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Home My WebLink AboutPW14-118 - Change Order - #3 - Tapani, Inc. - Briscoe-Desimone Levee Improvements Reach 2 & 3 - 10/24/2014 • it s Rite c0rds Manag' ' 'te '" n KENT Document W AS HMGTON CON TRACT COVER SHEET This is to be completed by the Contract Manager prior to submission to City Clerks Office. All portions are to be completed. If you have questions, please contact City Clerk's Office. Vendor Name: Ta ani, Inc Vendor Number: 747093 JD Edwards Number Contract Number: 14-118 This is assigned by City Clerk's Office Project Name: Briscoe Desimone Levy Improvements Reach 2 and 3 Description: ❑ Interlocal Agreement ® Change Order ❑ Amendment ❑ Contract ❑ Other: Contract Effective Date: 1/30/2014 Termination Date: Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Ken Langholz Department PW Engineering Contract Amount: Approval Authority: (CIRCLE ONE) Department Director Mayor City Council Detail: (i.e. address, location, parcel number, tax id, etc.): Change Order#3 --- — As of: 08/27/14 i KE1dT w«�, oro �I CHANCE ORDER NO. #3 NAME OF CONTRACTOR: Tapani. Inc. ("Contractor") CONTRACT NAME & PROJECT NUMBER: Briscoe Desimone Levee Improvements Reach 2 and 3 ORIGINAL CONTRACT DATE: January 30 2014 This Change Order amends the above-referenced contract; all other provisions of the contract that are not inconsistent with this Change Order shall remain in effect. For valuable consideration and by mutual consent of the parties, the project contract is modified as follows: 1. Section I of the Agreement, entitled "Description of Work," is hereby modified to add additional work or revise existing work as follows: In addition to work required under the original Agreement and any prior Amendments, Contractor shall provide all labor, materials, and equipment necessary to: Reconstruct the bioswale per revision #2. Reconstruction of the bioswale will elimante the need for placement of hydrophillic joint sealant on Reach 2. The change will save approximately $45,000.00. 2. The contract amount and time for performance provisions of Section II "Time of Completion," and Section III, "Compensation," are hereby modified as follows: Original Contract Sum, $6,709,555.56 (including applicable alternates and WSST) Net Change by Previous Change Orders $185,016.68 (incl. applicable WSST) Current Contract Amount $6,894,572.24 (incl. Previous Change Orders) Current Change Order $12,000 Applicable WSST Tax on this Change $1,140.00 Order Revised Contract Sum $6,907,712.24 CHANGE ORDER - 1 OF 3 Original Time for Completion 200 working days (insert date) Revised Time for Completion under 200 working days prior Change Orders (insert date) Days Required (f) for this Change 0 calendar days Order Revised Time for Completion 200 working days (insert date) In accordance with Sections 1-04.4 and 1-04.5 of the Kent and WSDOT Standard Specifications, and Section VII of the Agreement, the Contractor accepts all requirements of this Change Order by signing below. Also, pursuant to the above-referenced contract, Contractor agrees to waive any protest it may have regarding this Change Order and acknowledges and accepts that this Change Order constitutes final settlement of all claims of any kind or nature arising from or connected with any work either covered or affected by this Change Order, including, without limitation, claims related to contract time, contract acceleration, onsite or home office overhead, or lost profits. This Change Order, unless otherwise provided, does not relieve the Contractor from strict compliance with the guarantee and warranty provisions of the original contract, particularly those pertaining to substantial completion date. All acts consistent with the authority of the Agreement, previous Change Orders (if any), and this Change Order, prior to the effective date of this Change Order, are hereby ratified and affirmed, and the terms of the Agreement, previous Change Orders (if any), and this Change Order shall be deemed to have applied. The parties whose names appear below swear under penalty of perjury that they are authorized to enter into this contract modification, which is binding on the parties of this contract. 3. The Contractor will adjust the amount of its performance bond (if any) for this project to be consistent with the revised contract sum shown in section 2, above. IN WITNESS, the parties below have executed this Agreement, which will become effective on the last date written below. 1L CONTRACTOR: CITY OF KENT: (signature) A 3 _ (signature) Print Name Nlrf%1' 't 7"r a Print Name: I, Its " Mr Its I r (title) (Gate) DATE: ,i 0 -, DATE: / 0 CHANGE ORDER - 2 OF 3 ® FILE NO: 200.2 KENT i CHANGE ORDER WORKSHEET NO. 3 Construction Management Division - Public Works _ Project: Briscoe-Desimone Levee Improve Project No.: 09-3010 Project Engineer: Kelly Casteel Fed-Aid No.: N/A Owners Rep: Jason Bryant Contractor: Tapani Inc Date: 9/15/2014 I. PROPOSED CHANGE Reconstruct the bioswale per Revision #2 Ii. REASON AND BACKGROUND FOR CHANGE Reconstruction of the Bioswale will eliminate the need for placement of hydrophilic joint sealant on Reach 2. The change will save approximately $45,000.00, III. METHOD OF PAYMENT NEW PAY ITEM(S) ® Not Applicable Change Order No. j 1 _ 1 iFOR ACCOUNTING USE ONLY Sch. No. Item Description Total Est. 1 Qty this Unit Unit Price Total Estimated Cost of Qty PE I Item — l Bloswale sand placement w�1 1 � FA $6,,586 65 [ $12,000.00 _ ! — ® Independent Estimate Attached I EJ ! CREATE PAY ITEM ONLY- Payment to be made ® � PAY THIS PAY ESTIMATE -REQUIRED i at later date upon completion of work _ _ _______ ___ ---- — ----_. ------ ------ — ----- "---- ----------------- Material Submittals Required - CC: ConstructionCoordinator 1 New Sub Reqrd? I No DELETE EXISTING PAY ITEM(S) per 1-09.5 ® Not Applicable Change Order No. i I _ I i I j FOR ACCOUNTING USE ONLY Sch. No. j 8.1. No. j Item Description j Qty Unit Unit Price Cost of Item - -- -.. ----r _r -- _ -- - ----------- — - - ! . - ----- Independent Estimate Attached -REQUIREDI El INCREASE/DECREASE TO EXISTING PAY ITEM(S) ® Not Applicable Change Order No. _ FOR ACCOUNTING USE ONLY Sch. No. { B I No, Item Description Qty Unit I Unit Price iCost of Item .-- -... .--- - __ i-_._—_----— ____ ____—y.._— --- i -__ _ —_ .._. ❑ I Independent Estimate Attached - REQUIRED 0 1 REV. DATE: 4/01/10 FILE NO: 200.2 KENT TOTAL ESTIMATED COST OF CHANGE ORDER 0.00 _112100 � *Total of the Cost of Item Columns THIS PAY ESTIMATE $6,586.65 IV. WORKING DAYS Original Contract-j I Due This Change Order* 10 1 Previous Total 200 RATE,._j 9115/2014......... .............................1_DATE:__l 9/15/2014 1 Exyla nation/Justification-Aequjrg!t On critical path for levee completion TOTAL WORKING DAYS* 200 *This Change Order + Previous Total All work, materials and measurements to be in accordance with the Standard Specifications and Contract Special Provisions for the type of work described. Prepared By: Date: y Jas Brya_t Date: C>Construction Supervisor: PaulLeh Construction Manager: Date: Eric Connor 2 REV. DATE: 4/01/10 FA Sheet No.: T-44 DAILY REPORT OF FORCE ACCOUNT WORKED KEI T Project Name: Briscoe-Desimone Levee R-3 Project No: 09-3010 Item No.: Date: 9/16/2014 Description of Work: Place sand in Bioswale Work by Subcontractor?: NO i Prime Contractor: Tapani Underground Sub-Contractor: LABOR' STRAIGHTTIME OVERTIME DOLLAR NAME CODE OCCUPATION Hrs Hourly Rate Hrs OT Rate AMOUNT Brandon Luelling Operator Excavator 64.07 $ Jeff Scmidt General Laborer 3 47.89 S 143,67 Jaden Nelson General Laborer 51.46 $ - Ryan Nelson Forman 2 65.17 $ 130,34 Per Diem $ - SUBTOTAL-LABOR: $ 274,01 LABOR OVERHEAD&PROFIT @ 29% $ 79,46 LABOR TOTAL $ 353A7 EQUIPMENT EQUIPMENT OR ATTACHMENTS OPERATED STANDBY DOLLAR Equipment# Equipment Description Hrs Hourly Rate Hrs Standby Rate AMOUNT Crew Truck 2 10.81 $ 21.62 Icon Sand 231.94 T75 $ 1,797.54 SUBTOTAL-EQUIPMENT $ 1,819.16 EQUIPMENT OVERHEAD&PROFIT @ 21% $ 382,02 EQUIPMENT TOTAL $ 2,201.18 MATERIALS/SERVICES/RENTALS MATERIALS/SERVICES Quantity Units Unit Price DOLLAR AMOUNT Cad Trucking 24 hrs $ 150.00 $ 3,600.00 $ i $ $ SUBTOTAL $ 3,600.00 OVERHEAD&PROFIT @ 21% $ 432.00 TOTAL $ 4,032.00 Verification of Hours Worked: TOTAL: $ 6,586.65 12%MARKUP (for prime when subcontract work) $ - Contractor's Representative Date SHEETTOTAL: $ 6,586.65 Owners Representative Pay EstKate Eater d: Date: By: F P.O.one 19.0 Urr °�ry$LLPAV.J1(�p�y_�5p Bahl,G,..nd WA 9a604 VYA®�1l Vi PYVVCV®S INC. Mai 36 n 0f6c01016aT-0149 &chin 0f6ce(Fax16969T49 HaBdlln"oulderm'Pk Br Rdown, Project Nam.: #REFI Data 91252015 Cenlrad No: #RLFI ZJob No. #REFI !. L No. d Owner No. #REFI General No. #REFI Qasodptlon: I'sand on Bbfi ,* j The Nocking le$15011hr.No better rateo were available,Tickets are attached. ::La F:.::::: uo. Poreman SUn195�R t'4 a HR S teu1M:14 Ope:alw S e4.W HR 5 Oeatle Chacker E 4T.69 a IIR $ 143dT Labor SUb 3.1 E P➢a 01 ]9V° Markup 5 T946 p% $fna11 T005 $ I Tobl L Noum E I:p dl rAdvl:•::.:.. 1-1 io�a 320 Ex $UM91.30 HR S 336 Ex S I-- HI3 I. JD 100 5 TT.60 HR S JD644K Y 6201 HR E p..-- Cr¢w True 5 10.81 2 HR $ 2182 E EgWprtient SUb TOfal $ 21.62 21N Mark Up $ a(A _ ::>JMat al U!tllasu amntiry UAt Tad 1f /Sand S 1>6 1J1.94 f L>9T.54 �F rf�• OI Material9vb Total 5 1.]9T.64 f'j OY. Ma kU $ [✓ ' irvching-0AD b 160.OD 24 NR �� 3.60000 $ D $ SobeonlaclOrsSubTOlal $ 3.600.00 IRY. Mark-ll S 432.00 Unp Pale OwnlXy It., E - 0 5 D Idl al 5 Ma,k- 0% Merk-Up S ExdUslons IIY�CFerye hnearzslnelane m<¢vpx!^Ue lymen W. 0 oayb, We-a-av Ind drn'mwda a/e°sme<u!abwas al tree ea!< TOIal Coil S 5riat 17 0�° OVefh $ Sub Total 6309.17 $ General(lability lnsw $ load $ - O.Oa r ' Total Amountbt S f -�s/.T � �5/ c WWW ',de:rhecHI.ap..,P¢o.TN.ILa=nCCE4iRlRS AIM.PNO INCOP9oMnnab1.an'c.MPPCTuILI. 0 �� WE PECEIKA WPIirrN Reo-pISE taro Vnu Irand.nTNEPVnae Wbro ne NOUP6.W. .PPEGEP 111ed .E ORnea IEn.al..TO a f ab he AN.Irle"EDI. Plaw,d bK Awepled by: Dale; Data: I — PUBLIC WORKS DESIGN ENGINEERING Mark Howlett, P.E. Design Engineering Manager 400 West Gowe .