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7/11 MATERIALS, INC. <br />WEIGHMASTER <br />P.O. BOX 4770 <br />MODESTO, CA 95352 <br />(209) 529-4050 <br />MATERIALS, INC. <br />WEIGHMASTER CERTIFICATE <br />THIS IS TO CERTIFY that the following described commodity was weighed, measured, <br />or counted by a weighmaster, whose signature is on this certificate, who is a recognized <br />authority of accuracy, as prescribed by Chapter 7 (commencing with Section 12700) of <br />Division 5 of the California Business and Professions Code, administered by the Division <br />of Measurement Standards of the California Department of Food and Agriculture. <br />CONTROL NO. 527 <br />SOLD TO: SHIP TO: <br />TIME MIX NO. LOAD SIZE CU YD/METERS ORD'D SLUMP PLANT/TRANSACTION TRUCK # DRIVER <br />DATE CONTACT NO OF LOADS ACCUM CU YD/METERS ZONE P.O. JOB # LICENSE tt TICKET NUMBER <br />QUANTITY CODE DESCRIPTION PRICE CU YD METER EXTENDED PRICE <br />SUBTOTAL <br />SALES TAX <br />TOTAL <br />PREVIOUS <br />STANDBY <br />WEIGHED AT: DEPUTY <br />GRAND <br />TOTAL . V <br />REV COUNT <br />ARIV JOB ARIV PLNT LEFT JOB FIN POUR JOB NOT READY TRUCK BROKE DOWN <br />SLOW POUR OR PUMP ACCIDENT <br />TRUCK AHEAD ON JOB CITATION <br />CONTRACTOR UNAVAIL OTHER <br />ADDED WATER <br />JOB DELAY EXPLANATION <br />Five (5) minutes per yd/meter free unloading time allowed. <br />Additional unloading time charged at current hourly rate. <br />Time Allowed JOB SITE CYLINDER TEST DYES 0NO <br />Water <br />Added Gals to full load YES <br />e e o <br />On Job <br />At Gals to 2/3 load YES <br />Time Due LEFT PLNT LEFT PLNT AIM/ JOB ST. POUR <br />0 0 0 <br />Customer's <br />Request Gals to 1/3 load DYES <br />Delay Time FIN POUR TTL RD TRIP TTL @ JOB POUR TIME <br />AUTHORIZED BY: <br />NOTICE: MY SIGNATURE BELOW INDICATES THAT I ACCEPT THE TERMS AND CONDITIONS OF THIS DELIVERY TAG. INCLUDING THE TERMS AND CONDITIONS ON THE REVERSE. WE MAKE <br />DELIVERIES NODE CURB LINES AND ON LOTS OR PROPERTY AT CUSTOMER S RISK ONLY AND ACCEPT NO RESPONSIBILITY WHATSOEVER FOR ANY DAMAGES RESULTING FROM SUCH DE- <br />LIVERIES. CUSTOMER SHALL INDEMNIFY, HOLD HARMLESS & DEFEND 7/11 FOR, FROM & AGAINST ALL CLAIMS FOR DAMAGES OR PERSONAL INJURY. EXPENSE OF <br />REMOVING MIRED TRUCK PAYABLE BY CUSTOMER. WE ARE NOT RESPONSIBLE FOR THE STRENGTH,SLUMP, OR QUALITY OF ANY CONCRETE TO WHICH WATER OR ANY OTHER MATERIAL HAS <br />BEEN ADDED AT THE BUYERS REQUEST. WE DO NOT GUARANTEE THE COLOR OF THE CONCRETE. WE HAVE NO CONTROL OVER THE PLACING, FINISHING OR CURING OF CONCRETE AND <br />DO NOT GUARANTEE THE FINISHED WORK IN WHICH IT IS USED, INCLUDING CRACKING. CONCRETE IS A PERISHABLE COMMODITY AND BECOMES THE PROPERTY OF THE PURCHASER UPON <br />LEAVING THE PLANT. ANY CHANGES OR CANCELLATIONS OF ORIGINAL INSTRUCTIONS MUST BE TELEPHONED TO OFFICE BEFORE LOADING STARTS. CUSTOMER IS RESPONSIBLE FOR PRO- <br />VIDING A SUITABLE PLACE, ON CUSTOMER S PROPERTY, FOR DRIVERS TO WASH CHUTES AS NECESSARY. ANY CLEANUP COST OF CUSTOMER-PROVIDED WASHOUT SITE OR REMOVAL OF <br />TRACKED-MUD FROM STREETS AND ROADS WILL BE BILLED TO CUSTOMER. <br />RECEIVED BY: