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ti <br />~'' INVOICE <br />~~ ~ `~ . t ; ~ . ~ f ~ r"j .E. f d :i ~F <br />~1i~01 cc~NCRE~!~ connpAr~~ ~,~ r~~, t~ l ~' ~ ~~-- 6.~ U Q 64 r~ <br />3440 W. Otd tiwy. 30 • Grande Bstand, NE 68801 •Phone308-384-2003 DATE """-/ <br />r /',, -- __ MILEAGE <br />O LO ~.a.~~._t ~_~.r_~~_ _ _ _..----'-_ _------ <br />MAILING END 11 _ ~ { 4~ ~ ~ ~_ <br />ADOAESS. ._-- -_- ._..._. ...__ <br />DELIYEW r •. .r" i ~' BEG. ~ ~ ~ r-, <br />.f <br />DIFF. /// <br />. ;Truck # ;Driver <br />- Quantity ~ Description Price Amount <br />j BO I <br />L ~, Cu. Yds. fr Sack Concrete <br />___-_~>1 _ ___ k A E A. <br />_ ~~ _~ ~~ .;Z~ F Y <br />/ <br />- Mileage <br />--- -- - -- <br />- i <br />_ <br /> <br />- . <br />f - ----_~. <br /> <br />~__ <br />' ~ %GalciumChlonde i ! <br />_~___ .. <br /> <br />--- <br /> Winter Service <br />_.. <br />-_ _ <br />-- <br />__.._ _ <br />_ - __ -- <br />-t----- i <br />T <br />-- <br />_, <br />j ldi <br />H <br />Ch <br />T ~ ~ <br /> ar e <br />ruck <br />n <br />Hours <br />o <br />9 <br />9 <br />~-__ _ _ ._ <br />--- -- .. - _ <br />- - ~ - ---- -._._. <br />.. <br />.--- -r <br />t <br />-' <br /> ----~-- ------ - - _.. __. _.. -------t- ---- f <br />--- w------- - <br /> -- -- <br />.-- -- _ _ ,, <br />t _. - f--- <br />-- <br /> <br /> ___ _ __ ` <br />SALES TAX <br />i <br />~" <br />' <br />~ <br />~ <br /> ---- '_ _ --- - <br />~ TOTAL ~ _ ~-- <br />~-„Y;. <br />_ <br />1 7~ ~ ~G - 1 <br />CAUTION: MAY CAUSE EYE OA SKIN INJUA <br />CONT4'NS PORP11N0 CEMENT- IF ANY CEMENT OR CEMENT MIXTURES GET INTO THE YE FLUS/('IM41E01ATEL Gals. Water Added <br />No; <br />Jcbslte <br />Arr. Plant <br />~ ( _.{ <br />REPEA.TFDIY VATN WATER. AND CONSULTA PNYStC1ANPROMPtLY <br />fRESNLY MIXEDCEMENf. MORTAR; CONCRETE OR GROUT MAY UUSE SXIN 1N,lURV AVOiO COMA WItH SKIN WHERE ~. <br />PO>tirLE AND WASX EXPOSED.SKIN AREASMOM-TlY WITH WATER. - ___ t ~ <br />KEEP OUT OF AEACN OF CNILDREN . ____1__- Left POdM ~ ' <br />. i ,:) 'C,{~ <br />Racerved above malenal in good tOntlrtion. Purchaser waives all clat or perso nal or property oamagu cause d by saRers [ruck <br />when delivery is made beyond street curb Mme. <br />R•ceivad <br />WINte -ORIGINAL • CsDary -CUSTOMER COPY eGoldenrod -FILE COPY • Green - DEDVERY COPY <br /> <br />