�. ` ''` "® Kent, WA 98032 �`e:�, KENT Fax: 253-856-6500 WnsNix oron PHONE: 253-856-5500 May 21, 2014 j To: Eric Knowles, Survey Manager Steve Shafer, Survey Project Coordinator Paul Kuehne, Construction Supervisor Jason Barry, Owner's Representative Jason Bryant, Senior Construction Inspector Jim Nickerson, GEI Consultants David Shearer, Shearer Design Lyle Stone, GeoEngineers From: Ken Langholz, Engineering Supervisor Through: Mark Howlett, Design Engineering Manageo ' I' Re: Briscoe-Desimone Levee Improvements Reach 2 & 3 Revision No. 2 Please make the following revisions: Plan Sheet 8 of 47 — Profile Delete the hydrophilic joint sealant in interlocks of steel sheet piles between Sta. 16+91,49 and 20+49.77. Plan Sheet 10A of 47 (Attached) Reconstruct the bioswale between the south side of the Reach 2 wall and the parking lot as shown on the attached plan sheet 10A. j 0 Y C y� L- MAYOR SUZETTE COOKED City of Kent Public Works~Department Timothy 3. LaPorte, P.E., Public Works Director I I `�.,� 20+49.W - GRAVEL SHOULDER 83 -- 20+56.05, da aS------- 10.02' L _s""�FG=36.44 18+64.68, 9.45'L �.--- �_ FG=3O.00 Ep----------__""_.EP EP _ ' - 00 20+24.65, 33.7O'L l __-- -_ ._ LANDWARD FINISHED FACE OF', SEE SHEET 10 F�OR' /FG=30,00 - r�'� M CONC, BARRIER AND CONST. / r + CONTROL LINE ACCESS RAMP GRADING / 31 ." m FG=30.B9 '\ 1 RIVER PROTECTION EASEMENT 1 /SEE RIGHT OF WAY PLAN. /a f � o t/666 ' I s ry < v m ��rrJJ 11�y i N li j � v i m N I a A o m I i 2 3 w z a I g w I 0 m m 0 'c 0 oevcNco: PAWS BRISCOE & DESIMONE SHEET US DRA1'M, 6W 1W.Sc LEVEE IMPROVEMENTS CA of 47 Amm B%% AU RW 6-8-14 ND, RENSION BY OATe AVPR�Yc0. FILE N0. Bryant, Jason From: Kuehne, Paul Sent: Wednesday, August 27, 2014 8:33 AM To: Barry,Jason; Bryant,Jason Cc: Connor, Eric Subject: FW: Request Construction Change Approval - Briscoe Levee Bioswale Fyi I Proceed... Paul Kuehne, construction Management Supervisor Construction Management I Public Works Department 220 Fourth Avenue South, Kent, WA 98032 Phone 253-856-5543 1 Cell 253-740-5015 PKuehne3?a KentWA.oOV CITY OF KENT,WASHINGTON KentWA.00v Facebook YouTube PLEASE C6 NSMER THE ENVIRONMENT 2EFOPE PPINTIN©THI5 E-MAIL From: Bieren, Chad Sent: Wednesday, August 27, 2014 8:28 AM To: Connor, Eric; Kuehne, Paul Cc: Casteel, Kelly; Howlett, Mark; Langholz, Ken Subject: RE: Request Construction Change Approval - Briscoe Levee Bioswale ` Eric, Thanks for the clarification, just let us know if/when it's getting close to $12,000 and how much more work is left. Thanks, Chad I From: Connor, Eric Sent: Wednesday, August 27, 2014 7:27 AM To: Bieren, Chad; Kuehne, Paul Cc: Casteel, Kelly; Howlett, Mark; Langholz, Ken Subject: RE: Request Construction Change Approval - Briscoe Levee Bioswale j i Good Morning Chad, It is my understanding that it is the contractor's intent to perform this work on a T&M basis (force account), and his quoted price of$12,000 is likely just a Rough Order of Magnitude (ROM). That being said, I think the contractor and Jason have a good game plan for completing this work completed for less than the $12, ...but there is the risk for this value to be exceeded. Please feel free to correct me if this changed yesterday afternoon. t i Thank you, I Eric I Eric Connor, Construction Engineering Manager Construction Management I Public Works Department Phone 253-856-5533 1 Cell 253-797-0693 CITY OF KENT, WASHINGTON FLF:P,E CONSIGER i kG EN UTRON NI ENT BEFORE PRT NTT NG THIS!-IAA,L From: Bieren, Chad Sent: Tuesday, August 26, 2014 4:26 PM TO: Kuehne, Paul; Connor, Eric Cc: Casteel, Kelly; Howlett, Mark; Langholz, Ken Subject: RE: Request Construction Change Approval - Briscoe Levee Bioswale Hi Paul, Please move ahead with placing the material at the contractor's quoted price. I spoke with Jason Bryant about the details on this one, he did a great job working with Ken to get it done. Thank you, Chad Chad Bieren, P.E. City Engineer Engineering Administration I Public Works Department 400 220 Fourth Avenue South, Kent, WA 98032 1-"a Phone 253-856-5534 1 Cell 253-740-9139 KENTcbierenP—KentWA.gove www.KentWA.aav ? °�° PLED-SE CONSIDER Tit F.ENVIRONMENT BEFORE PRINTING THIS E-MAIL From: Kuehne, Paul Sent: Monday, August 25, 2014 12:38 PM To: Bieren, Chad; Connor, Eric Cc: Casteel, Kelly Subject: Request Construction Change Approval - Briscoe Levee Bioswale Hello Chad and Eric, Shall the City accept the Contractor's bid to provide and place fine aggregate sand per Bio-swale Revision #2? Contractor's price is $44,80 per CY and estimated to total about $13,440. Paul Kuehne, Construction Management Supervisor Construction Management I Public Works Department 2 I I 220 Fourth Avenue South, Kent, WA 98032 Phone 253-856-5543 1 Cell 253-740-5015 PKuehne@KentWA.gov CITY OF KENT, WASHINGTON KentWA.QOV Facebook .. YouTube Vt ;E CONSrt -H,, Luh r u) uc rz Przh NG T1;IS E-WhIL From: Bryant, Jason Sent: Monday, August 25, 2014 12:03 PM To: Kuehne, Paul Subject: FW: Placement of Sand in Bioswale Paul, j Tapani has provided us with a proposal to place the fine aggregate sand in the BID Swale Per Revision #2. The cost is $12,000.00. We deleted the sealant between the steel sheets and saved the estimated $50,000. I used this product on horseshoe bend; the bid price was $150.00 per CY. I think the price is fair and we should proceed. Please advise. Thank you, Jason Bryant, Owners Representative Construction Management I Public Works Department 220 Fourth Avenue South, Kent, WA 98032 Phone 253-856-5541 I Cell 253-261-5663 - 'b7_ryant@KentWA.gov `- KENT www.KentWA.caov ( ;°I PLEnSE CONSIDER Th'E ENVIRONMENT SErORE PRINTING THIS E-61AIL From: Justin McClellan [mailto:imcclellan@tapaniunderground.com] Sent: Monday, August 18, 2014 4:27 PM To: Bryant, Jason Cc: Ryan Nelson; Derek Kemppainen; Jerod Estelb Subject: Placement of Sand in Bioswale Jason, I am planning on getting a conveyor truck to place roughly 300 tons of the sand in the bioswale. I am getting the same material from Icon as the submittal you guys sent over. I estimate the total cost of the placement of the sand to be around $12,000 and want to verify this will be paid on force account. Thanks! Justin McClellan Tapanilnc Office 360-687-1148 Mobile 360-609-6380 3 Bryant, Jason i From: Justin McClellan <jmcclellan@tapaniunderground.com> Sent: Wednesday,August 27, 2014 9:03 AM To: Bryant,Jason Cc: Ryan Nelson (ryann@tapaniunderground.com) Subject: Re: FW: Placement of Sand in Bioswale Will do, thanks. I On Wed, Aug 27, 2014 at 7:39 AM, Bryant, Jason<JBryantgkentwa.gov> wrote: Justin, Please proceed with sand placement in the bio Swale. Thank you, 3ason Bryant, Owners Representative Construction Management I Public Works Department 220 Fourth Avenue South, Kent, WA 98032 s Phone 253-856-5541 1 Cell 253-261-5663 EVENT - :7ibrvantaLKentWA.gov www.KentWA.aov PLEASE CONSIDER THE ENVIRONMENT BEFORE PFYNiING THIS E-WO,LL From: Justin McClellan [mailto:jmcclellan@tapaniunderground.com] Sent: Monday, August 18, 2014 4:27 PM To: Bryant, Jason Cc: Ryan Nelson; Derek Kemppainen; Jerod Esteb Subject: Placement of Sand in Bioswale t i Jason, I am planning on getting a conveyor truck to place roughly 300 tons of the sand in the bioswale. I am getting the same material from Icon as the submittal you guys sent over. I estimate the total cost of the placement of the sand to be around $12,000 and want to verify this will be paid on force account. i Thanks! Justin McClellan Tapani Inc Office 360-687-1148 Mobile 360-609-6380 Justin McClellan Tapani Inc Office 360-687-1148 Mobile 360-609-6380 2 pq ts a Is aq - - CY �P4 aq JV- Jo am 51 CID Q(D so ?L f F3 o"t 2 R '9 ig n Li x 1 � i OR LA ` a f o 'j a �� GO Wd 1 R Tt 't 1 � Z ash+ lM1 I ;- � m O a a v 4 3 vg F a ag 3, ,' C A 4! \ V 3 °c m a o 3 xu 9 a•a o m � 9 «£ � � � c 2 ' 43 g• � � d ` �6 e a� � .. OR �i° 3 r SJC r T M o a c o Ai ooDo $ Ng b 2L , j 3 € af y a x a r- � to ccs N €o N i i i i .O ._ 2. 0 5 04 3" 0 3 2g p 0 c a w a r��o m a C ii=5i.o RRR Ya f' I N 51 6 e - o � R - � rF N p x = a � a H n m CD w ^ W P N cn Concrete: InJgrious to eyes.Causes skin inilalion.Conialns Portland Gemont. Read the follrnving waiting before using: Contact with wet, T Q,,ih s L- nburdened comets,annual mount or cement matures ban cause skd inflation,severe cirectiri bums or assets eye damage. Avoid contact van eyes and If stun have to sand In gloves,a ts,use vale,long beat said,billionairare a[tilioe top and tl h enough toe protection from working Stith these i mffiishing f you have to stand i awed moats,use waterproof boots any are tight at tic top and huh eneugh e keep discrete dean flarring into Intact If finishing concede,wear kneepads to protect knees.Afterconladvelh any ot these matedals,wash off Fmm.WiatayWrthfresh,deanwater.Indirect contact through clothing is as dangerous so comply rinse these materials from clothing.Seek immediate Medical attention 9 you have persistent a severe discorrtott.ln used of eye contact,Bush will plenty of water fa at least 15 mnules,Consult physician immediately.li out of reach of childrenl User agrees to convey this waiting to or peace who may use or counter Into contact with wet(unhardarech comets,modar,second or cement mtxWras. Aggregates; Pmboged inhalations of dust from a gravel product may be hazardous to Your IeaJth.Measures to control fsgiWe dust should is taken when h oing ids product Hot Asphalt emits nuisance fumes.Avoid creating hyars.Alm,Asphafl may muse severe bums.Wear pro'ecWe safety over(long s!aserm panic and gkwes).If burned,and wild water and see a physician. Water added at customer's own risk.Additional water added to concrete will Property Damage Indemnification & Release reduce its strength.Buyers agent agrees to accept responsbiillyfor reduced stoned) The operator of This pace of heavy equipment,In presenting this RE Unloading&Standby Excess unloading will be due lowaleradded above design. LEASE toyed for your signature,is of the opinion that the opera6en of his charged at posted truck time rates.Truck standby mood eely In the manner required to sedan our ranked with yen may time charged at posted truck time rates. Arrived at job with _ inch slump. F pcvsby cause damage to the premises re property.It is our wish to help you ineveryway that we can,but in order to do this,the operate is as king Limited Warranty The only liability of the seller tot I Added gal violet at customer request. Teslcylle ers that you sign this RELEASE.In corrodaaion of the pmeda use of the product defectis the return of the purchase price.In no taken Sella of its cientact}mth me,I the undemirned hereby INDEMNIFY the event strait the seller be liable for any direct indirect, Other additions seller and its employees fa any damage and for all darns to the prerNsts, incidental or consequential damages resulting from _ badlding,utility listings acables,telephone Ines,dmeway or other the use of the products orarigng oul of breach of any l Received 't appadenancess, at: warranty.All cleans for damagobscene ages mustbe In made within 24 hours of deliver y.We do not assume Buyer's Agent receipt of product and approval of any added items. - responsibility for any damage beyond the curb line. and RELEASE the seller and its employees from .. .,_ The addition of any extra products to our mixer may void any warranty any liability, expressed or implied by the seller. The seller accepts no liability for any -- personal injury incurred by you while adding additional products to our mixer. Signature of Owner or Its Agent —.. Signature of Owner or its Agent NWGDELT.KTO9040 Leave Plan! Arrive Job Sit Start Discharg Ftmsh Discharge, Leave Job Site Arrive Plant irf �k jt Drivers' .. Comments Company/ Customer POI Order No. Cust. No. Customer Job Phase Code TICKETNO. Driver Co. Prof. No. Customer Delivery Address oats .. ... .. . .... w,aP zone Delivery Instructions Scale Load City City Order Oty ProductCode UOM Product Description Unit Price Amount i Load Size Prod. No. Description -- Slump Type CC Use Haul Co. PiUPlant Sales Tax, '.. TOTAL DUE Truck Gross Weight Tare Weight Trailer Trailer Taken by Check# m... ®. .. . .. yam ram_.