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JIM BRISCO ENTERPRISES, INC <br /> Mailing Phone: (209) 356-3275 Weighed at: <br /> Address: 221 Air Park Road, Suite A Dispatch: (209) 761-2280 14960 Vinewood Ave. <br /> Atwater, CA 95301 Livingston, CA 95334 <br /> SOLD TO: SHIP TO: <br /> LOAD TO JOB ON JOB BEGIN POUR FINISH POUR TO PLANT O.T. MINUTES <br /> DATE PLANT# CUSTOMER # TRUCK# TYPE MATERIAL TICKET# <br /> MIX #- NAME/LOAD#-ACCUMULATED TOTALS (YARDS) WEIGHMASTER <br /> WATER ADDED: 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 /> PRODUCT DESCRIPTION UNITS <br /> CEMENT <br /> 5 MINUTES <br /> PER YARD 1 x 4 RK <br /> FREE UNLOADING <br /> TIME ALLOWED. PEA RK <br /> Additional unloading SAND <br /> time charge at current <br /> hourly truck rate of WATER <br /> $90.00 per hour. O.T.Minutes @ $ __ /min = <br /> ADD MIX SUBTOTAL <br /> ADD MIX SALESTAX <br /> INSPECTOR'S <br /> SIGNATURE ORDER TOTAL <br /> DRIVER �A`~�� o ` RECVD. BY <br /> ALL WEIGHTS ARE IN POUNDS UNLESS OTHERWISE SPECIFIED <br /> All claims for shortage or allowances must be made in writing within five days from date of delivery. TERMS:All purchases not paid by the last day of the month following date of purchase <br /> WE MAKE DELIVERIES INSIDE CURB LINE AND ON THE LOT AT CUSTOMER'S RISK ONLY AND AC. shall incur a minimum of$2.00 service charge per month or 1'/a�6 per month finance charge, <br /> CEPT NO RESPONSIBILITY WHATSOEVER FOR DAMAGE RESULTfNG FROM SUCH DELIVERIES. whichever is greater. 1'12%per month is equivalent to an annual percentage rate of 18%. <br /> KEEPTHIS DELIVERY TICKET FOR FUTURE REFERENCE Buyer will pay reasonable costs of collection and attorney's fees. <br /> BY: <br /> `6 ti 1`I <br /> I' <br />