signature of, Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect Check Without Standby Charges: Charge Comments: WATERADDED: 1. GAL YARDS IN. DRUM: WHEN ADDED. - * CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST: E'TE DISPOSAL FCE PARTIAL. FULL LOAD- WiRDS'a SIGNATURE '❑ LOAD WAS TESTED BY: " lur drivers will make every effort to place materials where the customer designates, but the SPECIALTERMS: Any water added is at customers own risk. If water is added on job, concrete strength Sumno responsibility for damages inside curb or propertyMne. Customer agrees to the Is no longer guaranteed. WARNING: Product may cause akin and/or eye imitation. CAUTION:.Material 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 livery,this Company will not accept any responsibility for the finished results. No credit for safety handling information, and to the materialgafny data sheets for additional information. Ste. Buyers exceptions and claims shall be deemed valved unless made to us in wrib'ng AUTHORIZED SIGNATURE: % ass day after the receipt of materials. — © /I %�/?� 'iI C.V IIU I'e tV�•L G.,J f:u .^ ru,_\..•\a'Lnf+ J� n1V iu-u\ Il4 i• I y �:BAB 'NUN. t.. 4L INVOICE {! t" This Delivery Ticket incorporates herein by reference Buyer's previously executed'"' -it Application, if any, Seller's Standard Terms and Conditions, Seller's Quotatio any, and Seller's Order Confirmation (ir ilia limitation4�of-w,iIranties), as if fully set forth on this Delivery Ticket ("Agree.......:'). Seller will provide the Standard Tern.,. ".,d 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. Hazards: Freshly mixed wet cement and/or fly ash can cause eye irritation, skin and eye burns and allergic skin reactions. Dry concrete and aggregate dust may cause irritation to eyes, skin, and/or respiratory tract. Dust from handling; crushing, grinding, cutting and/or drilling may contain silica, which may cause silicosis and cancer if inhaled. If ingested, keep warm, at rest, and drink large amounts of water. Fly Ash may contain trace amounts of ammo- nia. Moisture can cause the ammonia to be released. Inhalation of ammonia can cause coughing and irritation or bums of the 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.comexusa.com. Este ticket de entrega incluye Como referencia al comprador (ya previamente ejecutada en su aplicaci6n de cr6dito); cualquier t6rmino estindar, 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 proveeru los t6rminos est5ndares 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. AGREGADOS / CEMENTO / PRODUCTOS DE CONCRETO / Los productos de agregados son materiales naturales como piedra caliza, dolomita, granite, rota 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, rocs volcanica, arena, grava, y otros materiales silicios. Estes productos incluyen cenizas volantes (fly ash) la coal puede contener mds 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 piel. Concreto seen y polvo de agregados, pueden causar irritaci6n 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 cftncer si son inhalados. En caso de ser ingcridos. mantenerse en temperatura calida, 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 at 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. Livese las manor conjab611 suave y agua despu6s del manejo de materiales. Evite inhalar auxilios: polvos. Si se expone a polvos mas de los limites recomendados, use protecci611 respiratoria. Primeros auxilios: En caso de contacto en los Ojos, inmediatamente fluya agua en la pane afectada per 15 mim Si se inhala polvo, exp6ngase a aire fresco. Si el cemento fresco tiene contacto con sus Ojos, ldvelos a fondo agua. Acuda a atenci6n m6dica inmediatamente si la irritaci6n continua. A CEMEX, Memorial Hermann Tower 929 Gessner, Suite 1900 V7 combinado Houston, Texas 77024 02/12 Para mas informaci6n visita www.cemexusi.com. -MGX 5858223 �- I Lo+ ZB SIC [sit -or s r Plant: Begin Loading: To Job: Arrive Job: 'Start Unload: Finish Unload: Leave Job: Return Plant: Customer Cade:, Customer Name:. Customer Job Number:. Order Code/Date: 3'..�: - ((-�,}I_ZL&ISTRLG1 TON SERVICES-1 LC 'Pro _7O,c -— <<6li6._ Prone Coda: act Name: ProjectP.O.Number. Omer P.O Number. ber —rtF $�T L.ti I HRC, - V�:kU PO PIEC-U f RE 1 F'17 ^,. I I- n'E1) Ticket Datay.. Delivery Ad areas: ,. _ Map Pager Map/Row/Column: 01' Delivery Instructions: 1 - Dispatcher: t:..5t. . I Ticket Number. ' ` 34229535-9 I - Due On Job: Slump: Truck Number. Driver Number: Driver Name: End Use: 2:f i 9,5lt :0022589 109251 FLLRICH JEAN—P1ARY I BLDNG: EXT SHEL LOAD QUANTITY CUMULATIVE QUANTITY ORDERED QUANTITY MATERUILCODE PRODUCTION DESCRIPTION VOM UNIT PRICE - AMOUNT R' Y. 00 RC't itii C FUEL SURr>1q 7GE 1>00 1:.s':C- Iu EIQV1P0NIrENTAL CHARGE I Cash Checkk/Auth Code: Signature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect 'Check _ Without Standby Charges: Charge z Comments: WATERADDED:vGAL YARDS IN DRUM: _ WHEN ADDED. SIGNATURE CURB LINE CROSSED AT OWNER'S/AGENT'SREQUEST: LiIV.r.;aZC'TE 77 i �'C75AL r`E� ' PARTIAL FULL WAD !LARDS SIGNATURE ❑ LOAD WAS TESTED BY: Nodes: Our drivers will make every effort to place materials where the customer designates, but they SPECIALTERMS: Any water added is at customers own risk. Ifwater is added on Job, concrete strength Company assumes no responsibility for damages Inside curb or. property line. Customer agrees to the is no longer guaranteed. WARNING: Product may muse skin endfor eye Irritation. CAUTION: Material terms of sale. and delivery and accepts concrete as Is. Due to Important factors which are out of our may be hazardous to your safety and health. Please refer to the:backside of this ticket for Important control after delivery, this Company will not accept any responsibility for the finished results. No credil for safety handling information, and to material safety data sheets for additional information. returned concrete. Buyers exceptions and claims shall be deemed waived unless made to us in writing AUTHORIZED SIGNATURE: within one business day after the recelpl of,matedals 68UNIVER$AL F'KtV I KK: -; �-/ N !UFIU NUN INVOICE This Delivery Ticket incorporates herein h- reference Buyer's'previously executed 1" - -ait Application, if any, Seller's Standard Terms and Conditions, Seller's Quotatio many, and Seller's Order Confirmation (i ing limitations o£ w6i•antics), as if fully set forth on this Delivery Ticket ("Agree....,.,:'). Seller will provide the Standard Tern..-,.,.d 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. Hazards: Freshly mixed wet cement and/or fly ash can cause eye irritation, skin and eye burns and allergic skin reactions. Dry concrete and aggregate dust may cause irritation to eyes, skin, and/or respiratory tract. Dust from handling, crushing, grinding, cutting and/or drilling may contain silica, which may cause silicosis and cancer if inhaled. If ingested, keep warm, at rest, and drink large amounts of water. Fly Ash may contain trace amounts of ammo- nia. Moisture can cause the ammonia to be released. Inhalation of ammonia can cause coughing and irritation or 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 skiti, 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.cemextisa.com. Este ticket de entrega incluye come referencia al comprador (ya previamente ejecutada en su aplicaci6n de crddito); cualquier t6rmino estandar, conditions del vendedor, propuestas del vendedor •y orden de confirmaci6n del vendedor (con limitations y garantfas), come acuerdo total del ticket de bntrega ("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 come 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. AUAJV UAVVJ / L 1V1EA 1 V / YKV17U1:1 VJ VIS k UINl:KE I U / UE1N14A�1 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 alba5ileria, 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 curl puede contener mas de 0.025% de silicio etistalino. Peligros: Mezcla de cemento fresco y/o cenizas volantes;0u6den causar irrifaci6n en los ojos, quemaduras en piel y ojos, y reactions alergicas 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'triturarltieuto; pulido, torte y/o perforaci6n puede contener materiales silicosJos cuales pueden causar silicosis pulmonary cancer si son inhalados. En caso de ser ingeridos, nantenerse en temperatura calida, repo'sar y tomar grandescantidades de agua. Las cenizas volantes pueden contener amoniaco. Seguridad: La humedad puede causar la liberaci6n del amoniaco. La inhalaci6n del amoniaco puede causar toser, initaci6n o quemaduras en la nariz, garganta y pulmones'. Acudir inmediatamente at medico. El riesgo en la salud depende en la duraci6n y el aivel de la exposici6n. Segutidad: Evite el contacto con ojos y contacto prolongado con ]a pie]. Use guantes, protecci6n en los ojos y ropa Primeros adecuada para protecci6n. Livese las manes con jab6n suave y agua despu6s del manejo de materiales. Evite inhalar auxilios: pelves. 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 per 15 minutos. Si se inhala polvo, exp6ngase a aire fresco. Si el cemento fresco tiene contacto con sus ojos. lavelos a fondo con agua. Acuda a atenci6n medica inmediatamente si la irritaci6n continua CEMEX, Memorial Hermann Tower 929 Gessner, Suite 1900. V7 combinado Houston, Texas 77024 02/12 Para mas informaci6n visita www.cemexusa.com.