-".__._ .usa asp vmsa®sumo ®. .� ww Concrete s hnjudous to eyes.Causes skin irrtailon.Contalres Portland Cement. Read the slowing warning before using Contact void wet, r ,IE T r11"'D €=rQF vnhardened marble,mortar,cement or anent mixtres con muse skin inimtirn,severe proper al bums or serious eye damage. Avoid contact verb eyes and lark.wear walacroof gives,a falkyouttoned,long sleeve shirt,fldHengn trousers and fight-fi(tiry eye protection when workirg with these materials.If you have to stand in wet concrete,use warrepro of beets that are fight at the top and laid enough to keep concrete from fio>rint Into fl ern. Iffinshing ccnaea,wear knee pads to posters mace.Agar contact aid)any ofthem materials,wash off thromat Atli fresh,dean ways.Indirect sweet through dothing is as dangerous so promptly dose dhow materials from dai n g.Seek immediate madical attention t you have persistent or severe disoxnfonkn case of eye contact,flush vd+h plenty of water for at least ib riddles,Consult physician imnpeuIablly,KEEP out of reach of cheroot User agrees to convey no warning to al persons who may use or cane into cooled w,tr wet(unhardeneed concrete,mortar,cement or cement mixtures. Aggregates: Problaw Inhaaers oI dust from a gravel product may to hazallous to your tedih. Massums to wintml Iuguive dust should be taken when handling the product. Hot Asphalt emits nuisance fumes.Avoid breathing fumes.Also,Asphalt may muse severe bums.Wear preserve safety gear(long sleeves,pants and graves).If burned,cod with water and sea a physician. Water added at customer's own risk.Additional water added to concrete will Property Damage Indemnification & Release reduce Its strength.Buyers agent agrees to accept responslellty for reduced strength The operator of this piece of heavy equipment,in burrow ing Ihts RE- Unloading&Standby Excess unloading will be due(a water added above design. LEASE toyer its your rescue,is of the opinion fiat the operation of this charged at posted truck time rates.Truck standby cods orrery in the manner required to perform our=led vAlh you may time charged at posted truck time rates. Arrived at job with inch slump. F possibly muse damage to the premises or property.It is our wish to help yen ineveryway that we ban,but in order to do this,the operator is asking Limited Warranty The only liability of the seller for Added_. gal water at customer request festcylinders tiatyou one his RELEASE.In consideramin of the performance of the producldefectis the return ofthe purchaseprice.In no taken seller of its modest with me,I the encouraged,hereby INDEMNIFY the event shall the seller be liable for any direct Indirect, Other additions seller and its employeesfa any damage and fa as dams to the proposes, incidental or consequential,damages resulting from building, utility pipelines or makes, telephone lines, driveway or other the use of the products or arising out of breach of any warranty.All eims for damages or shortages must he Received = - appurtenances, at made within 24 hours of dehvery.We do not assume by _ responsibility for any damage beyond the curb line, Buyer's Agent receipt of product and approval of any added items. and RELEASE the setter and its employees from - The addition of any extra productsto our mixer may void any warranty any liability. r +r expressed or implied by the seller. The seller accepts no liability for any personal Injury incurred by you while adding additional products to our mixer. --- --Signature of Owner or Its Agent ' Signature of Owner or,its Agent _ _ li(GDELTKT09L9p___ g Leave Plant Arrive Job SIt Start Disobae Finish Dlsohargel Leave Jab Site Arrive Plant 'r i r I t!it yj r f rmrt rI r r Drivers' ..._ , Comments _. - Company/ Customer POi Order No. Cust No. Customer Job Phase Code TICKETNO. Driver Co. Proj, No, Customer Delivery Address Dare „ tAap Zone Delivery Instructions boom Load Oty Delivered Oty Order Oty ProductCode TOM( Product Description Unit Price Amount I Load Size Prod. NO, 0--._ -__— -�-- — --_---a escription Slump Type CC Use Haul Cut PitlPlant Sales Tax TOTALDUE Truck, Gross Weight Tare Weight Trailer Trailer Taken by — -- Check N Concrete: In}unous to syes.Causes skin irrilomper nialns Portland Cement. Reed e cfollowing warning before using:Contact with wet, unharpened'ocnae,e,motor,cermnt a anent mixWres can cause skin iRIL30ai,severe chemical bums crackers eye dame. Avdd confadwllh eyes and skin.Wear waterproof gives,a fulybutoned,Iongsleeve stint,full fength armans and fightfiting eye protection when working with these materials.If you have to stand in wet concrete,use waterproof boots bat are tight at the top and high enough to keep concede from Barring into them. If finishing cmaete,weer areas pads to proledknows.AftercantactWin any ofthese moraines,wash off Burundiatelywith fresh,dean water.Indirect contact through clothing is as dangerous so promptly rinse these materials from clothing.Seek immediate medical attention L van have persistent or severe dsoondai.ln rase of eye contact,Bush with plenty of water fa at least 15 infrared.Consult physician imrtespalely.KEEP out of reach of children!User , agrees to movey this warning to of sesame who may use or cane into=facct with wet(unherdmisch aspects,mortar,cement a cement mirrors. Aand ates: Rebound inhalators of dust from a gravel product may be hazardous to your health, Measures to robot figure dust good be taken when handing this pefouut Hot Asphalt emits nuisance fumes.Avoid breathing(ruse.Also,Aspreff may cause severe bums.Wear protective safety gear(long sleeves,pants and gloves).If burned,burn with water and see a physician. Water added at customers own malt.Additional water added to concrete will Property Damage Indemnification & Release reduce its strength.Buyers agentmous to accept responsibility for reduced strength The operator of this piece of heavy equipmel8,in upcoming Ihis RE- Unloading&Standby Excess unloading will be metowaleradded movedesign. LEASE to you for your signature,isof the opinion that the operation of this charged at posted truck time miss.Truck standby machinery in the manner required to part=our contract with you may time charged at posted truck time rates, Arrived at job with inch slump. F possibly cause damage to the premises or proti It is our wish to help you in are,yway thi can,but in order to do this,the operator is asking Limited Warranty The only liability of the seller for Added_ gal water at customer request. Teatcyluders that you sign this RELEASE In oangdera6ah of the pe crecou ce of the product defen(is hp return of thepurchase price.ln no taken seller of its contract van me,I the undersigned,hereby INDEMNIFY the event shall the seller be liable for any direct indirect, seller and iG employees for any damage and for al claims to the premises, incidental or consequential,damages resutbng from Other additions the use of the pimpacts or arising out of breach of any building,utility spans or cables, telephone fines,runaway or char warranty.All claims for damages or shortages must be Received appurtenances,at made within 24 hours of detvery,We do not assume li b y I r responsily fly for any damage beyond the curb line. Buyer's Agent receipt of product and approval of any added items. and RELEASE the seller and its employees from The addition of any extra products to our mixer may void any warranty any liability expressed or Implied by the seller. The seller accepts no liability for any personal injury incurred by you while adding additional products to our - - - - - -- mixer. Signature of Owner or Its Agent Signature of Owner or its Agent--.. _ _. _ _ _ WGDELTKTO9040 , Leave Plant Arrive Job 91t 6tart Drsoharg Fnish Discharge Leave Job 91ts Arrive Plant r' i I t�i t i s v r r rr t t! � Irf lilt{ Drivers' V _ Comments Company/ Customer POI Order No. Cust. No. Customer Job Phase Code TICKET NO. Driver Co. Frei. No. Customer Delivery Address 0a1e ,__-. -. . - - ..c' Mao zoos Delivery Instructions c',} sole Time: Load City Delivered Qty Order Qty ProductCode UOM Product Description Unit Price Amount Load Size Prod, No, Description Stump Type CC Use Haul Co. --ein�r4ant Sales Tax TOTALDUE Truck,' Gross Weight Tare Weight Trailer Trailer Taken by Check N ®�.. ® ®-.