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Plant: Begin Loading: To Job: Arrive Job: Start Unload: Finish Unload: Leave Job: Return Plant:'
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Customer Code: Customer Name: Customer Job Number: Order Code/Date:
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P.ojectCode,:.. Pr-:act,Name, jectP.O.Number: br er P.O.Number.
Ticket Date: Delivery Address: Mapager Map/Row/Column:
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t}Delivery Gstrudwns: ". . j.. :j f' �a�E Dispatcher:»''
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Due On Job: Slump: Truck Number: DriverNpmber: Driver Name: =se:{ nr�i: <,ar r�r",a,ert_e.f; •,i
LOAD CUMULATIVE ' ORDERED- MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT
QUANTITY QUANTITY QUANTITY [f a yy,� r^ 1h rr'- T�•4 6, t
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Cash Check#/Auth Coder Signature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect
Without Standby Charges:
Check
Charge
Comments: ,,//��
WATERADDED: _GAL ;f YARDS IN DRUM: f
O WHEN A DED. 7/7
/ U SIGNATURE
CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST:
FULL. Li]-if-ID a C SIGNATURE;
• " Ll 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
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 mane to us in writing AUTHORIZED SIGNATURE:
within one business day after the receipt of materials. 0
68UNIVERSAL r'i�E V _1'€*'%& ,l.{,7{_!s^`.r iF r:
CUSTOMER
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Plant,-, Begin Loading: To,Job: Arrive Job: Start Unload: Finish Unload: Leave Job: Return Plant::-"
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Customer Code: Customer Name: Customer Job Number: Order Code/Date:
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Project Code: Project Name; Project P.O.Number. ' Order P.O.Number:
Ticket Date: Delivery Address: Map Page: Map/Row/Column:
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rY Dispatcher:
Delivery Instructions: '
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Ticket Number:
Due On Job: Slump: Truck Number: Driver Number: Driver Name: End Use:
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LOAD CUMULATIVE ORDERED MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT
QUANTITY QUANTITY, QUANTITY
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Cash Check#/Auth Code: Signature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect
Check Without Standby Charges:
Charge
Comments:
WATER-Al�DED: GAL YARDS IN DRUM:
-WHEN ADDED.
/SIGNATURE
' CURB LINE CROSSE Al OWNER'S/AGENT' REQUEST:
'"i..kL.I_ 4..C1 i.:lT's 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 cr 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 maybe hazardous to your safety and health. Please refer to the backside of this ticket for important
control after delivery,this Company will not accept any responsibility for the finished results. No credit for safety handling information,and to 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. O
i•'':—�� 1 ,'.i�.,i, r i,_C,%F'�A t�}7.}1'I w a.
CUSTOMER