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finqv <br />INVOICE <br />PLEASE PAY FROM <br />THIS INVOICE <br />P.O. Box 8532, Coburg, OR 97408 <br />(541) 686-3031 <br />Date <br />r° <br />Sold To t s , # <br />Y' <br />Address r tr 0kt7 <br />Quantity <br />Description <br />Total <br />t / 6 <br />Yards <br />P.S.I ' <br />Mileage Charge <br />Stand By Time <br />CQ ~G <br />Overtime 57 <br />/ 5y a <br />Hot Water <br />qZ <br />9 <br />Admixture: <br />Slump r° <br />Air Content % <br />ARRIVE LEAVE <br />JOB JOB <br />t fS <br />TIMEON <br />JOB <br />TIME CHARGE <br />r MINUTES <br />~S-PER HOUR <br />TOTAL <br />- R CA- <br />' <br />t <br />DETENTION <br />DETENTION OF TRUCKS AT THE BUILDING SITE <br />No claims for delays encountered in delivery will be allowed as all deliveries are made to the best of our ability and dispatch. . <br />ALL ORDERS ARE FOR STREET CURB DELIVERY <br />1. the undersigned, will assume all responsibility for any damage where delivery is made inside of the curb. <br />WARNING <br />Use of this product without protective clothing could cause bodily injury. Every effort should be taken to avoid contact with skin. <br />TERMS OF PAYMENT <br />The balance is due and payable on the 10th of the following month. After 20 days a LATE CHARGE of 2.0% monthly (ANNUAL <br />PERCENTAGE RATE OF 24%) will be added to the unpaid portion of the balance due. I agree to pay and/or guarantee payment of the <br />charges listed on this Invoice when due, plus any applicable late charges. In the event of default of payment, I agree to pay reasonable <br />attorney's fees and court costs incurred by Nation's Mini-Mix Inc. including these reasonable attorney's fees and court costs incurred by <br />Nation's Mini-Mix Inc. in any bankruptcy proceeding in collection of the balance due whether or not action is filed in court. I agree that the <br />liability is being personally assumed by me unless otherwise indicated below and this agreement does not constitute a release of liability. <br />By my signature below, acknowledgment and agreement of the above is hereby made. <br />LIENS <br />Nation's Mini-Mix Inc. Concrete Service hereby gives notice of its reservation of the right to assert any and all liens against purchaser and <br />third parties arising under all applicable federal, state or local laws in the event the prices stated in this agreement are not paid when due. <br />1 reviewed and approved a completed copy of this Invoice <br />ACCEPTANCE <br />Nation's Mini-Mix, Inc. agrees to provide all services and materials indicated on this Invoice. <br />ltd #fi t°} <br />By <br />I am a authorized agent of <br />P O cg] l n l la Q I S1 <br />Signed <br />s tN c _ <br />Small Yardage Concrete <br />I <br />31 <br />• <br />• <br />