-®®® .u.. ® . we. a®e a ®sue ®®®- I Concrete; Injurious to ews.Causes skin in atioo.Contains Portland Cement Read the following yarning before using:Contact with wet, unhardened concn:e,molar,cement or cement divoyes can cause skin unladen,severe chemral bums a names eye damage. Avo'd contact with eyes and skin.Wear'waterproof gloves,a fu'y-buHoned,iongsloeve shirt,fink trousers and fight-Ming eye protection when working with time i mandate.If you have to stand In wet concrete,use waterproof boots that are tight at the top and high enough to keep ouncrete from ticking into them. If finishing concrete,wear knee pads to faced knees.After conlad and any of these boards,wash&If Immediately svi n fresh,dean water,Indired earn ad bough doting is as dangerous so promptly rinse these materials from docang.Seek immediate medical allenfim if you have persistent or severe discountable case of eye contact,flush win plenty of water for at least 15 minutes.CansaH physician immediately,KEEP out of reach of children!User agrees to convey this warning to ail persons who may use or cone Into contact with wet(unhardened)canonic,money,cement or cement mixtures. ` n Aggreqatri PmIDreged Inhalations of dust tram a gravel cocoa may be swalloue to your health.Measures to pound l4we dust should be taken , r when handFrg Ibis podmt Hot Asphalt emits nuisance fumes.Avoid breathing(upon.Alan,Asphalt may cause severe bums.Wear protective safety gear dung sleeves,pants and gloves).It burned,cad wfla water and me a physician _ Water added at customer's own risk.Additional water added to concrete will Property Damage Indemnification & Release reduce its strength.Buyer's agent agrees to accept responsibility for reduced strength The operator of Btls plea of heavy equipment,In presenting this RE Unloading&Standby Excess unloading will be due to water added above design. LEASE to for your signature,isof the opinion that the operation of this charged at posted truck time rates.True k stand by ! m menery More manner required to part=our cool with yen may time charged at posted truck time rates, Arrived at job with inch slump. F-1 passfay cause damage to the praness;or propaty.it is our wish to help you of maryrvay that we can,but In order to do li the operator is as king Limited Warranty The only liability of the seller for Added_ gal water at customer request. Test cylinders that yen sign this RELEASE.In consideration of the pedomen of the product defect is the return of the purchase price.inno taken seller of he conhad lean me,I the undersigned,hereby INDEMNIFY the event shall the seller be liable for any direct,indirect, Other additions seller and its applause for anydamage and for all dalms to the pre sea incidental or consequential,damages resulting from building, uh?ity pipnes or cables, telephone lines, driveway or oUra the use of the pproducts or arising out of breach of any Received '� appurtenances,plik warrant99.All claims for damages or shortages must be by ys p made within 24 hours of delwery.We do not assume Buyer's Agent receipt of product and approval of any added items. responsibility for any damage beyond the curb line. and RELEASE the seller and its employees from - - - - The addition of any extra products to our mixer may void any warranty any liability. expressed or implied by the seller. The seller accepts no III for any rs peonal injury incurred by you while adding additional products to our mixer. Signature of Owner or Its Agent _Signature of Owner or its Agent _ _ __ ___ __ _ y�nP!TK205949B Leave Plant Arrive Job Sit Start Drschar Finish Discharge Leave Job Bite Arrive Plant �r r�� I i 'l ( y r' (r +'tit g� I f i t :14.t t t o If , i <,r, i€ t "l� 4r r I I; rsr ,�t wt r Y`` ! rr , ' I I I t{, Drivers' Comments Company/ Customer POI Order No. Cost. No. Customer Job Phase Code TICKETNO. Driver Co. Pro, No, Customer Delivery Address Date Map Zone Delivery Instructions -Load City Delivered Cry Order Qty ProductCode UOM Product Description UMPirrice Amount L-1. r Iti.'•t Load Size Prod. No, Description Slump Type CC Use Haui Cd. PitlPlant Sales Tax Truck TOTAL DUE r .';f: Gross Weight Tare Weigh! Trailer Trailer Taken by - - • Check# ass - -® ®- ®mom-e»®ei®sat... Concretes injurious to eyes.Causes skin im'btion.Conldas Portland Cement. Read the following warning before using Contact with Viet, %TG ,L 1 LT' i;I-t�k '- unhcrdened"ohna=ter,matter,cement a cement foures can cause and Inflation,severe dhereca bums or serious eye damage. Avoid contact W h eyes and skin.Wear waterproof gores,a bNly buttoned,king sleeve stied,mumble trarsws and tight-fining eye protection when worr✓ng wid,these materials.if you have to stand In wet concrete,use,waterproof boors that see tight at the top and high ertu;p to keep concrete from ending Into Diem If finishing carcrete,wear kne,pads to added,knees.After cmtactwith any of idesemeterds,weak off Mma)latdywilh fresh,dean water.Indirect softest I through do'.hng Is as dangerous an promptly dose these materials iron coding.Seek Immediate medical attention H you have persotent a severe dscanforLin case of eye cabinet,flush will plenty of water fa at least 15 minutes.Consult phystrian Ih rodfatey.KEEP out of reach of children!User t agrees to convey this warning to all persons who may use a cane into coned with wet(unharderrecil concrete,trader,.anent a cement reverse, "� t '�t j Aggregates: Pnoged inhalators of dust from a gravel product may be hazardous to your haalOt.Measure to conlml fugitive dust should be taken Wren hadlirg this prbort Hot Asphalt emits nutsznce fumes.Avid brooking Name.Aso,Asphalt may cause severe bums.Wear protective j safety gear(II sleeves,pairs and gloves).If burned cad with water and see a physidam Water added at customers own rich.Additional water added to concrete will Property Damage Indemnification & Release reduce its strength.Buyer's agent agrees to accept responsibility for reduced strength The operator of this piece of heavy equipment,in presenting this RE- Unloading&Standby Excess unloading will be one to water added above design LEASE toyauforyourslgnabire,is of fie opinion that the operation of this charged at posted truck time rates.Trek standby machinery in the manner required to seem our contract with yen may time charged at posted truck time rates. Arrived at job with _ inch slump. El possihy,cause dame to the premises a property.It is our wish to help you n everyway,that we can,but in order to do lhs,the operator is asking Limited Warranty The only liability of the seller for Added gal water at customer request. Testcylinders that you sign(his RELEASE.In consideration of fire performance of the product defect is the return of the purchase pncaJn no taken seller of its contract with me,I the undersigned,hereby INDEMNIFY he event shall the seller be liable for any direct,indirect, silo and its employees fa any damage and is all dams to the premises, incidental or consequential,damages resultingfrom Other additions the use of the rod nets or arising out of breach of any bu➢ding,utillty plpdines a cables, telephone lines,driveway or otter warranty.All claims for damages or shortages must be Received appurtenances, alb made within 24 hours of dehvery.We do not assume by _ responsibility forany damage beyond the curbline, Buyer's Agent receipt of product and approval of any added items. and RELEASE the seller and its employees from The addition of any extra products to our mixer may void any warranty any liability. _ expressed or Implied by the seller, The seller accepts no liability for any Personal injury incurred by you while adding additional products to our . mixer, Signature of Owner or its Agent Signature of Owner or Its Agent _ ---- 1 WO➢ELTKT0904n _._ Leave Plant Arrive Job Sit Start Discharg� Finish Discharg� Leave Job Site Arrive Plant I t( i j k. i iijj(k .ECG '�ili It t It� Drivers' - - - " - Comments_ - -- Company/ Customer PO/ Order No, Cust, No. Customer Job Phase Code TICKETNO. Driver Co. Proj. No. Male Customer Delivery Address Map Con Delivery Instructions Sole Tore: Load Qty Delivered Qty Order Qty ProductCode UOM Product Description Unit Price Amount i' i I i r Load Size Prod. No. Description Slump Type CC Use Haul Cd. Pitifolant Sales Tax TOTAL DUE Truck, Gross Weight Tare Weight Trader Treiler Taken by Check# Concrete:_Injurious to eyes Causes skin imusion.Conlons Portland Cement. Read the following waming before using: Contact with wet, unh:rderni eepar le,motor,cement a cement mizWres can cause skid inflation,severe chendcel bums or serious eye damage. Awed contact with eyes and An.wear waterproof gloves,a fitly-bulto od,long-sleeve sold,fulNength trousers and light-fidmJ eye protected when waking wills these materials:If you have to stand in wet concrete,use waterproof boots that are tight at did top and high arty to keep demands from fi wily into them. If finishing caverefe,wearknee,palliate proted knees.Afterca,tatafth any of these miler es,was r of immediately with I deanwaler.Indiredoaeta o through clothing Is as daw,Iero s so promptly nose these materials horn call".Seek ar nediafe medical attention if you have persistent a severe disoornfoLor rase of eye contact,flush with plenty of water far at loops 15 minutes.Consult physician in reediately.KEEP out of reach of children!User agrees to purvey this warning to al persons who may use a cane into contact with wet(unhardened)concrete,mortar,cement or cement matures. Aggregates: Pmbnged'mhalations of dust from a grand P¢dect may M hazarmus to your indl@ Mosums to punted furtive dust should be taken when handling this pmdint Hot Asphalt smuts nuisance fumes.Avoid mealhirg fumes.Also,Asphafl may cause severe bums.Wear selective safety gear(bag sleeves,pants and glares).If bumps,cost wills water and sea a physician. Water added at customers own risk.Additional water added to concrete will Property Damage Indemnification & Release i reduce itssteengu,.Buyer's agent agrees fo accept responsibility for reduced eirengU, The operator of this piece of heavy equipment,In presenting this RE- Unloading&Standby Excess unloading will be due to water added above design. LEASE to yen for your signature,is of Use opinion hat the operation of He charged at posted truck time rates.Truck standby machinery in the manner required to perform our oantrad with you may time charged at posted truck time rates. Arrived at job with inch slump. possibly cause damage to the premises or property.It is our wish to help you n everyway lhatwe can,build order to do this,the carbonate asking Limited Warranty The only liability of the seller for Added_ gal water at customer request. Test cylinders that you sign this RELEASE.In mnAdleaton of the perforrnave of be productdefectis thereturn of the purchaseprice.ln no taken septa of his contract will,me,I Use undersigned,hereby INDEMNIFY the event shall the seller be liable for any direct Indirect, l sellumdtemplayaesfaanydamagearxifa aidennalothepreutlses, incidental or consequential,damages resulting from Other additions the use of the products or arising out of breach of any building,ones pipadlnes w tables, telephone fines,driveway or other warranty.Ail claims fordamages orshortages elustbe I Received appurtenances,at: made within 24 hours of delwery.We do not assume by �( responsibility for any damage beyond the curb line. Buyer's Agent receipt of product and approve) of any added items. and RELEASE the seller and its employees from .. _ The addition of any extra products to our mixer may void any warranty any liability. I expressed or implied by the seller. The seller accepts no liability for any personal injury incurred by you while adding additional products to our mixer. Signature of Owner or Its Agent Signature of Owner or its Agent_._. _._.