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W A R N I N G CONTROL NUMBER IRRITATING TO THE SKIN AND EYES WEIGHMASTER CERTIFICATE C ERTIFY that the following described commodity was weighed,measured. Contains Portland Cement.Wear Rubber Boots and Gloves. a weighmaster,whose signature is on this certificate,who is a recognized '1PROLONGED CONTACT MAY CAUSE BURNS. ccuracy,as prescribed by Chapter 7(commencing with Section 12700)of a3 V0Avoid Contact With Eyes and Prolonged Contact With Skin. the California Business and Professions Code,administered b the Division In Case of Contact With Skin or Eyes,Flush Thoroughly With yWater.If Irritation Persists,Get Medical Attention. ent Standards of the California Department of Food and Agriculture TICKET NUMBER NOTICE:Cement,fine and coarse aggregate contains chemicals `. ■ known to the State of California to cause cancer or birth defects The Company shall have no liability for and hereby excludes warranties or merchantability and or other reproductive harm. NOTE:fitness for any purpose,and all other warranties express or implied, with respect to reactive KEEP OUT OF REACH OF CHILDREN. aggregate,and popping(Pop-Outs),checking,discoloring of surface cracking of concrete. LOADING LEAVE PLANT ARRIVE JOB START UNL FINISH UNL LEAVE JOB ARRIVE PLANT OVERTIME WATER ADDED DRIVER:I have verified the specific slump for this job to be: DRIVER NOTES I verifV that this load will meet the slump sec on the rob X Please initial ❑ JOBSITE DELAY ❑ 100%OF LOAD gal CUSTOMER:READ BEFORE SIGNATURE BELOW CONSTITUT IMP 0 R TA N T ACCEP ANCE OF ALL T RMS,IGNINGCONDIT OINS&WAIVERS PR NAFFECT YOURI ED ON RONT&BACK OF THIS FORMES ❑ PLACEMENT [1 75%OF LOAD gal ALL INVOICES SHALL BE PAID IN FULL ON OR BEFORE THE LAST DAY OF THE MONTH FOLLOWING THE DATE OF DELIVERY.CUSTOMER ❑ EARLY ARRIVAL ❑ 50%OF LOAD gal AGREES TO PAY A SERVICE CHARGE 1 1/2%PER MONTH ON ALL INVOICES WHICH ARE PAST DUE.IN ADDITION,CUSTOMER AGREES TO PAY ALL COSTS AND EXPENSES FOR COLLECTION OF ANY AMOUNTS DUE HEREUNDER,INCLUDING ACTUAL ATTORNEY'S FEES INCURRED. ❑ EQUIPMENT FAILURE ❑ 25%OF LOAD gal ❑ ADD'L WATER ADDED ❑ WAS NATER ADDED BY CUST/INSP/PUMPER AFTER BEING ON JOB FOR 30 MIN OR MORE LOAD TIME: PHONE# SOLD TO P.O.# CUSTOMER# ❑ C.O.D. ❑ DATE CASH CHECK DELIVERY ADDRESS MAP PAGE ZONE TIME DUE CROSS STREETS PROJECT# ORDER# MIX LOAD SIZE LOAD# USE PLANT �TRUCKI DRIVER WEIGHMASTER LOAD QUANTITY CUMULATIVE QTY. ORDERED QTY. PRODUCT CODE PRODUCT DESCRIPTION UNIT PRICE AMOUNT EXCESSIVE TIME ON JOB WILL RESULT MIN. LOAD CHG. Rev/Start Rev/Stop IN ADDITIONAL PER MINUTE CHARGES. TAX ❑ Full load returned SUB TOTAL OVERTIME L] Partial load returned TOTAL D U E WATER ADDED AT PLANT °o MOISTURE F.M. T.A. SLUMP Returned checks may subject maker.in addition to the amount owing,treble the amount owing,up to a maximum of$1500.00 (Civil Code Sect.1719). A returned check charge of$35.00 will RECEIVED BY The terms and conditions on the reverse side of this Delivery ticket and any attachments thereto are a part of the agreement between be charged plus an additional$100.00 for any mechanics lien. Company and Customer.Acceptance of this order constitutes agreement to all terms and conditions shown on the face and back. X READ FRONT AND REVERSE SIDES CAREFULLY. MINUTES OF UNLOADING TIME PER YARDS The above signee is over the age of eighteen(18)years and has authority to execute this Agreement on behalf of Customer. ADDITIONAL U NLOADING TEIMECH GED AT CURRENT HOURLY TRUCK RATE.