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Matt Domler Trucking <br /> 907 Zephyr Lane <br /> Vacaville, CA 95687 <br /> Phone (707) 718-5758 <br /> CA# 0114748 <br /> IDIST. <br /> ATE <br /> OB <br /> DATE: _ MATERIAL: EQUIPMENTTYPE FREIGHT `a4I(a ' � l - I � ' "� � � BILL NO:DESTINATION: /1 ❑ END DUMF RK <br /> WHEREMArLDELIVERED {;(� C. r) - 0.CC\POINT OF ORIGIN: /} �/� y` 'y / ❑ LOW BED OS <br /> WHERE MAIL WAS LOADED �� R - .:5 I 0 C f U,CONSIGNOR: ( / / CONSIGNOR ❑ FLATBEDRS <br /> WHOOWEDMArL eA-f!� C �cr+� r. r�7ia�1 ADDRESS <br /> �� NS <br /> CONSIGNEE: /} CONSIGNEE lSHIGHSIDE <br /> WHO RECD MArL 9�P(. )fADDRESS RATE NOTICE AND DATE <br /> DEEBTOR: DEBTOR <br /> CONTRACTOR ADDRESS <br /> LOCATION AND WHEN ZONE RATES APPLY: YARDATE CAP Y , I <br /> DRIVER MILEAGE: CY <br /> REPORTED TIME ' PROD AREA: DEL.ZONE: IF APPLICABLE <br /> • ■ • • ■ <br /> TAG REMARKS <br /> 60 <br /> G. r <br /> 4 <br /> 5 <br /> 6 <br /> 8 <br /> 9 <br /> 10 <br /> fi <br /> 12 <br /> 13 <br /> TERMS: <br /> 14 PAYMENT DUE BY 20TH OF FOLLOWING MONTH <br /> (Section 7108,6 of the California Business b <br /> 15 Professions Code).A service charge of <br /> 1'/A per month(18'/,per annum)will be charged <br /> 16 on past due accounts, Debtor(Contractor)agrees ! <br /> to pay red''onable attorney fees and court <br /> 1 r cosh In casee�of SUN to collect, <br /> DISPATCH ELAPSED RUNNING TIME FROM LINE G TO LAST LOAD TIME THAT DEBTOR N!LELAPSEE)UNLOADING <br /> (LOADED TRAVEL TIME)OF <br /> OLESS <br /> OR WEIGH TIME PLUS DOUBLE SHOULD NOT HAVE TO ME OF LAST LOAD <br /> TIME: LINE 0 PLUS LINE 0 O PAY FOR SHOWDOWN MINUTES. `, <br /> LAST LOAD IN MINUTES <br /> ©ELAPSED TIME FROM LINE 0 ®TIME FOR LUNCH,ETC. <br /> START LINE OADOED TO LAST UNLOAD TIME IS TO LINE0IS IN REMARKS SECTION LINECIS <br /> TIME:] Ot) ©END TIME: "? '� I uNE T <br /> . ��� TOTAL TIME: � � DEDUCTIONS: NET Tllkff: <br /> DRIVER'S SUSHAULER'SNo.of TONS OR HRS. RATE A OUNT DUE <br /> SIGNATURE /11,� CALTNC. //,/ / /'�y AXLES: 7 <br /> TRUCK NO. CHECx t UNDER <br /> Sd BE YiEEN 1ST <br /> UNDERLYING TRUC i ANDLASTAXLeS <br /> CARRIER SEMI ❑ <br /> ADDRESS PULL f �� <br />