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JIM BRISCO ENTERPRISES, INC Mailing Phone: (209) 356-3275 Address: 221 Air Park Road, Suite A Dispatch: (209) 761-2280 Atwater, CA 95301 Weighed at: 14960 Vinewood Ave. Livingston, CA 95334 SOLD TO: SHIP TO: WEIGHMASTER CERTIFICATE THIS IS TO CERTIFY that the following described commodity was weighed, measured, LOAD TO JOB ON JOB BEGIN POUR FINISH POURt TO PLANT O.T. MINUTES ., IN i, N t 5 MINUTES PER YARD 1 x 4 RK DATE PLANT # CUSTOMER # t TRUCK # TYPE MATERIAL TICKET # MIX # - NAME/ LOAD # - ACCUMULATED TOTALS YARDS WEIGHMASTER WATER ADDED: WEIGHMASTER CERTIFICATE THIS IS TO CERTIFY that the following described commodity was weighed, measured, PRODUCT DESCRIPTION or counted by a weighmaster, whose signature is on this certificate, who is a recognized UNITS authority of accuracy, as prescribed by Chapter 7 (commencing with Section 12700) of CEMENT Division 5 of the California Business and Professions Code, administered by the Division ., IN i, N of Measurement Standards of the California Department of Food and Agriculture. DRIVER RECVD.BY ALL WEIGHTS ARE IN POUNDS UNLESS OTHERWISE SPECIFIED All claims for shortage or allowances must be made in writing within five days from date of delivery. TERMS: All purchases not paid by the last day of the month following date of purchase WE MAKE DELIVERIES INSIDE CURB LINE AND ON THE LOT AT CUSTOMER'S RISK ONLY AND AC shall incur a minimum of $2.00 service charge per month or 1'/z % per month finance charge, CEPT NO RESPONSIBILITY WHATSOEVER FOR DAMAGE RESULTING FROM SUCH DELIVERIES, whichever is greater. 1'/z % per month is equivalent to an annual percentage rate of 18%. KEEP THIS DELIVERY TICKET FOR FUTURE REFERENCE Buyer will pay reasonable costs of collection and attorney's fees. BY: PRODUCT DESCRIPTION UNITS CEMENT ., IN i, N Yd3 5 MINUTES PER YARD 1 x 4 RK FREE UNLOADING TIME ALLOWED. PEA RK i Additional unloading time charge at current SAND hourly truck rate of $90.00 per hour. WATER �r lt�J O.T. Minutes @ $ /min = $ ADD MIX SUBTOTAL SALESTAX ADD MIX INSPECTOR'S SIGNATURE ORDER TOTAL DRIVER RECVD.BY ALL WEIGHTS ARE IN POUNDS UNLESS OTHERWISE SPECIFIED All claims for shortage or allowances must be made in writing within five days from date of delivery. TERMS: All purchases not paid by the last day of the month following date of purchase WE MAKE DELIVERIES INSIDE CURB LINE AND ON THE LOT AT CUSTOMER'S RISK ONLY AND AC shall incur a minimum of $2.00 service charge per month or 1'/z % per month finance charge, CEPT NO RESPONSIBILITY WHATSOEVER FOR DAMAGE RESULTING FROM SUCH DELIVERIES, whichever is greater. 1'/z % per month is equivalent to an annual percentage rate of 18%. KEEP THIS DELIVERY TICKET FOR FUTURE REFERENCE Buyer will pay reasonable costs of collection and attorney's fees. BY: