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A <br />California Rock & Ready Mix <br />1200 E. Turner Rd. • Lodi, CA 95240 143312 <br />C (209) 368-5351 • Fax (209) 368-5824 <br />Z <br />DATE � <br />NAME%q q- l <br />ADDRESS ��— - �i� /�� Jt .-e ` p PHONE C^'�/ G �4( 0 <br />JOB SITE AM ❑ TRUCKNO. TRAILER NO. <br />TIME �,,AM ❑ TIME <br />OUT PM ❑ IN F , <br />QTY. <br />DESCRIPTION <br />3 �. <br />V� r <br />i I <br />CAUTION <br />Freshly mixed cement, mortar, <br />concrete or grout may cause skin <br />injury. Avoid contact with skin <br />W 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 get prompt medical <br />attention. KEEP OUT OF REACH <br />OF CHILDREN. <br />MTRAILER <br />SALES & RENTAL AGR <br />• If the equipment is not properly cleaned atter use, lessee agrees to pay a $ <br />• if the equipment is used more than two hours, fee of S25 per hour on v, <br />charged. <br />• The lessee acknowledges that the above equipment has been delivered I <br />consideration he agrees to pay the rental charge and sign this agreement. T <br />mortgage the leased equipment and to return the same in as good condition <br />• The lessee acknowledges that he has inspected said trailer, trailer hitch ai <br />and-ihal he has found the trailer and hook-up safe and sjcure and the of <br />agreeing to assume all respons�)ility for said leased equipment while it is in t <br />- The lessee further agrees to Indemnify and saveCalifornia Rock & R( <br />Parise arising from any injury or damage to his person or property that may c <br />proximate result of its being in his custody. In the event of any accident, t-' <br />California Rock & Ready Mix. <br />- The The lessee agrees to comply with all laws of the State covering the use of <br />sume all responsibility for fire, theft, confiscation, and all citations and p <br />possession. <br />We are not responsible for any damage encountered while Cal <br />materials customer has ordered. Customer will pay all tow cha <br />while clumpindl or working in the area the customer re uested. <br />5NATURE <br />X <br />CALIFORNIA ROCK AND READY MIX <br />1200 E TURNER RD <br />LODI CA 95240 <br />209 368-5351 <br />Merchant ID: 0449 <br />Term u: 0003 Store u: 4039 <br />Ref it: 0022 <br />Phone Order <br />WWWW3233 <br />UISR - Entry Method; Manual <br />Total: $ 1,250.29 <br />05/23/22 <br />Inv a: 000022 Oppr Code: 04420D <br />Tmnaction I0: 462143742932824 <br />Opprvd:Online Batch4:000174 <br />A Code: WCH M <br />I agree to Pay above total amount <br />according to card issuer agreement <br />(Merchant agreement if credit voucher) <br />Merchant COPY <br />THANK YOU <br />PLEASE COME AGAIN <br />