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, <br />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 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 />Ki <br />LAMTELEPHONE (209) 334-9234 <br />ORDER NO. <br />CUSTOMER <br />DRIVER <br />DATE 200 <br />TRUCK LOAD CU YDG <br />CONCRETE MIX <br />START TIME <br />DESCRIPTION <br />UNIT PRICE <br />CEMENT <br />ARRIVEJOB <br />CU YDS <br />CONCRETE <br />A-1 <br />ADMIX 1 <br />LEAVE JOB <br />A-2 <br />END TIME <br />A-3 <br />ADMIX 2 <br />TOTAL <br />A-4 <br />FREE <br />WATER <br />NET <br />0 l m VVCIUnCUHI <br />GUARANTEED CUBIC CON- MIX 901 SIMMERHORN <br />TO YIELD YARDS CRETE NO. _ GALT, CA. <br />PEARSONS READY MIX CONCRETE INC.— WEIGHMASTER <br />cV <br />QUANTITY <br />UNITS <br />DESCRIPTION <br />UNIT PRICE <br />AMOUNT <br />CU YDS <br />CONCRETE <br />MIN. <br />STAND BYTIME <br />HOURSI <br />RENTAL <br />5 MINUTES PER YARD FREE <br />UNLOADING TIME ALLOWED <br />I CHARGE <br />C.0.D. <br />TOTAL <br />=nnuna IN rnlrrt UAI eNSwN ANL) AUU111UN SUIIJEC t TO CORRECTIONS <br />TERMS: Net 30 Days. One and one-half (11/2%) 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: V <br />