Okaloosa County BOCC — September 3, 2013 — Fort Walton Concrete Ticket — reading text

i Pee ee ; . CRESTVIEW READY MIX, INC. Dial 1070 FARMER ST. (890) 682-6117 CRESTVIEW, FL ¥ 850) 689-8535 32536 S% 2 Tie (850) 892-0197 Job? PO. #._ Job AcctS / Date 7 ‘ee Name of Deliver To Desc. ra bor SOLD BY C.O.D. CHARGE BATCHER DRIVER TRUCK# On demand without grace | promise to pay the amount specified herein to Crestview Ready Mix, Inc. on order together with a FINANCE CHARGE OF 11/2% on the unpaid balance (or minimum of 25). This is an ANNUAL Percentage rate of 18%, and a reasonable attorney's fee, and all the cost of collecting this note, if placed in the hands of an attorney. | waive all my rights of exemptions as to personal property under the laws of the Constitution of Florida against the collection of this debt. QTY DESCRIPTION UNIT PRICE AMOUNT _ | OVERTIME CHARGE totoina ree arren 1s Hour DELIVERY CHARGE woensyaavs Strength of concrete Guaranteed Only When All Testing is Done By Qualified People, Per Applicable A.S.T.M. Standards. Gallons of water added at job site per instructions of the undersigned. We are responsible for OSHA compliance only to job site delivery not for job conditions SUBTOTAL LOT BLK TAX * OF BAL. DUE All deliveries are for street curb delivery, except where the curb and sidewalk are entirely bridged and protected, and a good road provided to actual point of unloading inside of curb. We will assume no responsibility for any damages where delivery is made inside of the curb. This concrete is delivered at proper working consistency to render strengths as indicated. We assume no responsibility for quality of concrete when water is added at job site by purchaser, agent or sub-contractor, or representative of same. LEAVING PLANT ARRIVING ON JOB UNLOADED ON JOB LEAVING JOB SITE RETURNED TO PLANT ' Received By ~~ oN 668 2 SSS OSS SS SF SSS SO SF eS SS eS oS —————— —_——— a — ee ee