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WEIGHMASTER CERTIFICATE <br /> THIS IS TO CERTIFY that the following described commodity was weighed,measured,or <br /> counted by a weighmaster,whose signature is on this certificate,who Ise recognized authority <br /> of accuracy,as prescribed by Chapter 7(commencing with Section 12700)of Division 5 of the <br /> California Business and Professions Code,administered by the Division of Measurement <br /> Standards of the California Department of Food and Agriculture. <br /> 10284 UNDERWOOD RD., ACAMPO, CA 95220 <br /> Freshly mixed cement, mortar, TELEPHONE (209) 334-9234 <br /> ,J concrete or grout may cause skin ORDER NO. DATE-,200— <br /> injury. <br /> ATE ,200_injury. Avoid contact with skin where CUSTOMER <br /> Rpossible and wash exposed skin <br /> areas promptly with water. If any <br /> cement mixtures get into eyes, rinse <br /> immediately and repeatedly with DRIVER TRUCK LOAD CU YDG <br /> water and get prompt medical CONCRETE MIX START TIME <br /> attention. CEMENT ARRIVE JOB <br /> KEEP OUT OF REACH OF CHILDREN. A-1 ADMIX 1 LEAVE JOB <br /> A-2 END TIME <br /> ADMIX z <br /> A-3 TOTAL <br /> Dear Customer: <br /> A-4 FREE <br /> THIS LOAD <br /> WATER NET <br /> WEIGHED AT <br /> Syr" � , i IF TO YIELD ET <br /> GUARANTEED CUBIC <br /> 1: p <br /> CONMIX ELD SACK 901 SIMMERHORN <br /> YARDS CRE NO. GALT,CA. <br /> PEARSONS READY MIX CONCRETE INC.—WEIGHMASTER <br /> ttl BY <br /> r, QUANTITY UNITS DESCRIPTION <br /> e E <br /> The driver of this truck,in requesting the additional signature below,is of the opinion <br /> that the size and weight of the truck may possibly cause damages to the premises CU YDS CONCRETE UNIT PRICAMOUNT <br /> and/or adjacent property if the driver places the material in this load where you desire <br /> it.It is our wish to help you in every way that we can,but in order to do this,the driver <br /> is requesting that you or your representative sign below indicating you have released <br /> the driver and PEARSONS CONCRETE from all responsibilty for any damage that <br /> may occur to the premises and/or adjacent property,buildings,sidewalks,driveways, <br /> curbs, etc. by the delivery of this material. Further, as additional consideration, you <br /> agree to help the driver remove mud from the wheels of the driver's vehicle so that <br /> the driver will not litter the public street, and you agree to indemnify and hold <br /> harmless the driver of this truck and PEARSONS CONCRETE for any and all liabilities <br /> and damages to the premises and/or adjacent property which may be claimed by MIN. STAND BY TIME <br /> anyone to have arisen out of delivery of this order. HOURS RENTAL <br /> 5 MINUTES PER YARD FREE CHARGE C.O.D. <br /> Signature: UNLOADING TIME ALLOWE131 I TOTAL <br /> fill ERRORS IN PRICE EXTENSION AND ADDITION SUBJECT TO CORRECTIONS <br /> TERMS: Net 30 Days.One and one-half(1112%)percent per month will be charged on past due accounts. <br /> Any reasonable legal fees incurred In collection of above will be added to this charge. <br /> ;1 <br /> Received By: <br /> GERMANY BROTHERS PRINTING — REV.9/01 <br />