- WG➢ELTKTO9990 Leave Plant Arrive Job Sit Start Drscharg Finlsh Discharge Leave Job Site Arrive Plant p'r ,l Elrir Lr ,'i 1 i' t It j t a flit 4tj Drivers' 1. Comments Company/ Customer POt Order No. Curt. No. Customer Job Phase Code TICKETNO. Driver Co. Pro). No. u91'i _ i Customer Delivery Address Date Map Zone Delivery Instructions Seale Load Qry Delivered Qty Order Qty ProductCode UOM Product Description Unit Price Amount n r � - k Load Size Prod. No. Descnption Stump Type CC Use Haul Co. PrtlPlani Sales Tax TOTALDUE Truck Gross Weight Tare Weight Trailer Trailer Taken by Check# Concrete: Injurious fo eyes.Causes skin irdlatlonContains Poaand Cement. Read the following welding before using: Contact with wet, -! ` fir, {.,.-.r "t'�'I C- unhaNened exxraete,mortar,cen>rnt a cement rdxWres can cause skin initatan,swore chemical bums a serious eye damage. Avoid comad Will eyes and-skln.-Wear wtitaproof glo✓es,a hilly-fwftoned,Tong-s!.�eve shut,fulllengur tipplers and light-fieing eye prokeem when working will these I materials:Ii you have io stand in wet mnae[e,use waieiprod lrwLs chat are tight at the top and high enough to keep concrete from(bend Into them If finishing ocnaete,w2arknee pads to proled knees.AffercontadtM(h any of these materials,wash ofianmediatedywhr fresh,deanwater.Inured ca tad Uhrough dothing Is as dangerous so promptly nose these material from doling,Seek immediate medial attention 0 van case persistent or severe discan[orLln case of eye mniad,lush wM plenty of water far at(east 15 minutes.Consult physician Immediately,KEEP cut of reach of chikenl User agrees to convey this worming to all persau who may use or arms into contact with wet(Dependence)concete,mortar,cement a cement matures. 1 Aggreqafes: Pmbrgei Inhalalians of duel from a gravel pNduat may hrdinary to your adapt. Measures to cannot fugitive dust should to taken when haltlNrvg this pmdul Hot Asphalt imps nuisance fumes.Avoid breathing from.Also,Asphalt may cause severe bums.Wear protective sa(ery gear(Icng sleeves,panes and gloves}.I(bumetl,cod w,tir water and see a physician. - Water added at customers own risk.Additional water added to concrete will Property Damage Indemnification & Release reduce Its strengtoBuyees agent agrees to accept responsibility for reduced strength The operator of this piece of heavy equipment,In emeenh'ng ibis RE- Unloading&Standby Excess unloading will be due to water added abovedeclgn. LEASE to you fa ycurmcature,isof the opinion that the opemton of this charged at posted truck time rates.Truck standby machinery In the manner required to perform our wntred wild yen may time charged at posted truck time rates. Arrived at job with inch slump. F-1 possbly cause damage to the promises a properly,It is our vrrsh to help you m everyway that we can,but in order to do this,the operator is asking Limited Warranty return eonof the pirchase liter for Added gal water at customer request. Test cylinders that you sign this RELEASE.In consideration of he performance or the product defect is the return of the purchase price.in no taken seller of its=test win me,I tlhe undersigned,hereby INDEMNIFY the event shall the seller be liable for any direct,indirect, value and its empoyeesfa any damage and for all chins to the premises, incidental or consequential,damages resulting from Other additions -- building, fiG(y pipagines or cables,telephone lines, driveway or other the use of the products or arising out of breach of any ukk Received accumulators, at warranty.All claims fordamages orphanages masted made within 24 hours of detveryMer do not assume by X responsibility for any damage beyond the curb line. Buyer's Agent receipt of product and approval of any added items. and RELEASE the seller and Its employees from _ ... , The addition of any extra products to our mixer may void any warranty any liability. expressed or implied by the seller. The seller accepts no liability for any personal Injury incurred by you while adding additional products to our mixer. Signature of Owner or its Agent c, _....— Signature of Owner or.its Agent _ _ ------ ycrC� DELZKT0909U1 Leave Plant Arrive Job Sit Start Discharg Finish Discharger Leave Job Site Arrive Plant I4(!Ih ,ipt r i r I ) f at —__ _.�• - _..- ,t...i r �ts" ' ti .,I ,�f , j ' f � I it Drivers' - - Comments Company/ Customer PO/ Order No. Cost. No. Customer Job Phase Code TICKET NO. Driver Go. Proj. No. Customer Delivery Address oaio = MeP Zane Delivery Instructions scale Time: Load Qty - Delivered Qry Order City ProductCnde UOM Product Description Unit Price Amount Load Size Prod. No. Description Slump Type CC Use Haul Cd. Pit/Plant Sales Tax TOTALDUE Truck . Gross Weight Tare Weight Trailer Trailer Taken by Check# ® .® . e cover Concrete: Injurious to eye never skin irmation,Contams Portland Cement. Read the following wam!ng before using.Contact wain wet, ` si m ,j ,<,) f"IC Joherdeatad"tenant,,ipplar,cedont or cement now res can cause skin imtatlon,severe granted burns or serious eye damage. Acted contact with eyes and skirt Wear'tvaterproof gloves,aNay-buttoriad,IoriO-stases shth,fortength awards and bighl-6mirg eye protection kirgq on when wor oath these materials.If you have to stand in wet conaele,use waterpracf boots That are tight at the top and high enoug to keep enhance from flowing into from. I(fislshing concrete,wear knee pads to protect knces.Aftercentadwlth any of these materials,wash off imunediatetyWin fresh,dean water.Indirect invited through doihing Is as dangerous so promptly rinse these maedais from dograg.Seek immediate traded aftention if you have persistent or severe discomfat.ln case of eye canted,slush witlt plenty of water for at le�l 15 minutes.Consult pirys w dmmadafey.KEEP tut of reach of children!User r. agrees to convey icts waming la all persons vfio may use or come auto�Tthd with wet fundamentd)concrete,mortar,cement a cemsrt in fares. t Aggreqates: Probn2ed'mhaMibns of dust Irom a grovel pmdtel may tz reactions to your haatlh. Measures to round lugn e dust should hz taken I r. vhan haM.ing tltis pmdml Hot Asphalt ,mils nuisanoa fumes.Avid breathing fumes.Also,Asphalt may cause severe bums.Wear protative sa[ery gear(kxr9 sleeves,pants and glees).If homed,cod with water and see a physician. Water added at customers awn risk.Additional water added to concrete will Property Damage Indemnification 6 Release reduce its strength.Buyees ageniagrees to accept responsibility forreduced strength The operator of this place of heavy equipment,in pressuring this RE- Unloading&Standby Excess unloading will be due to water added above design. LEASE to yen ter your signature,is of the opinion that the operation of this charged at pasted truck time rates.Truck standby j machinery,in the manner required to perform our oonMat with you may time charged at posted truck time rates. j Arrived at job with _ inch slump. El possibly cause damage to Ina premiss;or property.If is our wish to help you in Werywaythatwecan,butin orderto do this,the accidents asking Limited Warranty The only liability of the seller tot Added— gal water at customer request. Test cylinders that you sm this RELEASE.In consideration of the performance of the product defect is the return of the purchase price.In no taken seller of its contract win me,I the undersigned,hereby INDEMNIFY the event shall the seller be liable for any direct indirect, Other additions seller and its employees for any damage and for al Jaime to the chances, Incidental or consequential.damages resulting imo building, uliliry pipelines a cables, telephone lines, difveway or other the use of the�roduets or arising out of breach of any warrantyy.All e aims for damagges or shortages must be Received appurtenances,at: made within 24 hours of delivery.We do not assume by X responsibility for any damage beyond the curb line. t Buyer's Agent receipt of producCand approval of any added items. and RELEASE the seller and its employees from The addition of any extra products to our mixer may void any womanly any liability. i, - expressed or implied by the seller. The seller accepts no liability for any personal injury incurred by you while adding additional products to our - -- mixer. Signature of Owner or its Agent Signature of Owner or its Agent _ -.-___ _ GDELTKTD3➢40B Leave Plant Arrive Job Sit Start Dlsohaeg Finish Drscbarga Leave gob Site Arrive Plant e I pp F f r i t t r'li i ri 4 p (}i �it i y �i I;f� 4i i rr ti li r,ft �__ Drivers' Comments -- Company/ Customer PO/ Order No. Cost. No. Customer Job Phase Code TICKETNO. Driver Co. Prof. No. Customer Delivery Address °ate 11 Map Zonis Delivery Instructions r Scale Load Qty Delivered Qtyi OrderQty ProductCade UOM Product Description Unit Price Amount 1 Load Size Prod. No Deascription Slump Type CC Use Haut Co. PiUPIani Sales Tax TOTAL DUE Truck Gross Weight Tare Weight Trailer Trailer Taken by •. -. Check# i Concrete: Injurious to eyes.Causes skin Irritatlon.ConSt Portend Cement. Read [he following warning before using: Contact v,-0fh wet, C.. `*Tf,j "her late oanaete,mortar,cenznt or cement mixWres can cause skin cracks,severe charred bums a serious eye damage. Avoid Damao win eyes and skin.lh'ear waterproof q!wes,a Nily-buttoned,Tong-sleeve cut.fuMength transom and Ugh"O rg eye prolech'on When working win these mafenalsi If you have fo stand in wet conaele,use waterprod boots that are tight at kie top and high enough th kcep conaete flan Oofnng Info Diem. If Unishing cgsaete,wear knee pads(oprotectknces.Aflerconladwith any dihese matedaN,vmsh oB immedia[eywtbr fresh,deanwater.Indfredcmthre Unroagh dorhNg is as dangerous so promptly rinse Umse materials flan dofhing.Seek N(mediate medlnl aftentlon d you hale perslstanl a severe dlswrMoi.ln case of eye caniad,(lush vdlh planry of waterfor at least t5 ndnules.Caruuft physician Imnediah9y,KEEP cut of reach of ditldrenl Usa agrees to corrvey this warning to all persons who may use or cane into oxttad vAm wet{unhardened)casaele,molar,aanenl a cement mirWres. r (jgaregates: Pmbrgal InhalaGans of dust iron a gravel pmiml may tie hazardous N yrour health.Measures to mniml(ugdNe dust sfrouN be taken I when handGrtg this prodcel. Hot Asphalt emus n;rsence Nines.Avoid breattring Nines.Alm,Aspha!f may cmrse severe bums.Weer protertive safety gear(brig sleeves,pants and gloves}.If homed,cod witlr water and see a physkian. - i Water added at customers own risk.Additional water