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PEARSONS CONCRETE <br />10284 UNDERWOOD RD., ACAMPO, CA 95220 <br />te TELEPHONE (209) 334-9234 <br />WiliGHMASTER CERTIFICATE <br />THIS IS TO CERTIFY Mei 0,1 following described commodity Wee Weed. measured. Of <br />counted by a weIghtriader, whose Mena-tuns le c•-• Otis certificate, iehia is amortised authority <br />Of abetnitY. 23 2922,1b2d by Cbibler 7 (Commencing witth Section 12T110) of Division Sof the <br />Ceillomia Business and Professions Cods, administered by the Wahl:ion of faaanuement <br />Standards of Me Crifornis Department of Food and Agricutture <br />CAUTION <br />Freshly mixed cement, mortar, <br />concrete or grout may cause skin <br />Injury. Avoid contact with skin where <br />possible and wash exposed skin <br />areas promptly with water. If any <br />cement mixtures get into eyes, rinse <br />Immediately and repeatedly with <br />water and get prompt medical <br />attention., <br />KEEP OUT OF REACH OF CHILDREN.' <br />Dear Customer <br />NOTICE: WE MAKE DELIVERIES INSIDE THE CURB LINE <br />AT CUSTOMER'S RISK ONLY, AND ACCEPT NO <br />RESPONSIBILITY WHATSOEVER FOR DAMAGES <br />RESULTING FROM SUCH DELIVERIES. <br />The driver at this truck, In requesting the additional signature below, is of the opinion <br />that the size and weight of the truck may possibly cause damages to the premises <br />aricifor adjacent property if the driver places the material In this Iced where you desire <br />it his out wish to help you in every way that we can, but in order to do this, the driver <br />is requesting that you or your representative sign below indicating you have released <br />the driver and PEARSONS CONCRETE from all responsibilty for any damage that <br />kf, may occur to the premises and/or adjacent property, buildings, sidewalks, driveways, :7 <br />curbs, etc. by the delivery of this material. Further, as additional consideretion, you <br />agree to help the driver remove mud from the wheels of the driver's vehicle so that <br />C:r the driver will not litter the public street, and you agree to indemnify and hold <br />C.A harmless the driver of this truck and PEARSONS CONCRETE for any and all liabilities —.C.. s.,..,,, o ... and damages to the premises and/or adjacent property which may be claimed by %.. <br />„.....% ....tsi. anyone to have arisen out of delivery of this order. <br />Signature: <br />ORDER NO DATE .200 <br />CUSTOMER <br />DRIVER TRUCK LOAD CU YDG <br />CONCRETE MIX START TIME <br />1 CEMENT ARRIVE JOB <br />-- --7 <br />i / Y-L) <br />A-1 <br />ADMIX I <br />LEAVE JOB <br />A-2 END TIME <br />A-2 <br />ADMIX 2 <br />TOTAL <br />A-4 FREE <br />WATER NET <br />THIS LOAD SACK WE IGHED AT <br />GUARANTEED CUBIC .1 CON- MIX 7 901 SIMMERNORN <br />TO YIELD <br />YARDS CRETE NO. GALT CA. <br />PEARSONS READY MIX CONCRETE INC.— WEIGHMASTER <br />QUANTITY UNITS DESCRIPTION UNIT PRICE AMOUNT <br />CU YDS CONCRETE <br />MIN. STAND BY TIME <br />1 <br />% <br />HOURS RENTAL +. <br />5 MINUTES PER YARD <br />UNLOADING TIME <br />FREE CHARGE C.O.D. <br />ALLOWED TOTAL . <br />ERRORS IN PR CE EXTENSION AND ADDITION SUBJECT TO CORRECTIONS <br />TERMS: Net 30 Days. one end one-halt ft trrej percent per month will be charged on pail due accounts <br />Any reasonable legal tees incurred in concoction of atoye will be added to this charge. <br />• BY <br />Received By: X <br />GERMANY EIROTHERS PRINTING — REV.9/0 1