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^�1NCRETE DISPATCHERS:
L•
AMI-DADE: (305) 264-710.1
DEERFIELD: (954) 480-9333
•
"The On Time Concrete
BLOCK PLANT: (305) 805-3226
Company"O
WWW,SUPERMIX.COM
-v' CENTRAL CONCRETE .SUPERMIX, INC.
LARGEST INDEPENDENT READY -MIX
CONCRETE PRODUCER IN FLORIDA
.vDELI,UERYTICKET� ,,„`},3 DATE
MAIN OFFICE: 4300 S.W. 74th Ave. • Miami, FL 33155
NOR.VRUST #Z•- 728155 29—Nov-12
PHONE: (305) 262-3250 • FAX: (305) 267-0698
SERVING MIAMI-DADE, BROWARD, PALM BEACH, MARTIN & ST..LUCIE COUNTIES
s Y�
DELI�/ERYADDRESS
- .. , ... ,: ,.., r , :�•_, ?;^„..-dw 4"r' t �; �' ¢v
z....
NORVELL RUSTY
2107 JOHNSTON RD FT'PI.ERCE
800 ULRICH RD
VARIOUS JOBS/. FT P- STUART PB MARTIN ...
FT PIERC,FL 34982
PO #
ORDER# 52
PROJECT #: 1021E
MAP PAGE:' CAZ24 ,LOT%BLO.CK:. A748474
INSTRUCTIONS:
5.00 50PM/5000 PR/Phi
ENV
FUEL•SUR
EXTRA UNLOADING TIME CHARGE MINUTES
*6 MINUTES PER CU. YD. ALLOWED
SLUMP
THIS DELIVERY TOTAL
4+/-1 •
in OF YOUR ORDER FOR 5. 00 CU. YDS.
CUSTOMER OR HIS AGENT ASSUMES FULL RESPONSIBILITY FOR STRENGTH AND/OR
PERFORMANCE OF ANY CONCRETE PLACED ABOVE DESIGN SLUMP Ok WHEN
WATER IS ADDED. WATER ADDED ❑ YES ❑ NO GLS.
I eY
s
ALLOWABLE TIME' PER MINUTE
X $1.60 =
SHORT LOAD CHARGE
5. 00 CU. YDS. I AMOUNT
TAX
�TAL •In
TIME ARRIVED ON JOBS STARTED UNLOADING ' :FINISHED ;UNL,OADINGL EAVVNG THIS JQB,TQTAL�TLME
SUBJECT TO THE TERMS, CONDITIONS AND "CAUTION" WARNING LISTED ON.BOTH THE
FRONT AND BACK OF THIS TICKET
TRUCK . r,t DRIVER I acknowledge that.l have receiv d and accepted t ateriais listed o this ticket. •I
understand and agree to the on tfi from nd back of this ji et. .
RECEIVED BY: X'
34E5 Jackson Der ti:c
AA&W,
CONTROL 1'9 LOADING POINTS AT 16 LOCATIONS TO SERVE YOU BETTER
oA\0 COyc MIAMI • AIRPORT • OPA LOCKA • MEDLEY - PERRINE • PEMBROKE PINES • DEERFIELD • BOCA RATON
1 4 m 2293 RIVIERA BEACH • STUART • W. BROWARD • FT. PIERCE • E. BROWARD • DELRAY • LOXAHATCHEE (
PRODUCERS AND SUPPLIERS OF QUALITY READY MIXED CONCRETE AND CONCRETE.BLOCK ARMCA
AM'
Concrete, Company of Florida );
1142 Watertower Road, Lake Park FL 33403
Palm Beach: (5'61) 844-99 4`Martin/St.Lucie: (772) 219-99 9
Concrete Tested ❑ Yes N�� LOT #
Wper Added at Customer's
Cylinders Taken ❑ Yes ❑:'' o f
f'/ Request
�f
gals. to full load
Comments
gals. to 2/3 load
gals. to 1/3 load
-
Customer's Rep - Water Added
NOT RESPONSIBLE FOR
WARNING IRRITATION TO THE SKIN AND EYES
ADDITIONAL WATER ADDED TO THIS
VARIATION IN COLOR OR
Cement polymer or freshly mixed concrete may cause skin injury. Avoid contact with
skin and wash exposed skin areas promptly with water. If any cement powder or
CONCRETE WILL REDUCE' ITS STRENGTH
SURFACE DISCOLORATION
mixture gets into eyes, rinse immediately and repeatedly with water and get prompt
medical attention. Keep children away from cement powder and all freshly mixed
AND DURABILITY. ANY WATER ADDED IS
AT CUSTOMER'S OWN RISK.
BATCH TIME
?', ;
cement products.
r
PLANT
TICKET# ORDER
#
JTRXCK #
I IOAD SIZE
MIX
SLUMP
DATE
CUSTOMER #
SOLDTO
P.O. #
PROJECT#
DELIVERY ADDRESS
ZONE :#
USE
DRIVER
INSTRUCTIONS TIME DUE
a
DESCRIPTION
U.OA.
UNIT PRICE
AMOUNTPRODUCT
4.rVI V 1r:1.+
SIGNATURE
OR RECEIPT'-,@ONC
ETE U-ACKNOWLEDGEMENT
OF HAZARD
-WARNING
asc Meyer ogcre a ompany w n,Qf assumeliability or any property amage or any
t6 r SUB -TOTAL
r
-ma
equipment dage roS.�leliveYies be, the curb line.
/ d`r #� _ TAX
1 AU HORIZEQ BY
1 +t U, '
SHIPMENT SUBJECT TO CONDITIONS ON REVERSE SIDE., TOTAL
THI�S WHJV:NT;,S MADE SUBJECTTO THEFOLLOWINu �_:ONDIT
- v f m ter a
prxwoe o yKade roadway, for ourtrucks Yom qy Mob pavew,,enit a 1 1.
VSS&I SuKabe "Ic", ciovidsdgve reserye Ote,,�ghtto stop&-;iiverk�s urtil �.ctna�!Icms Fire terne'dicdatid, in such
&a hyM fur any ioss thereuy
:nao'e, ocycnd Tz !ine at the cuzstomer or custoirrer repre�,P,,Mafive' -< regist, any damages including
in? oo: AmAea ta manaks, dKeways, buildings, Uses- shn.iblheri, se!)dc tanks and sepbc system% imKiding Me drain
lip! 0:0 a H:c ova,, S YOK
".o ro i Tx b. i (" Do rn pan y f o r I os s of timeand eq tj i p me at E3y r¢;8 s c. n, . cr,,' SS. ch do Ii tiery; at, d al so to
'not-'y arld Sme Qm was edd CorrqP-rq irom any and all claims demari�ds and s'wts fof (jon account of or in any
d !nar tr-uck trnf)r, s'riown are lot qcE t a i W and Sep %,ices showin have been mcele
�xjyn a—lat Ot Wye[ ine -,L!-,torner's requebtis shown coneefy
hNnAed ms=Wainod from this 1(,)ad of concrete; many inir-loriant la,,,.fons affecting the ulflnrl'Att
of arid t-,Ontml'
OWWWWan No -son'-, K yn "I W HOWIng Ums
1
02 WK T :i P q 4n, ren due. ',ast dito to a " 1/2r:.. t,t' r'ce
1 mnx,; -ebyackriciviedge's no('ei"J, C� 1�:2 copy oft�-is Con'tracl,
maschmc]AM '
Concrete. Company of Florida
1142 Watertower Road, Lake Park FL 33403
Palm Beach: (561) 844-9994 Martin/St.Lucie
t � el
(772) 219-9994
Concrete Tested ❑ Yes I No LOT #
Water Added at Customer's
Cylinders Taken ❑ Yes t No #"
Request
gals. to full load
Comments a • 9.
gals. to 2/3 load
"�p
t $t
gals. to 1/3 load
Customer's Rep - Water Added
NOT RESPONSIBLE FOR
WARNING IRRITATION THE SKIN AND EYES
ADDITIONAL WATER ADDED TO THIS
VARIATION IN COLOR OR
Cement or freshly mixed concrete may cause skin Injury. Avoid contact with
CONCRETE WILL REDUCE ITS STRENGTH
SURFACE DISCOLORATION
skin and wash exposed skinareas promptly with water. if an p cement owder or
mixture gets into eyes, rinse immediately and repeatedly with water and get prompt
medical attention: Keep children away cement powder and all freshly mixed
AND DURABILITY. ANY WATER ADDED IS
AT CUSTOMER'S OWN RISK.
BATCH TI,+
{ME_
;
cement products.
• ..
• .
PLANT
TICKE_ T# ORDER
#
TRUCK #
LOAD SIZE
1
MIX SLUMP
DATE
CUSTOMER #
SOLDTO t
P.O. #
PROJECT#
71
DELIVERY ADDRESS
ZONE#
USE
DRIVER
,.I'"
f'-- iVr ' ., ,
INSTRUCTIONS
TIME DUE
• 1
• • •
• • • •PRODUCT
DESCRIPTIONI.I.O.M.
•
•
•
•
,I. .-iI{�
,i
ICI
OR RECEIPT - CONCRETE
AND ACKN
EDGENIENT OF HAZARD
SIGNATURE
WARNING
• asc Meyer oncre e.n ompany Will not assume HaDlIny Tor any property damage or any SUB -TOTAL
the
equipmer�f damage for"any deliverie beyond curb line.
TAX
/ AUTHORIZED BY
SHIPMENT SUBJECT TO 4 ND.IT Of�l •ON REVERSE;SIDE '+ TOTAL
s-3 r ��EU)IF fS MADE 'SUWi CT T() THE .FMI OINM DN
Pw b;oci �o, away for, our lruc,,�,S from ornenplace of deliver of materIal.
unl,fl condftions are remedied and, in such
resewe'(1
,;z' h ZNk 3Z-I !II) Si b IG fcr ar%ylos�� caused 11hefeby.
r.,. ll—a` 'he custorne, or custom e(repr sent�'Aivi��s request, an, ClUding,
:-111-:'..."', y damages lr-
�,7 , -4 &, I
- , -q�� - i cl din drai
kls, dt �v':!Ys, bt.;ildingsi, tIE �s, shrubbery, ,�qptictanks and s.Fptic system n u g the n
kwine ,-,.no equ "un" by rs.--�,:;on ofsuch doliver�y, and alwto
��al 00,-iloany f-), 4OSS 01
harrr1ess, Oomoak"Y lrorn arly i Sr a at! cizJrrls, obwnanj-, and su-Its fflsortjn account of o,, m any
•
-,,ni hat,, t:, been t�ai -rev[, and
�hown are coi
ustorner's requk,.�st is snown corfecli�,� C4U'flaN. -,'ne addition of water teduces
x vv��ji� r
'A'a ago. totr* 'Ue, I',- fini -hed oblFained kcifn this loa, i onrrelm: 'roar"Y ilmpar,*aw fac'mrs affectling the ut try'late
Vard ti axceed'ad.
("'harged after 8 mir .ite 5 per cubi,
law 0 -Aver 'o rn I I T.o v) r,,,,v `jq a s i fj vv, a s da "N n f a C i I itv f o r o w ru � KS ---A 1 to! d �� F at t' z 1, f d" of rnaterial.
k and expr-,,r..cdes, -f c0leclion, lncJ-diti g :;t w 4cmav's tce, ii' he ShaW
F r, � ac-COIjillS, 2v 0 XD a 5Eii Vice
;af-:z*x;Ia,J in �11,s invofc, v"'herl aue ast d 'a
I h,*. cucstorner h�.�- rebv ackn6wiedge,3 r�x�elw of the cornp�tete. copy of ibis contract
Meschmel
Concrete Company of]Florida �.