added to concrete will Property Damage Indemnification 8 Release reduce itsstrength.Suyersagenl agrees to accept respcosl6111ryfor reduced strength The gnareta of this piece of heat''egrrvpmenl,In presenfing this RE- Unloading&Standby Excess unloading will be due lowaleradded abovedesign. LEASE to inufa annex naWre,is of the oplrnoutha 9 operation of is charged at posted truck time rates.Truck standby machNeay in the manner rtkabpr to s; am our conUad vnih you may time charged at posted truck time rates. Arrived at job with __ _inch slump. gambit'rouse damage to the prertises a property.Il is our t i to help you in evayway thatwe can,but in order to do Oils,the opaalaaasking Limited Warranty The only liability of the seller for al water at customer request. TestcyGrders that you sign this RELEASE.In considemtlon of the pedamancedthe productdefectis the return ofthe purchase price.In no Added_ 9 g taken seller of Its banked with me,I the undersigned hereby INDEMNIFY the event shall the seller be liable for any direct Indirect, seller and Or employees for any damage and fa all dalmsto theprerdses, incidental or consequential.damages resulting from Other additions - buttoner,uglify plpames or cables,telephone Imes,driveway or other the use of the rod nets or arising out of breach of any appurtenances at: warranty.All claimsfor damages or shortages must be Received pp made within 24 hours of delivery.We do not assume by V( responsibility for any damage beyond the curb line. Buyer`s Agent receipt of product and approval of any added items. and RELEASE the seller and its employees from _ The addition of any extra products to our mixer may void an warranty any liability. - - expressed or implied by the seller. The seller accepts no liabl ity for any r personal Injury incurred by you while adding additional products to our mixer. - Signature of Owner or its Agent . Signature of Owner or its Agent __ _ _- WG➢ELTKT09090 Leave Plant Arrive Job Sit Start Dlscharg Fmrsh D fee harge f.eave Job Site Arrive Plant i 1 III ( t i r li; I ( r i 'f` S ;j ' k r h ` 1 i rl 'J �_— Drivers' - -- Comments-_ - - - Company/ Phase er CodPO/ Order No. Cost. No. Customer,lob Phase Code TICKETNO. Driver Co. Proj. No. , Customer Delivery Address zbae Delivery Instructions Srale Load Qty Delivered Qty Order Qty PraductCode UOM Product Description UnitPrice Amount Load Size Prod.No Description Slump Type CC Use Haul Co. PdlPant Sales Tax TOTALDUE Track, Gross Weight Tare Weight Trailer Trailer Taken by1 Check# Concrete: Injfi ou ds to eyre.Causes skin inttaon.Conietns Portland Cement Read the following warning before usmi Granted with wet, f r fs;( I I`ir"' '[C`r. unhardened't ontmes,maiar,cenent or anent matures can cause skin imlaticn,were chemical bums a seian eye damage. Avoid contzd with eyes and.skip.Wear waterproof gloves,a HIlybuftoned,longeleave shirt,finder i trailers and tight-fling eye protection when working with these matelots.If you have to stand In wet concrete,use waterproof boots that are fight at The top and high enough to keep concrete from toning into them_ Ifhearing concrete,wear knee pads to protect knees.Aftercontacf hirm any of dead materials,wash off immustabyadd fresh,dean water.Indirectcoilad Through doth'utq K as dangerars so promptly rinse Urese maloiiais from doihig.Seek!mmedlate medical attention f you have persistent a:zvero discarrfon.ln case d eye caataH,Uush wtlh plenty of water fa at(east 16 minutes.CmaAt phYysldan imrtred'rafey.KEEP ouI of reach of children!User agree to convey Ynis warning to all pasau Wno may use a crone into axrlad w,th wet{unhardenetl)concrete,mortar,cement or cement m�xWres. ,, .. , Agpregates: PmbTtged Inhalations of dust Irom a gravel pmflCl may bs haxardaa Io your health.Measures d coniml IugiVve dust sibuid tk taken when hanUl:rg Otis pmimt Hot Asphalt emid nuisance fumes.Avoid brcethirq fumes.Also,Asphalt may cause severe bums.Weer pmta�Uve safety gear(Inng sleeves,Pants and 91mzs).I[burned,oxd with water and see a physidan. Water added at customers own ask.Additional water added to concrete will Properly Damage Indemnification & Release I reduce its Strength.Buyers ayent agreesto acceptresponsibility for reducedstreng(h The operafa of This piece of heavy equipment,in presenting this RE- Unloading&Standby Excess unloading will be dueto water added above design LEABE toyaJ foryarr sgnalure,Ts oflhe opiniw drat the operation of this charged at posted truck time rates.Truck standby madimey ni Ure manner required to perform our contract vnth you may time charged at posted truck time rates. Arrived at job with inch slump. possbry cause damage to the pranises or property.It is err wish to help ywmeveryway thatwe can,buUn oNer to do this,the operator is asking Limited Warranty The only liability of the seller for Added gal water at customer request, Tel cylinders that you sign this RELEASE.In conatlera6on of the perfaniance d the produetdefect is he return of the purchase price,In no .,.._ taken seller of its contract with me,I the undersigned,hereby INDEMNIFY the event shall the seller be liable for any direct,indirect, seller and its empioyeesfar any damage and fa all dorms to theprerNses, incidental or consequential,damages resulting from Other additions_ _ building,uUlUy ptpopmes a cables, telephone In driveway or other the use of the produent or arising out of breach of any warranty.All claims for damages or shortages must be Received - i appurtenances, al: made within 24 hours of delivery.We do not assume by X t ` _ responsibility for any damage beyond the curb line, Buyer's Agent receipt of product and approval of any added items. and RELEASE the seller and its employees from _ The addition of any extra products to our mixer may void any warranty any liability. r expressed or implied by the seller. The seller accepts no liability for any personal injury incurred by you while adding additional products to our mixer. Signature of Owner or its Agent . !. Signature of Owner or its Agent NNNVVGDELTKTO9040 Leave Plant Arrive Jab Sitg Start Discharg Finish DlschargelLeave Job Site Arrive Plan r I r � ,:l t . tjI{ if�uf r I, p �! t(rjr (I it r t, I t Drivers' Comments---- Company/ Customer POI Order No. Cost. No. Customer Job Phase Code TICKETNO. Driver Co. Pool. No. Customer Delivery Address rz,te r leaP Zrme Delivery Instructions Scale Time: . . Load Qty Delivered Qty OrderQty ProductCode DOM Product Description UnitIzrice :..Amount rev-. ,. ...,. ..r.;.;.. Load Size Prod. No Description Slump Type CC Use Haul Co. PhiPjant Sales Tax TOTAL DUE Truck Gross Weight Tare Weight Trailer Trailer Taken by Check# -__cam.®.saw -...ems.. �.a-.w.m...vsn-.-eves now. — — l—' cr`, ,Ww( "lrr-- Concrete. Injurious to eyes.Causes skin imlauoaConsto Portland Cement.Read the following warning before using Contact with wet, unh� air enle- marac matey s mnt or cement muWres can cause skin i ilmon,severe chemUzl bums a serous eye damage. Avoid cooked v4b eye and skih.Wear 'a eyes gloves,afully-buttoned,(ongsleeve shim fuWengtr suarvers and tigh"Ong eye protection when wei in vAih these materials:If yrou have to stand In wet co,na full use w te,fond butts tllaf am tight at the top and high enough to keep concrete from baring into mean ltfioishirg oanaete,wearknee pads to protedkneas.Afteroceiadw`Ih any dlhesemgedais,wssh eUimmed+ateywdrfresh,deanwater.Indire,{antad tlsrough doUBng Is as dangerous so promptly rinse mere matedais ftwn dolhing.Seek Immediate mzd;r�aUention ti you have persistent a severe discanlom.in case o[sye mniad,flush�,plenty of water fa at least 15 rdnules.Consult physidan Immedatety,KEEP art of read of cfllidrenl User c agrees to Garvey This warning to all persons who may use a cease into oantat#wNr wet(unhardened)�aele,modar,ce'nent a cement mixtures, r ;` ,` Aggregates;Pmbnged inflations of dust from a gavel przdcet may he hazardous to your Card,tdaasums b rnnlml(tg'Nve dust should he taken • vA,sn ha,YJinrg In's pmdmL Hot ks halt eanits nuisance fumes.Avdd 6reaU,Ing fwnes.Also,Asphalt may causa severe bums•.Wear prMective � safety gear(brrg sleeves,Danis and gloves}.I(bumed,ocd with water and sae a Phys:�dan. - ; Water added al customer's own risk.Additional water added to concrete will Properly Damage Indemnification & Release reduce its strength.Buyer's agentagreas to accept responsibility(or mducedstrenpih The cparetor or fhb plain of heavy equipment,in presenting this RE- Unloading&standby Excess unloading will be is due to waleradded above design, LEASE toyoufa yaursgnamre,isofihe op;mar drat the operaUm of this charged at posted truck lime rates.Truck standby , mad,inery in the manna required fo perform our contract vnih ycu may time charged at posted truck time rates. Arrived at job with inch slump, possibly cause damage to the premises a property Jtls ourvds tohelp Limited Warrant Tire liability of the seller for - you In everyway that we can,but In older to do this,the operator b eking p Y Y Added_ gat water at customer re east. Test cylinders that yen sign this RELEASE.In c nsdemton of the parformance of the protluctdefeet is the return of the purchase pnce.Inno q taken seller of its mntmd vAih me,I the undersigned,herehy INDEMNIFY the event shall the seller be liable for any direct indirect, sister and its amployees(a any damage arvJ for all datms bmapremses, incidental or consequential,damages resulting from Other additions_ building, utility pipelines a cables,telephone lines,driveway or oUro the use of the products or arising out of breach of any —T - warrar%Are aims fordamages or shortages mustbe Received ;' appurtenances,at: made within 24 hours of delivery.We do not assume by i responsibility for any damage beyond the curb line. Buyer's.Agent receipt of product and approval of any added iterra and RELEASE the seller and its employees from r. The addition of any extra products to our mixer may void any warranty any liability. expressed or implied by the seller. The seller accepts no liability for any personal injury incurred by you while adding additional products to our - -- mixer. Signature of Owner or its Agent Signature of Owner or Its Agent --.____ WGDELTKI➢9D4➢ Leave Plant Arrive Job Sit Start Olscharg Frmsh Dtschar eI Leave Job Site Arrive Plant , - t _ I g (Il , �ii4r Ito i�r It Drivers' " Comments Company! Customer PO/ Order No. Cust. No. Customer Job Phase Code TICKET NO. Driver Co. Proj, No. Date Customer Delivery Address - " Map Zone Delivery Instructions Scale True _ _. — Load City DelivereOty d Order Oty ProductCode UOM Product Description UnitPrice Amount Load Size Prod No. Description Stump Type CC Use Haul CcL PiUPlant Sales Tax TOTAL DUE --- f Taken b Truck Gross Welghi Tare Vyeight Trader Tmilor y Check# .