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Freshly mixed cement, mortar, <br />concrete or grout may cause skin <br />injury. Avoid contact with skin where <br />possible and wash exposed skin <br />areas promptly with water. If any <br />cement mixtures get into eyes, rinse <br />immediately and repeatedly with <br />water and get prompt medical <br />attention. <br />KEEP OUT OF REACH OF CHILDREN. <br />Dear Customer: <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 <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 <br />anyone to have arisen out of delivery of this order. <br />Signature: <br />GERMANY BROTHERS PRINTING — REV.9/01 <br />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 is a recognized authority <br />of accuracy, as prescribed by Chapter 7 (commencing with Section 12700) of Division 5 of the <br />California Business and Professions Coda, administered by the DNision of Measurement i <br />Standards of the California Department of Food and Agriculture. <br />10284 UNDERWOOD RD., ACAMPO, CA 95220 <br />v r _ <br />_� TELEPHONE (209) 334-9234 <br />ORDER NO <br />CUSTOMER <br />DRIVER <br />DATE_ ,200 <br />TRUCK 1nAr-) r.ltvnn <br />CONCRETE MIX <br />STARTTIME <br />DESCRIPTION <br />UNITPRICE <br />CEMENT <br />ARRIVE JOB <br />CU YDS <br />CONCRETE <br />A -'f <br />ADMIX 1 <br />LEAVEJOB_ <br />A-2 <br />END TIME <br />A-3 <br />ADMIX z <br />TOTAL <br />A-4 <br />FREE <br />WATER <br />NET <br />GUARANTEED .—M wtlUHLU AT <br />CUBIC CON- MIX 901 SIMMERHORN <br />TO YIELD _YARDS CRETE NO. GALT, CA. <br />PEARSONS READY MIX CONCRETE INC. — WEIGHMASTER <br />BY <br />QUANTITY <br />UNITS <br />DESCRIPTION <br />UNITPRICE <br />AMOUNT <br />CU YDS <br />CONCRETE <br />MIN. <br />STAND BY TIME <br />HOURS <br />RENTAL <br />5 MINUTES PER YARD FREE <br />UNLOADING TIME ALLOWED <br />CHARGE <br />I <br />C.O.D. <br />TOTAL <br />..•. • •.• .. r cnsarufY Arvu Auur I fury JUt3JtG I 1 V GUHHEGTIONS <br />TERMS: Net 30 Days. One and one-half (11/2°6) 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 />Received By: X <br />