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CAUTION <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 />NOTICE: WE MAKE DELIVERIES INSIDE THE CURB LINE <br />AT CUSTOMER'S RISK ONLY, AND ACCEPT NO <br />RESPONSIBILITY WHATSOEVER FOR DAMAGES <br />RESULTING FROM SUCH DELIVERIES. <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 />1 A it. It is our wish to help you in every way that we can, but in order to do this, the driver <br />V is requesting that you or your representaffve sign below Indicating you have released <br />the driver and PEARSCNS CONCRETE from all responsfbilty for any damage that <br />4 may occur to the promises and/or adjacent property, buildings, sidewalks, driveways, <br />Q curbs, etc, t)y the d0ivery of this material. Further, as additional consideration, you <br />agree to help the driver remove mud from the wheels of ttre driver's vehicle so that <br />the driver will not fitter the public street, and you agree to indemnify and hold <br />harmless" he driver of this truck and PEARSON$ 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 ditlivery of this order. <br />Signature: —_— _- - <br />WEIGHMASTER CERTIFICATE <br />THIS IS TO CERTIFY that the I011owing described commodity rola weighed. neassured. or - <br />counted ey s weghmaatat,whose niprestura u on Ifs Certlfrosle. who is a recopnlr•daNhartty �w <br />of accuracy, ax prescribed by Chapter 7 (commeriCing vdtn Section 12700) of Division 5 d the '`n -ft,► 4 <br />Callturnla SuMness end Proieselona Code, adddnistered by the Division Of MessummaM <br />standards of the CUIMrnle Department OI Food and Agriculture. <br />PEARSONS CONCRETE <br />10284 UNDERWOOO RD., ACAMPO, CA 95220 <br />_ TELEPHONE (209) 334-9234 <br />ORDER NO <br />CUSTOMER <br />TE 200 <br />DRIVER TRUCK -' LOAd CU YDG <br />CONCRETE MIX <br />STARTTfME <br />DESCRIPTION <br />UNITPRICE <br />CEMENT <br />ARRIVE JOB <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 />sar�;tc WEIGHED AT <br />GUARANTEED CUBIC CON- mix 801 SIMMERHORN <br />TO YIELD YARDS CRUSE NO. GALT, CA. <br />PEARSONS READY MIX CONCRETE INC. — WEIGHMASTER <br />BY <br />OUANTITY <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 <br />UNLOADING TIME ALLOWED <br />FREE CHARGE C.O.D. <br />I <br />TOTAL. <br />_n"M-0 ■s Fnu.c u. craatvn Antu fkuustsurd butiillL;7 -vii GORHEGTIONS <br />TERMSi Net 30 Days, One and one-herf (11/2%) percent per month will be charged an past due accounts. <br />Any reasonable legal fees Incurred in collection of above will be added to this charge. <br />Received By- X <br />GERMANYBROTHEnSPRINTING — REV. 9/01 <br />