Okaloosa County BOCC — November 1, 2016 — FWConcreteTickets

On demandiwithoul "81:8 I promi8e ID pay the amount lp8Cilled hel9in ID Fort W8llon Concnlle Coqlany, Inc. on Older together with a ANAtlCf CHARGE OF 1112% on the unpaid balance (or mininum of 25).This is an ANNUAL P8R:entage rate of 18%, and a ~ ~a tee, and al the cost of collecting lhis note, Wplaced In the hands of an allomey. I WllNe all my righ1s of ~ lions as ID lii9fsonal property under 1he laws of the ConstiMlon of Florida againsl the collection of !his debt. UNIT PRICE 11 AMOUNT OVERTIME CHARGE KJ.JlNlFEUFT!AfST ...... OVERTIME CHARGE __,....,...,.,.,.,....., DELIVERY CHARGE LNJEA•.,...,. DELIVERY CHARGE -•""""' Slrength o1 c:onae1e G - Only- Al T~ 18 S1ronglh ol c:onae1e G<.....- Only- Al T-*'g 18 Done By Oualfied People, P8r ~ A.S.T.M. - Done By Oualfied People, P8r ~ A.S.T.M. - ) I==:,..,- -11jab • . , . inllrucliono o1.,. Galano " ' - - l l j a b l i l o p o r _ o l . . '"1danigned. :-.:...~.:=.:..=:-~ SUB1UTAL 1--~~~~-+-~~~+-~- :"'jcX>araale~,!'=:.:::-~ SlBJOTAL 1-~~~~-+-~--~+-~- LOT BU< ~ - LOT BU< ~ OF BAL DUE tar - curb dolivery. llCcepl whent lhe aJrb and - ... entlr8ly bridged and . , . _ , and • good road ptOVidad to aCtual - of curb. We will assume no respcnaibilily tar any dlmages whent ~ ii . - inside of !he curb. Thill aincrel8 ii waftling cor-.cy to - ~ as indicalad. We assume no 11181J011Sibi1i tor quality of c:oncrw - - ii lddeo:t al ·, -"or-.orrepr-*liwolume. IT . I ARRIVING ON JOB I UNLOADED ON JOB I LEAVING JOB SITE I RETURNED TO PLANT