®min®.®®mom.. - . - -now...-®. ®.®- ®. Concrete: Injurious to eyes.can ses skin imlation.Contains Pwtand Cement. Read the following worried before using: Contact with we,, unhardened wnaete,molar,cement or cement inlxWrun can cause skin imifaton,severe chemical bums a actions eye damage. Avoid cad wish eyes and sit Wear worsened gloves,a fully-buttoned,long-sleeve shirt fW length Cocoons and tght-fining eye proom on when waking with these materials.If yen have to stand in wet controls,use waterproof boots that are Ight at the top and high enough to keep concrete from having into them If finishing concrete,wearknee pads to p!oteceknees,AteraxtedMth any ofthese metedals,wasbufi Immediateywilh fresh,deanwaler.lnd�rectcmtad through clothing Is as dangerous so promptly time these malerims from datttg.Seek someone medical attention a you have persistent or severe dlsowmfon.bh case of eye rotted,Lush with plenty of water for at least 15 fig utes,Consult physician imnadately.KEEP out of reach of childrent User i agreks to convey Me warning to all persons who may use or comR into cmtad with visa hanhardened)cassava,manor,cement or cement maWres. _ Aggregates:P*brgd creators of dust from a g2vel pmiset may be hmardcus to yoar heath,dre asuees to sent*]forive dust scrud be taken hden handing Its prodml. Hot Asphalt emits nuisance fumes.Avoid breathing fumes.Also,Asphalt may cause severe bums.Wear protective safety gear(tong straws,pants and gloved If burned,cod with water and see a physician. Water added at essences ova risk.Additional water added to concrete will Property Damage Indemnification & Release reduce Its strength,Buyres agent agrees to accept responsibility for reduced strength The operator of this piece of heavy equipment,in presenting this RE- Unloading&Standby Excess unloading will be due to water added abovedesign. LEASE to you fwyour signature,is of Me opinion that the operation of this charged at posted truck time rates.Truck standby machinery in the manner regdred to perform our camnId with you may time charged at posted truck time rates. Arrived at job with _inch slump. F possbty cause damage to tee premises a property.It is au wish to help ! yet m everyway that wer can,but in under to do this,the operator is asking Limited Warranty The only liability of the seller for Added___ gal wafer at customer request. Test cylinders that you sign Its RELEASE.In axhsideraton of the performance of the product defect is the return of the purchase price.In no taken seller of Its ranked with me,I the undersigned,hereby INDEMNIFY the event shall the seller be liable for any direct,indirect, xygrand its ernployeesfa anydamageand forallda!ms to to presses, incidental or consequential,damages resulting from Other additions .,_ the use of the pproducts or arising out of breach of any building,utility pipelines a cables,telephone lines,driveway or other warranty,All cl aims for damages or:vantages must be Received _ r; j appurtenances, at: made within 24 hours of dellvery.We do not assume by �' _ responsibility for any damage beyond the curb line. Buyer's Agent receipt of product and approval of any added items. and RELEASE the seller and its employees from - The addition of any extra products to our mixer may void any warranty any liability. expressed or implied by the seller. The seller accepts no liability for any personal Injury Pounce by you while adding additional products to our mixer. Signature of Owner or its Agent Signature of Owner or its Agent _ NW-GDECCKTD9D40 Leave Plant Arrive Job Sit Stan Dischar Finish Discharge Leave Job Site Arrive Plant o h, g I c�( hif° fur i ;E'h{ijII,h IlE' i if -fhl I , Drivers' _ ! Comments - — Company/ Customer PO/ Order No. Cust. No. Customer Job Phase Code TICKETNO. Driver Co. Pro]. No. Customer Delivery Address Dare .. ... ... . . r_ Mao Zone Delivery Instructions : - _ .. .... scale Tme: _ Load Qty Delivered Qly Order Qty Product Gode UOM Product Description UnitPricke Amount r / r jr v C Load Size Prod. No Description Slump Type CC Use Haut Cd. Pit/Plant Sales Tax TOTALDUE Truck Gross Weight TaW re eight Trailer Trader Takn by e ! - Check 8 _.. ....®.moo. s v ano V,io,am....reev-.e-aa caols'oo_ram ooarrm aca L Concrete: Injurious to eyes.Causes skin Ir orrieContalns Portland Cement. Read the tollowing warning before using: Contact with wee, !M"'Ci{ ( I unhardencel:onaete,mortar,cement or cement mixtures can cause skin hotaton,severe dwmical bums or serious eye damage. Avoid contact Win eyes and skin.Wear waterproof gloves,a fifty-buftonc-0,longsteeae shin,hammer trase s and tight-firing eye protection when waking vnth these materials.If you have to stand in wet ox,aete,use wakened boots that am tight at the top and high enough to kepi concrete from toning into them. If ruching anaete,wearknee pads to rangedknees.Afterconectvdt,any of those materials,wash ofiknmedeseyvith fresh,deranwater.Inured con ad through doUvng is as dangerous so pranpUy nose these metetlas from clothing.Seek immedaie medical atenton H you have persistent or severe disaarn(onln case of eye contact,flush witf plenty of water for at(east 15 minutes.Consult physlaan idunedatey.KEEP out of reach of children!Uss r � i agrem to envoy this warning to all persons who may use a inns Into c«,thd wish wet{unhardenatl)o>nae(e,mortar,cement or cement rnlxWres. r r " � , , � Ageregates: Pmbrg�ishdaFons of dust Imm a gravel Vradfpt may t2 hazallom is yotr health,Measums to coniml fugftive dust shouYJ be taken _ when halxllirg this prxlirt Hot Asphalt emits nuisance limas.Aveilu breathtny fun>es.Also,Asphalt may cave severe bums.Wear pmtodve safety gear{long sleeves,pants and gloves).If burned,cod with wafer and sce a phys%clan. Water added at customer's own risk.Additional water added to concrete will Property Damage Indemnification & Release reduce its strength.Buyers agent agrees to accept responsibility for reduced strength The operator of this piece of heavy equipment,In presenting this RE. Unloading&Standby Excess unloading will be due to wateredded above design LEASE to you for your signature,is of theopinlon Ufa[the operated of Us charged at posted truck time rates.Truck standby machinery in the manner required to perform our unmet with you may time charged at posted truck time rates, Arrived at job with inch slump. E-1 pasthy cause damage to the promises a property.It is our wish to help you in everyway that we can,but in order to do this,the operator is asking Limited Warranty The only,liability of the seller for Added - gal water at customer request, Testcionders that you sign this RELEASE.In ceragaekdon of the performance of the produmdefect is the return of the purchaseprice.In no taken seller of its rcntrad with me,I tie undersigned,hereby INDEMNIFY the event shall the seller be liable for any direct,indirect, Other auditors seller and its emboyees far any damage and for all claims to the premises, incidental or consequential,damages resulting from i " adding, utility pipelines or rabies, telephone Imes, driveway or other the use of the protlpote or arising out of breach of any Received r? / _ appurtenances, at: warranty.All claims for damages or shortages must be b y - ' made within 24 hours of delivery.We do not assume responsibility for any damage beyond the curb line. Buyer's Agent receipt of product and approval) of.,aui added Items. and RELEASE the seller and its employees from The addition of any extra products to mixer may void any womanly any liability. _ expressed or implied by the seller. The seller accepts no liability for any personal injury incurred by you while adding additional products to our mixer. t Signature of Owner or Its Agent Signature of Owner or its Agent_ _ G➢ELT=Rcb1➢!f Leave Plant Arrive Job Sit Start Discharger Pbtish Oischargel Leave Job Site Arrive Plant r r{ , r u' �it{�li , fi� r t Itt 4� r tll� li� inlet{t fl f Prit Drivers' _ fti{v, w' _ _ ,. Comments Company/ Customer PO/ Order No. Cost. No: Customer Job Phase Code TICKETNO. Driver Co. Prot. No. Customer Delivery Address Date Map Zone Delivery Instructions - scale Tine: Load Qty Delivered Qry Order Qty ProductCode UOM PreductDescription Unit Price Amount Load Size Prod. No. Description Slump Type CC Use Haul Co. Pit/Plant Sales Tax " TOTAL DUE Gross _-- - Truck Gross Weight Tare Weight Trailer Trailer Taken by Check N ® rs�sue_.®....ems. ®.e an_. . sass......sum-® _ - - Concrete: IrSurious fo eyes.Causes skin ImtatioaContains Portland Cement Read the following warning before using, Contact with wet 's:r°r ��",m{/C7E unharJened;.nnacle,mortar,a-men(w caneni m:a1ures can cause sk'm imtaten,severe chaboal bums a serious eye damage. Aved mnLd win eyes'and skin.Wear waterproof gloves,a fimiry-buttorred,tang-sleeae shirt,futaengm trcuse<s and tightfiiling eye protection when working vdih ti;ese materials:II ycu have to stand in wet concrete,use waterproa Goofs chat are fight at Ole(op and high enough fo keep concrete from IfoMrg mto Omer. If 6nishlmg oxmaete,vrearknee pads toprotectknccs.Aftercontactwilhany dihsse mafedals,wash ofirnmediatdywlOh ire h,deanwater.lndirect cenmd Through doming is as dangerous so promptly nose these materials from doming.Seek immediate medical a0ention f you have persistent or severe dismrtOon.ln case a(eye oamrad,(lush vriOm picimry of water[a at least 15 minutes.Consult physldan imrx;dately,KEEP ouI o(readt of dalidrenl User agrees to convey this warning to dl persons wiro may use or cane into axm4.ct wm wet{tnhazdened)concrete,mortar,cement or cement rnixWres. , Aggregates: i'mbrged InhalaUms of dust from a gravel pmiwl may to fmzardaus W yrour f>e'aIN.Measures b wnlrol fugifMs dust should be taken vAmen tlaadllfttJ O,'is podmt Hot Asphalt emOs nuisance fumes.Avoid breatr9rg fumes.Also,AsphaY may aaxso severe bums.Wear protectivo I safety gear(bog sleeves,pants znd gloves).I(bumecl,real wish water and see a tnryodan. Water added at customer's own nsk.Additional water added to concrete will Property Damage Indemnification & Release reduce its stremorguyees ageni agrees to accept responsibility for reduced strength The operator of this pig of heavy equipment,in presenfirg this RE- Unloading&Standby Excess unloading will be due to water added abovedeslgn. LEASE to yen for your signature,is of the opinion that the operation