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California Rock & Ready Mix <br /> 1200 E. Turner Rd. • Lodi, CA 95240 144484 <br /> VtLj (209) 368-5351 • Fax (209) 368-5824 <br /> ,_'1; <br /> NAME /� U DATE 7Z <br /> � / / t� <br /> ADDRESS L�'+^1 I PHONE (f , /! (C <br /> JOB SITE t� <br /> TIMET, AM ❑ TIME AM ❑ TRUCK NO. TRAILER NO. <br /> OUT IZIIZI-jG PM ❑ IN PM ❑ <br /> QTY. DESCRIPTION PRICE AMOUNT <br /> S� CtL <br /> i <br /> ,( EQUIPMENT RENTED F <br /> CAUTION HAND TROWEL <br /> / Freshly mixed cement, mortar, HAND FLOAT <br /> concrete or grout may cause skin <br /> 4 / injury. Avoid contact with skin EDGER <br /> where possible and wash exposed TRAILER <br /> skin areas promptly with water. If <br /> any cement mixtures get Into eyes, - <br /> rinse immediately and repeatedly <br /> awith ttention. KEEP OUT OF REACH ' APPr Code. 05593D <br /> V/ OF CHILDREN. Transaction ID; 582186717199152 <br /> �---�_ - -�— <br /> SALES & RENTAL AGF Rpprud; Online Batch: 000219 <br /> CVV2 Code; MATCH M <br /> •If the equipment is not properly cleaned after use,lessee agrees to pay a <br /> 9 •If the equipment is used more than two hours,fee of$25 per hour on <br /> charged. <br /> •The lessee acknowledges that the ahove equipment has been delivered <br /> consideration he agrees to pay the rental charge and sign this agreement. <br /> mortgage the leased equipment and to return the same in as good condaccording to card <br /> I agree to o c above total amount <br /> •The lessee acknowledges that he has inspected said trailer,trailer hitch ard i3e�,er agreement <br /> and that he has found the trailer and hook-up safe and secure and the (Merchant agreement if credit voucher) <br /> agreeing to assume all responsibility for said leased equipment while it Is lr <br /> •The lessee further agrees to indemnify and saveCalifornia Rock&I <br /> pense arising from any injury or damage to his person or property that mat <br /> proximate result of its being in his custody.In the event of any accident <br /> California Rock&Ready Mix. ---------------------------- <br /> •The lessee agrees to comply with all laws of the State covering the use -- <br /> sume all responsibility for fire, theft, confiscation, and all citations and <br /> possession. Merchant Cop, <br /> We are not responsible for any damage encountered while C <br /> materialscustomer has ordered. Customer will pay all tow c THANK YOU <br /> while dumping or working in the area the customer requested PLEASE COME AGAIN <br /> SIGNATURE <br /> X <br />