,ryr--,

Jt ,!

ALL OF SO

skin- PLANT CHANGES OR CANCELLATION OF TO

THE UPON

WE DO NOT
THE solely
CONCRETE ASTI\4, ANY DEICING
READY. I,1IX

BE if this
to and its
The this
etc., due to the
as additional
affiliates adjacent Property
and and

and iepeated on side of this document, solelY

IN
has authority to conlirm on
governs
!
behalf oJ

.,n

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and tr YES nNo
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SUPERIOR LLC

SKIN AND EYESi Avoid contact eyes and

ofcontad wilh skin flush
IS DETRII\,IENTAL
THE OF LEAVING THE PLANT, ANY CHANGES OR CANCELLATION OF TO

LOAD OF ULTIMATE OUALITY OF

or any
x
PLEASE NOTE: THIS LOAD OF CONCRETE lS MIX ASTt\,4. ANY DE.ICING
N4ATERALS, IIV1PROPER FINISHING AND LACK OF
NOTICEi BE DAMAGE CAUSED WHEN
CHARGED AT CURRENT SA
FULL % LOAD
Dear Customer of this the load is
- The
rn every this

document, solely
authority to conflrm on
tr nNo
NAI\,IE OF LAB:
SIGNED: X

lrlri r Tfii:rt]l" CUST# tdrs;i+:t

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{l 888:088 -4400 '.,tr-
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WATER ADDED AT CUSTOMER REQUEST
EXCESSIVE WATER IS DETRIMENTAL
CONCRETE IS A PERISHABLE COMMODIry ANO BECOIIIES THE PROPERry OF THE PURCHASER UPON LEAVING THE PLANT. ANY CHANGES OR CANCELLATION OF
TO CONCRETE PERFORMANCE.
ORIGINAL INSIRUCTIONS I\,1UST BE TELEPHONED TO THE OFFICE BEFORE LOADING STARTS.
WE DO NOT GUARANTEE"FINISHED RESULTS OBTAINED FEOM THIS LOAD OFCONCRETEASMANY.IT4PORTANTTFACTORSAFFECTINGTHEULTIMATEQUALITYOF
THE COI\,4PLETED JOB A_RE OUT OF OUR CONTROL We do not warant that the @ncrete can be us6d in any padicular environment or soil conditions or that lhe concrete is lit for any

PLEASE NoTE: THIS LOAD OF CONCRETE lS PRODUCED lN ACCORDANCE WTH STANDARD SPECIFICATIONS FOR READY MIX CONCRETE ASTI\,1. ANY DE-|CING REQUESTOR'S NAME
MATERIALS, II\,,IPROPER FINISHING AND LACK OF CURING WILL CAUSE DAMAGE OR A OECREASE IN SIRENGTH.
NOTICE: MY SIGNATURE BELOW INDICATES THAT I HAVE READ THE HEALTH WARNING NOTICE AND SUPPLIER WILL NoT BE RESPoNSIBLE FoR ANY DAIVAGE oAUSED WHEN
DELIVERING INSIDE CURB LINE ANO AGREE TO THE TERI\4S AND COND]TIONS ON REVERSE SIDE. TIME IN EXCESS OF FREE TIME WILL BE CHARGEO AT CURRENT SA
DELAY RATE. ALL C.O.D, DELIVERIES MUST BE PAID IN ADVANCE AND LOAD ACCEPTED BY SIGNING THIS DELIVERY IICKET-BEFORE POURING,
FULL LOAD %LOAD %LOAD
PROPERTYDAMAGERELEASE: Dear customer - The size and werght of this truck could cause aamage to ili-bTitemisesand/oradjacentpropertyifihisloadis
placed where you desire. lt is our wish to help you in every way that we can, but in order to do this we are requesting that you sign this RELEASE relieving this supplier and its
(GALLONS) (GALLONS) I (GALLONS)

uodersigned agrees to indemnify and hold hamless the driver of this truck and this supplier and its affiliates for any aid all damage to the premises and/or adjacent property RESULTS
which may be claimed by anyone to have ailsen out of delivery of this order.
document, solely
authority to confirm on
CYLINDERSTAKEN: I YES tr N.o
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eyes and
WATER ADDED AT CUSTOMER REQUEST
EXCESSIVE WATER IS DETRIMENTAL
UPON LEAVING THE PLANT, ANY CHANGES OR CANCELLATION TO CONCRETE PERFORMANCE.

x
REOUESTOR'S NAME

FULL LOAD %LOAO %LOAD %IOAD

RESULTS

CONC.