of this charged at posted truck time rates.Truck standby machinery In the manner required to perform our conked with you may time charged at posted truck time rates. Arrived at job with ._inch slump. possibly cause damage to the premises a property.It is our wish to help you in oayway Oratwe can,but in order to do Oils,the operator is asking Limited Warranty The only liability of the seller for Added_ gal water at customer request. Test cylinders tint you sign Oils RELEASE,In consideration of the performance of the producldefect is the return of the purchase price,In no l taken seller of it cndad Win me,I Ore undersigned,hereby INDEMNIFY the event shall the seller be liable for any direct,indirect, -- incidental or consequential,damages resulting from seller and its emooyeesfaanydamage and claim the por oths, Other additions— -- truilding,uOli(y pipelines a cables, telephone lines, driveway or other the use of the products or arisingor shortages o mustany be a unenances, at: made ty,Allwithin claims rs damag ery.Wedonot as must be Received PP made within 2f hours of age beyond and the not assume by X - responsibility for any damage beyond the curb Tine. Buyer's Agent receipt of product and approval of any added items. and RELEASE the seller and its employees from _ _ The addition of any extra products to our mixer may void any warranty any, liability. expressed or implied by the seller, The seller accepts no liability for any personal injury incurred by you while adding additional products to our mixer, Signature of owner or its Agent Signature of Owner or_its Agent _ <rIWGOELTKIJISIDADJ _-- I Leave Plant Arrive Job Sit Start Discharg Finish Discharge Leave Job Slte Arrive Plant r t [i t 1mi t r r r r 1 j iHli i r t t: I r�r IY-ii it, Drivers' - Comments Company/ Customer PO! Order No. Cost. No. Customer Job Phase Code TICKETNO. Driver Co. Proj. No, Customer Delivery Address Dale Map sense Delivery Instructions Scale Load Qty Delivered Qty Order Qty ProductCode UOM Product Description Unit Price Amount Load Size Prod. No Description Slump Type CC Use Haul Let. PItlPlant Sales Tax TOTALDU_E _ T . Gross Weight Tare Weight Terrier Troller Taken by Check ruck .. ems.®.seas. ®.e:sa.acce.a m _,cou a.a.esw-sera-ram.eaa roc... ® � - -er . .. Concrete: Injurious to eyes.Causes skin imtation,Contains Portland Cement. Read the following warning before using: Contact with wet, 1- unhardened ennais,matar,cerrud a wment m'!xiures can cause skin irrihafkxi,severe drem'cal bums a serious eye damage. Avoid carried with eyesani skin:W;z(waterproof gloves,a fulNbuHoned,Iagaiaehe shxt.hilFiangih 6cdsers arid tight-filling eye protectlon when worsting v✓,th fhese matefals.I(yau have to Bland in wet amaete,Use waterproof hoofs that are djht at the top and high enaJgh to keep concete from flaying into deem. - I(finishirg oaTaete,waarkneepads toprotad knaes.Aftercariadwiih anyefihese matenals,wasn oRimrtadiatelywilh Gash,dean water.Indirect oanfais through dothing is as dangerous so pmmp9y rinse These materials from dolhhg.Seek immediate medical attention n you bade parsistent a Bevan discanfat.in rase of eye oantad,Oush wth plenty of vraler fa at least l5 rrrwtes.CoTwit physidan im!rietliateFy.KEEP Dui of reach of children!User ' agrees to convey this warring to all persons who may use or osmz Into contact w%,Ih wet{unhaNened}conaelo,mortar,cament a cement mixWres. ' m Agg,regaYes; Probrgef loha!aUons of dust from a gravel pmdr>rl my hz hazardous to your haaln.tdeasures to coolml[uglfrve dust should be taken j whin handLm Usk proitxt. Hot Asphalt emits nuisance Nmas Avid ureadtixg fumes.Also,Aspha!I r»ay cause severe bums.Wear protective safety gear(kx>9 sleeves,pants and gloves).I(bumed,Doff with water and see a physktan. Water added at customer's own risk.Additional water added to concrete wits Property Damage IlSdemnificafion & Release reduce its strength.buyers agenlagreesfoaccepl responslhltitytor reducedsUengU The�remta o(ihis piece of heavy equipment,in pressntlng this RE Unloading&Standby Excess unloading will be to to wafer added abovedasign. LEASEtoyaafayoursgnaNre,is of iheopinion drat the opefat of ibis charged at posted track time rates.Truck standby machinery m the manner required to pedomr our mntr�t with yar may time charged at posted truck time rates. Arrived at job with _ - inch slump. pass*cause damage to the pranrses a propcvly.It is our wish to help Limited Wanant The only liability of the seller for you in everyway That we can,but in offer to do This,the operator is Wry; y Y Y al water at customer-request. Testcylinders that you slgn bills RELEASE.In consderatin of the performance ,the productdefect tithe return of the purchase price,In no Added_ gtaken seller of its contract with me,I the undersigned,hereby INDEMNIFY the event shall the seller be liable for any direct indirect, i sales and its employees fa any damage and for !I dams to the premdses, incidental or consequential,damages resulting from Other additions - the use of the rod nets or arising out of breach of any building,ursky ppelmes a cables, rheraate lines, driveway or other warranty.All claimsfar damages orshodages trustee Received ;` v predenanies,at: made wdho 24 hours of dehvery.We do not assume b y ` _ responsibility for any damage beyond the curb line. Buyer's'Agent receipt of product and approval of any added Items, and RELEASE the seller and its employees from The addition of any extra products to our mixer may void any wananty any,liability. expressed or Implied by the seller. The seller accepts no liability for any personal injury incurred by you while adding additional products to our mixer. Signature of Owner or Its Agent _ Signature of Owner or its Agent WGDELTKT09040 Leave Plant Arrive fob SitrlStart Drscharge�Finish Discharge)Leave fob Site Arrive Plant r t�tiri i t,{ �t IL IP,r r 1!I r LEi Drivers' - - - - Comments_. .----- -- - Company/ Customer PO/ Order No. Cust. No, Customer Job Phase Code TICKETNO. Driver Co. Proj, No. Customer Delivery Address Data .. , r ... _. flax Z. 'Delivery Instructions Scale Tine: _ . Load Qty Delivered Oty Order Oty P rod uctCode UOM ProductDescription UnitPrice Amount Load Size Prod. No. Description , Slump Type CC Use Haut Cd. PAPlant Sales Tax TOTAL DUE Truck ght Tare;, Gross Wei Weight Trailer Trailer Taken by Check# . ..rase-®-.. w.. . .._ .area-ewv�xvx .ow.. ® -. Concrete: Igwdous to eyPs.Gausm skin im allon.Contains Perform Cement. Read the following warl before using:Contact With wet, i !mho caned.mitbe`6,pester,cesmN or gent matures can cause skin rotation,severe meekest bums a serous eye damage. Avodi contact hdgi eyes andskin.Wrzr waiaprou(gives,a tiny-buttoned,long-sleeve shut,fulNengtls hatsers and tight-fining eye protection when wowing with these malanals.If you have to stand In wet omoete,use wateiprod boots that are fight ffi the top and high enough(o keep sensate frcm kwAng into Than If knisand mnaete,wearknee pads Ioµrotedknees.Aftercontadw3th any ofh ave materials,wash off Immediatetywagn Inch,dean water.Indirect contest huoirgh dogring a as designers so promptly nose These materials from dogsing.Seek immediate medical attention if yen have persistent a severe or achaort,11 case or eye pentad,hush wiUh plenty of water fa al 15 prinutes.Consult physican immediately,KEEP out of reach of children!User agrees to eaivey girls warning to dtl persons vJno may use or cane Info soonest wink wet(unhardenod)come(,mortar,cement a semen(nu mms. t Aggreqates: Pmiorged iohalalwns of dust Imm a gravel pnrdu.t may h2 hazardous tQ your haa`ih.Measuias Io mnkol fugitive dust should be taken when handling This piaJrnl Hat Asphalt atolls nuisance fumes.Avoid Larval fumes.Also,Aspiring may cause severe bums.Wear probarre e sa[ely gear to g sleeves,par ants and gloves).I(bumed,cod with water and see a physaan. Water added at customer's own risk.Additional water added to concrete will Property Damage Indemnification & Release reduce its strength.tiuyets agent agrees recession responsibility for reduced strength The operator of this piece of heavy equipment,in presenfing this RE- Unloading&Standby Excess unloading will be due to water added above design. LEASE toyed Larycursignalure,isof heopinion that the operation of mis charged of posted truck time rates.Truck standby machinery in Se manner required to pedam our contract wih you may time charged at posted truck time rates. Arrived at job with __ inch slump. priestly cause damage to tie premises a property.It is our Wait to help you nwerywaythalwecan,buthordertodothis,theoperibecisasking Limited Warranty The only liability of the seller for Added_... gal water at customer request. Test cylinders had you sign his RELEASE.In consideration of the performance at the product defect is tihe return of the purchase price.in no taken seller of its matred Win me,I me undersigned,hereby INDEMNIFY Ire event shall the seller be liable for any direct,indirect, sager and hsemployees m fa any damage and of all dares to the plain sm, incidental or consequential damages resulting from Other additions - t building, utility pipolnas or mbles, Ieiepkone lines dmeway or other the use of the pptraders or arising out of breach of any - Received - appurtenances, aC warranty All ctaimsfor damages or shortages most be made animn 24 hours of deivery.We do not assume b y )( r ' - responsibility for any damage beyond the curb line. Buyer's Agent receipt of product and approval of any added items. and RELEASE the seller and its employees from - �- The addition of any extra products to our mixer may void any warranty any liability. expressed or implied by the seller. The seller accepts no liability for any - personal injury incurred by you while adding additional products to our mixer. Signature of Owner or Its Agent - [ Signature of Owner or its Agent __ _ WjGDELT.KT08040 Leave Plant Arrive Job SI Start Discharg Pmrsh Discharge Leave Job Site Arrive PIan4 l f i l l)y j r , j ...- _ lirI it irr�� Drivers' Comments---- , .— ---- Company/ Customer PO! Order No. Cust. No. Customer Job Phase Code TICKETNO. Driver Co, Proj, No. Customer Delivery Address Date -_ - r t�;. Mac zone Delivery Instructions Scale !sIT Tea: Load Qty Delivered City Order Oty ProductCode UOM Product Description Unit Price Amount „ * l Load Size Prod, No Description Slump Type CC Use Haul Co. PitlPlant Sales Tax - TOTALDUE Truck Gross Weight Tare Weight Trailer Trailer Taken by Check N .saes..-..r»®®. _ _® a of sca was vss r'.a_m®.cope was ...®..ram. - - ® . .