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• California Rock & 'Ready Mix <br />1200 E. Turner Rd. • Lodi, CA 95240 1 -3 1708 <br />(209) 368-5351 • Fax (209) 368-5824 <br />NAME <br />DATE <br />ADDRESS �1 �t' It �' PHONE <br />108 SITE <br />TIME AM ❑ <br />OUT PM ❑ <br />TIME AM ❑ <br />IN PM ❑ <br />1 TRUCK NO. <br />TRAILER NO. <br />QTY. <br />DESCRIPTION <br />PRICE <br />AMOUNT <br />CAUTION <br />Freshly mixed cement, mortar, <br />concrete or grout may cause skin <br />inJury. Avoid contact with skin <br />where possible and wash exposed <br />skin areas promptly with water. If <br />any Cement mixtures get Into eyes, <br />rinse Immediately and repeatedly <br />with water and et prompt medical <br />attention. KEE� OUT OF REACH <br />OF CHILDREN. <br />EQUIPMENT RENTED PRICEDAY <br />SUB -TOTAL <br />HAND TROWEL <br />SALES TAX <br />HAND FLOAT <br />EDGER <br />EQUIPMENT <br />RENTAL <br />TRAILER <br />CLEANING <br />CHARGE <br />TOTAL <br />SALES & RENTAL AGREEMENT <br />• If the equipment is not properly cleaned after use, lessee agrees to pay a $50 cleaning charge. <br />• If the equip.nent is used more than two hours, fee of $25 per hour on weekdays and $35 per hour on weekends, will be <br />charged. <br />• R lessee acknowledges that the above equipment has been delivered to his custody and control for his own use, and in <br />consideration he agrees to pay the rental charge and sign this agreement. The lessee further agrees not to sell, loan, sublet or <br />mortgage the leased equipment and to return the same in as good condition as when received. <br />• The lessee acknowledges that he has inspected said trailer, trailer hitch and safety chain, and the other items of equipment, <br />and that he has found the trailer and hook-up safe and secure and the other equipment serviceable ano he accepts same <br />agreeing to assume all responsibility for said leased equipment while it is in his custody. <br />• The lessee further agrees to indemnify and save California Rock & Ready Mix harmless from any liability, claim or ex- <br />pense arising from any injury or damage to his person or property that may occur while said equipment is in his custody or as a <br />proximate result of its being in his custody. In the event of any accident, the lessee agrees to make a written report to <br />California Rock & Ready Mix. <br />• The lessee agrees to comply with all laws of the State covering the use of trailers, to travel within the speed limit, and to as- <br />sume all responsibility for fire, theft. confiscation, and all citations and penalties incurred against said trailer while in his <br />possession. <br />We are not responsible for any damage encountered while California Rock & Readv Mit is delivering <br />materials customer has ordered. Customer will pay all tow charges if our truck or equipment gets stuck <br />while dumping or working in the area the customer requested. <br />SIG NATRE <br />LICENSE <br />X <br />