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California Rock & Ready Mix <br /> 1200 E. Turner Rd. • Lodi, CA 9524-0 162153 <br /> (209) 368-5351 Fax (209) a68-5824 <br /> llQp _ f jr?' Z Y <br /> DATE c <br /> NAME <br /> PHONE <br /> ADDRESS <br /> fi✓ <br /> JOB SITE C't�t AM ❑ TRUCK N0. TRAILER NO. <br /> TIME AM ❑ TIME <br /> OUT ' PM [3IN PRICE AMOUNT <br /> QTY. DESCRIPTION PM ❑ <br /> r w� <br /> EQUIPMENT RENTED <br /> CAUTION HAND TROWEL <br /> Freshly mixed cement, mortar, HAND FLOAT <br /> concrete or grout may cause skin EDGER <br /> I% 6 <br /> ury. Avoid contact with skin <br /> w possible and wash exposed TRAILER ,t�F sn....•. <br /> ski reas promptly with water. If <br /> any cement mixtures get Into eyes, BASE AMT: $1250.29 <br /> rinse Immediately and repeatedly <br /> with water and get prompt medical -_-__--- <br /> OF CHILDREN OUT OF REACH <br /> Non-Cash A ,luStment <br /> 11 $40.63 <br /> y SALES & RENTAL AGRI TOTAL AMT• ,, USD $1290.92 <br /> •It the equipment is not properly cleaned after use,lessee agrees to pay a$5' Resp: APPROVAL 0047 3 D <br /> •II n WE the equipment is used more than ttvo hours,fee of$25 per hour oCode: 00473D <br /> charged. u 410721006427 <br /> •The lessee acknowledges that the above equipment has been delivered to Ref #: <br /> consideration he agrees to pay the rental charge and sign this agreement.Th <br /> mortgage the leased equipment and to return the same in as good condition a T ran s I D: 4641077$2287 <br /> 781 <br /> •The lessee acknowledges that he has inspected said trailer,trailer hitch ani <br /> and that he has found the trailer and hook-up safe and secure and the oth Cardho 1 der acknowledges <br /> agreeing to assume all responsibility for said leased equipment while it is in hi: re C e 1 t 0 f goods and <br /> •The lessee further agrees to indemnity and saveC.allfornia Rock&Be; <br /> pense arising from any injury or damage to his pt son or property that may oc <br /> proximate result of its being in his custody.In the event of any acc dent,th 0 by 1 the 1 C ard}lo 1 de forth <br /> California Rock&Ready Mix. <br /> •The lessee agrees to comply with all laws of the Scate covering the use oft agreement w 1 t}l 1 5 S lie r <br /> sume all responsibility for fire, theft, confiscation, and all citations and pe <br /> possession. <br /> We are not responsible for any damage encountered while Calif <br /> materials customer has ordered.Customer will pay all tow char X-------------------- <br /> while dumping or working in the area the customer requested. MERCHANT CUp7 <br /> SIGNATURE <br /> X <br />