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/®V"C& i PLEASE PAY FROM <br />THIS INVOICE <br />P.O. Box 8532, Coburg, OR 97408 <br />INVOICE Small Yardage Concrete (541) 686-3031 <br />Date <br />Sold To <br />Address <br />P.O./Job # <br />Quantity <br />Description <br />Total <br />Yards <br />P.S.I r <br />Mileage Charge <br />S <br />stand By Time <br />CD f} <br />Overtime <br />o Sad <br />Hot Water <br />Adnaxture: <br />Slump <br />AirCDntent yr; <br />ARRIVE LEAVE <br />JOB JOB <br />' <br />TIME ON <br />JOB <br />y".-- <br />TIME CHARGE <br />- <br />MINUTES <br />PER HOUR <br />TOTAL <br />t <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 />I, 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 2.01% 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 i ree that the <br />liability is being personally assumed by me unless otherwise indicated below and this agreement does not c liability. <br />By my signature below, acknowledgment and agreement of the above is hereby made. L~ <br />LIENS Q~ C <br />Nation's Mini-Mix Inc. Concrete Service hereby gives notice of its reservation of the right to assert any i ll hensg0iR t aser d <br />third parties arising under all applicable federal, stale or local laws in the event the prices stated in this a teemme're ttpt hen d <br />I reviewed and approved a completed copy of this Invoice. 5 t <br />ACCEPTANCE <br />Nations Mini-Mix, Inc agrees to provide all services and materials indicated on this Invoice. <br />By 2~1,5 <br />Nation's Mini-Mix, Inc. <br />Y~ tl ' II <br />I am a authorized agent of 0 01-5 K5 n <br />• <br />