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fijj <br />59291 <br />DISPATCH 541- 484 -2027 <br />OFFICE 541- 484 -2000 p <br />FAX 541- 484 -2028 <br />90436 COBURG R OAD <br />DATE: EQUIP. NO.: <br />EUGENE, OREGON 97408 <br />��� L <br />DELIVER TO: t <br />TIME: h U� �Z <br />� <br />P.O. #: /Z � <br />1,.q �, AP <br />PRODUCT: <br />✓ a <br />QUANTITY: <br />CUSTOMER: - rd�t�he , ✓� <br />; _ 0 <br />UNIT PRICE: <br />GROSS WEIGHT If delivery inside curb is reques nd ersigned will <br />save COBURG ROAD QUARRY harmless from Lability for <br />any damage caused thereby. Customer agrees to pay all <br />AMOUNT: <br />TARE WEIGHT wrecker or other expenses if delivery is inside of curb line <br />on pnvate property. <br />NET WEIGHT Undersigned agr es t conditions listed on reverse <br />CHARGE COD <br />.x Y <br />RECEIVED BY, <br />INVOICE DUE UPO aE <br />EIPT <br />nFi iVPQV <br />rnoV <br />ON ACCOUNT CHARGES DUE ON THE 10TH OF THE FOLLOWING MONTH. <br />