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domm <br />DisPATIcA 541-484-2027 6 Z 9 %6 48700 <br />2 > 0 OFFICE <br />541-484-2000 <br />0 676 <br />FAX 541-484-2028 <br />90436 COBURG ROAD <br />DATE: EQUIP. NO.: <br />EUGENE, OREGON 97408 <br />07! f'*l <br />TIME: 7'— <br />ELIVER TO: <br />PRODUCT: <br />P.O. #: <br />CUSTOMER: <br />3UANTITY: <br />GROSS WEIGHT If delive inside cut is requested, the undersigned wit saw <br />NIT PRICE: <br />COBURG ROAD QUARRY harmless from liability for any <br />dama caused thereby. Customer a to pa all <br />At <br />WEIGHT wrecker or other expenses R delivery is Inside of curb $me on <br />TAREWE <br />,..j <br />AMOUNT: <br />. private propert <br />Undersigned a to conditions hated o n me. <br />NET WEIGHT <br />CHARGE COD <br />RECEIVED BY 5 / <br />, <br />INVOICE DUE UPON RECEIPT ' 7 <br />ON ACCOUNT CHARGES DUE ON THE 1 OTM OF THE FOLLOWING MONTH. <br />DELIVERY COPY <br />-- — — — — — — — — — — — — — <br />— — — — — — <br />— — — — — — — — — — — — — -- <br />48570 <br />541-484-2027 <br />6:RA - "676 <br />=M� DISPATCH <br />OFFICE 541-484-2000 <br />FAX 541-484-2028 <br />7%- PAY <br />90436 COBURG ROAD <br />DATE: EQUIP. NO.: <br />EUGENE, OREGON 97408 <br />TIME: 17: <br />?LIVER TO: <br />2RODUCT: <br />P.O. <br />CUSTOMER: <br />)UANTrrY: <br />GROSS WEIGHT If delive inside curb is re Me undemi wit save <br />qIT PRICE: <br />COBURG ROAD QUARRY harmless from fimbilit for an <br />dama caused thereb Customer a to pa all <br />'t:" <br />TARE WEIGHT wrecker or other expenses If delli,or a inside of curb line on <br />AMOUNT: <br />pmate propert <br />NET WEIGHT Undersi a condl ons Its W ' raname. <br />CHARGE COD <br />RECEIVED BY mzo <br />INVOICE DUE UPON RECEIPT Z <br />ON ACCOUNT CHARGES DUE ON THE 10TH OF THE FOLLOWING MONTH. <br />DELIVERY COPY <br />