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California Rock & Ready Mix <br /> 1200 E. Turner Rd. • Lodi, CA 95240 137655 <br /> (209) 368-5351 Fax (209) 368-5824 <br /> NAME �l t �U�� t Zit� U( Z1 <br /> e: DATE <br /> ' ADDRESS 27337 �1y� PHONE �ly <br /> JOB SITE Led t\ <br /> TIMEf I ' AM [ITT-IME AM ❑ TRUCK NO. TRAILER NO. <br /> OUT N l j/ .3b PM ❑ JIN P <br /> QTY. DESCRIPTION <br /> L ) CALIFORNIA ROCK AND READY MIX <br /> 1200 E TURNER RD <br /> LODI CA 95240 <br /> Is 209 368-5351 <br /> Merchant ID: 0449 <br /> Term 9: 0003 Store 4: 4039 <br /> Ref 11: 0002 <br /> Phone Order <br /> KXXXXXXXXXXX6632 <br /> VISA Entry Method: Manual <br /> EQUIPMENT RENTED PF <br /> CAUTION HAND TROWEL <br /> Freshly mixed cement, mortar, HAND FLOAT Tota I: $ 1,569.63 <br /> concrete or grout may cause skin EDGER <br /> injury. Avoid contact with skin <br /> where possible and wash exposed TRAILER <br /> skin areas promptly with water. If <br /> any cement mixtures get Into eyes, 12/09/21 ` 0151;19 <br /> rinse immediately and repeatedly <br /> with water andet prompt medical Inv q. 000002 APpr Code: 03582D <br /> attention. KEEF OUT OF REACH <br /> OF CHILDREN. Transaction ID; 581343570793614 <br /> SALES & RENTAL AGRE APPrVd: Online htchq: 000003 <br /> •If the equipment is not properly cleaned after use,lessee agrees to pay a$50 CK Code: MATCH M <br /> •If the equipment is used more than two hours,fee of$25 per hour on wee <br /> charged. <br /> •The lessee acknowledges that the above equipment has been delivered to t <br /> consideration he agrees to pay the rental charge an,'sign this agreement.The <br /> mortgage the leased equipment and to return the same in as good condition as I agree to Pay above total amount <br /> •The lessee acknowledges that he has inspected said trailer,trailer hitch and: according to card i55uer agreement <br /> and that he has found the trailer and hook-up safe and secure and the other (Merchant agreement if credit voucher) <br /> agreeing to assume all responsibility for said leased equipment while it is in his i <br /> •The lessee further agrees to indemnify and save California Rock&Read <br /> pense arising from any injury or damage to his person or property that may occt <br /> proximate result of its being in his custody.In the event of any accident,the <br /> California Rock&Ready Mix. <br /> •The lessee agrees to comply with all laws of the State covering the use of fra �'"""""""""""""""""""'--- <br /> sume all responsibility for fire, theft, confiscation, and all citations and pene <br /> possession. <br /> We are not responsible for any damage encountered while Califoi Merchant Copy <br /> materials customer has ordered. Customer will pay all tow charg[ THANK YOU <br /> while dumping or working in the area the customer requested. <br /> SIGNATURE PLEASE COME AGAIN <br /> X <br />