CYLINDERS TAKEN: nYES nNO

NAME OF TESTING LAB:

SIGNED: X

HI,1 frl,lidTftdl{-;'I I f.l{} t-.LC CUST# t 'ii i J.

DELIVERY LOCATION

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SERVING ALL Ii/IICHIGAN

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WARNINGT IRRITATION TO THE SKIN AND EYESI contact with eyes and
prolonged contact with skin. ln ese of contact wilh skin or eyes, WATER ADDED AT
IS

x {
REOUESTOR S NAME

%IOAD % LOAD
- The could cause

affiliates from responsibility from and/or of this (GALLONS) (GALLONS)

street,
of this all damage to the premises

Customer coniirms, Terms andCondi'iions contained in side of this

he/she tl-lese and hds
CYLINDERSTAKEN: I YES

SIGNED: * ?+
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WARNING: IRRITATION TO THE SKIN Contalns Portland Cemenl, Wear r!bber boots BURNS, contact with eyes and
prolonged contactwith skin, ln @se of @ntact with skin or eyes, flush thoroughly with water' lf
WATER ADDED AT CUSTOMER REQUEST
EXCESSIVE WATER IS DETRII\,4ENTAL
CONCRETE IS A PERISHABLE COMMODIry AND BECOMES THE PROPERry OF THE PURCHASER THE PLANT, ANY CHANGES OR CANCELLATION OF TO CONCRETE PERFORMANCE,
ORIGINAL INSTRUCTIONS MUST BE TELEPHONED TO THE OFFICE BEFORE LOADING STARTS.
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x
PLEASE NOTE: THls LoAD oF CONCRETE lS PRODUCEO IN I ACCOROANCE WITH STANDARD FOR READY MIX CONCRETE ASTM, ANY DE.ICING REQUESTOR'S NAME
MAIERIALS, II\,,tPROPER FINISHING AND LACK OF CURING WILL CAUSE DAMAGE OR A DECREASE IN
NOTICE: MY SIGNATURE BELOW INDICATES THAT I HAVE
I READ THE HEALTH WARNING NOTICE FOR ANY DAMAGE CAUSED WHEN
OELIVERING INSIDE CURB LINE AND AGREE TO THE TERIVS AND CONDITIONS ON REVERSE IN WILL BE CHARGED AT CURRENT SA
DELAY RATE. ALL C.O.O. DE-LIVERIES MUST BE PAID IN AOVANCE AND LOAD ACCEPTED BY SIGNING
FULL L'OAD %LOAD %LOAD
PROPERTY DAMAGE RELEASE: DEAT Customer - The size and weight Bf this truck could if this
FtaGa wtr6i6-you aElEJt is6FliEh-to hetp you in every way that we can, bul in-brder to do this we are
affiliates from any responsibility from damage that may occur to the premises ahd/or adjacent property, . (GALLONS) (GALLONS) (GALLONS)
material, and that you also agree to help the driver remove mud from the wheels of his vehicle so that it litter street.
undersigned agrees to indemniry and hold harmless the driver ofthis truck and this supplier and its affiliates any and all damage to the premises and/or adja@nt property TEST
which may be claimed by anyone to have arisen out of delivery ol this order.
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watei nooeo lr cusroMER REQUEST

EXCESSIVE WATER IS DETRIMENTAL
TO CONCRETE PERFORMANCE,
. i .,

x ' .'::
REOUESTOR'SNAME , 1

HAVE SA
FULL LOAD % LOAD LOAD
c.o.o.
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Customer - The size and weight of this
(GALLONS) (GALLONS)
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property TEST

AIR%
CYLINDERS TAKEN: E YES N NO

NAME OF TESTING LAB:

SIGNED: X

frr'1I l".l1Ji"lI t] r-t."i:' CUST# 1*t}.}r+71

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DELIVERY LOCATION

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d'o.t MATERIALS CERTIFI ED TVIEETI MDOT'S SPECIFICATIONS
FINISH POIJR LEAVE JOB ARRIVE AT PLANT
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BATCH TIIME LEAVE PLANT ARRIVE JOB BEGIN POUR

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WARNING: IRRITATION TO THE SKIN AND EYES: Contains Portland Cement. Wear rubber b@ts and gloves. PROLONGED CONTACT MAY CAUSE BURNS. Avoid contact with eyes and
prolonged conbdwith skin. ln case ofconlactwith skin tr eyes, flush thor@ghlywith water Ifirilation persists, get medical attenlion. KEEP CHILDREN AWAY. WATERADDED AT CUSTOMER REOUEST
EXCESSIVE WATER IS DETRII\,,1ENTAL
CONCRETE IS A PERISHABLE COI\4MODIry AND BECOMES THE PROPERTY OF THE PURCHASER UPON LEAVING THE PLANT, ANY CHANGES OR CANCELLATION OF
TO CONCRETE PERFORMANCE,
ORIGINAL INSTRUCTIONS MUST BE TELEPHONED TO THE OFFICE BEFORE LOADING STARTS.
WE DO NOT GUARANTEE FINISHED RESULTS OBTAINEO FROM TH|S LOAD OF CONCRETE AS MANY IMPORTANT FACTORS AFFECTING THE ULTII\,,IATE AUALITY OF
THE COMPLETED JOB ARE OUT OF OUR CONTROL. We do not warant that the concrele car be used in any particllar environment or soil conditions or that the concrete is fit for any
x
PLEASE NoTE: THIS LoAD OF CONCRETE lS PRODUCED lN ACCoRDANCE WITHSTANDARD SPECIFICATjONS FOR READY l\rlx CONCRETE ASTlVl. ANY DE-|C|NG REQUESTOR'S NAME
MATERIALS, II,,IPROPER FINISHING AND LACK OF CURING WILL CAI]SE DAI\4AGE OR A DECREASE IN STRENGTH.
NOTTCE: MY SIGNATUne eeLOW iNOtCereS THAT r HAVE REAO THe UeaUtg Wnnrulrue NOTICE ANO SUPPLTER WrLL NOT BE RESPONSTBLE FOR ANY DAMAGE CAUSED WHEN
DELIVERING INSIDE CURB LINE AND AGREE TO THE TERI\4S AND CONDITIONS ON REVERSE SIDE. TIME IN EXCESS OF FREE TIME WILL BE CHARGED AT CURRENT SA
DELAY RATE. ALL C.O.D. DELIVERIES MUST BE PAID IN ADVANCE AND LOAD ACCEPTED BY SIGNING THIS DELIVERY TICKET BEFORE POURING.
FULL LOAD %LOAO %LOAD %LOAD'
PROPERTY DAMAGE RELEASE: Dear Customer - The size and weiqht of this truck could cause damage to the premises and/or adjacent property ifthis load is
EiEEA whqe yotliEsir6.lt- fiu7 wG[to hetp you in every way that we can, b-ut in order to do this we are requsstini that you iign this RELEASErelieving ihis aupplier and its
(GALLONS) (cALLoNs) (GALLONS) (GALLONS)
TEST RESULTS
which may be claimed by anyone to have arisen out of delivery of this order.
Customer confirms, agrees, and acknowtedges that the Terms and Conditions containedlin Supplier's quotation, and repeated on the reverse side ofthis document, solely
governs the parlies'transaction. Customer's representative hereby acknowledges that he/she has read these governing Terms and Conditions, and has authority to confirm on
behalf of and otheMise bind Customer to these Terms and Conditions. CYLINDERSTAKEN: E YES ENO
NAME OF TESTING LAB:
SIGNE6: X

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BATCH TII\4E LEAVE PLANT ARRIVE JOB BEGIN POUR FINISH LEAVE JOB ARRIVE AT PLANT USAGE CODE SUB TOTAL
r:V"f't-Jl
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DATE ORDER # PLANT TRUCK # PROFESSIONAL ORDER GRAND TOTAL TOTAL
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