AM'
1
1142 Watertower Road, Lake Park FL 33403
Palm Beach: (561) 844-9994 Marti n/St,Lucie: (772) 219-9994� � ��
� 7
i 7 I���
i 11
/i%
Concrete Tested., ❑Yes No LOT # `
Water AAlded at Customer's
Cylinders Taken ❑ Yes No
Request
gals. to full load
Comments+r
fr gals. to 2/3 load
gals. to 1/3 load
1'
AN
- ustomer's Rep - Water Added
NOT RESPONSIBLE FOR
WARNING IRRITATION TO THE SKIN AND EYES
ADDITIONAL WATER ADDED TO THIS
VARIATION IN COLOR OR
Cement polymer or freshly mixed concrete may cause skin injury. Avoid contact with
SURFACE DISCOLORATION.
skin and wash exposed skin areas promptly with water. If any cement powder or
CONCRETE WILL REDUCE ITS' STRENGTH
mixture gets into eyes,. rinse immediately and repeatedly with water and get prompt
medical attention. Keep children away from cement powder and all freshly mixed
AND DURABILITY. ANY WATER ADDED IS
AT CUSTOMER'S OWN RISK.
BATCH TIME
cement products.
t ant
�0� 7777
ER #
TRUCK #
LOAD SIZE
MIX SLUMP
DATE
CUSTOMER #
SOLDTO
Ro.#
PROJECT#
DELIVERY ADDRESS
ZONE#
USE
DRIVER
INSTRUCTIONS
TIME DUE
PRODUCT DESCRIPTION
UNIT PRICE
AMOUNT
i::k,
1
_1
±
SIGNATURE'
OR RECEIPT -CONCRETE
AND ACKNOWLEDGEMENT
OF HAZARD
WARNING
asc Meyer Concrete �, ompany willno assumeliability or any property damage,or any SUB -TOTAL
equip. nt damage�forany c eliverfes beyond.,the curb line.
4!,{j. l,� _ __.
Y TAX
6 r Y s --- -- AUTHORIZED BY
SHIPMENT' SUBJECT TO � ONDITIO ,S' ON REVERSE SIDE. TOTAL,
TM S DELIVE S MADE SUBJECT TO THE FOLLOWIN DNDITIONS: 0 ` .
Cry. Corr w i aqr4e§,-"o pro' vi&a suitable roadvlay for our trucks from the street pavement to the place of delivery of rnaterial.
tf such'sw'tab'6 roadways are not provided, we reserve the right to stop deliveries until conditions are remedied and, in such
event, customer will be, hold rpspprisible for any, loss caused thereby.
2. VVt teri delivery is made boyondthe curb line at, the customer or i customer rerresentative's request, any damages including,
ng,
bait rust lirri'lled to, sida ewalks, dw veays, buill .4.igs, trees, shrubbery, septic tanks and septic systems, including the drain
field are at the ovvner's risk.
',he custornar agrees to reimiourz-e said Company for loss of time and equipment by reason of such delivery, and also to
infIef n-lify and save narmiless said Company from any and all claims, demanas and suits for or on account of or in any
-anrercoused byoraoking fry; in private driveway delivery.
4, Customer acknowledge", "Nat ali material and services shown have been received, that trucktimes shown are correct, and
il'hiat the a.mount of water added at the customer's request is shown correctly. CAUMN: The addition of water reduces
conicrete --t�'angth and du�ab'04y,
5. 1,Neare not responsiNe forfinished results obtained from this load of concrete; many important factors affecting the ultimate
;afity ct trie tompleted job ai e beyond cur scope of responsiolity and control,
6. A charge cif jxrminute will be. charged after 8 minutes per cubic yard unloading bine 16 exceeded.
7, 1 no agrees tc provide a suitable wash down facility for our trucks and tools ai ,he place ofdelivery of materiai.
'
8. Tlh*, ;^Iereby agrees to pay all costs and expenses of collection, including-areasonabI6 ax torney's tee, if he shall
fair tG a, r il
the merchandise reflected in this invoice, when due: Past due accounts are quNect to a 1-1/2% service
charge on We ur;paid past due, galance, The customer hereby acknowledges receipt of the complete copy of this contract.