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Decatur Concrete Recycling Aggregate Material <br /> A Div of Mid America Sand&Gravel Delivery Ticket <br /> 2750N Jasper Decatur IL 217-875-4235 <br /> State Inspected <br /> Shipped Fronnecatur Unassigned Stock 51155-02 <br /> Ticket# Date Time <br /> Sold Tot 1133 62559 2/1/2012 07:13 <br /> BARR 5 ROBINSON SEWER AND <br /> Job ID:888 <br /> CITY OF DECATUR BALTIMAOR <br /> Carrier:BARR7 <br /> Product# Description Quantity Price Amount <br /> 41 CA7-11 1'WHITE ROCK 15.90 Ton <br /> Tax <br /> Loads: 1 Accum. Amount: 15.90 Ton Total <br /> Gross Weight 52,540 lb <br /> Tare Weight 20,740 lb <br /> Net Weight 31,800 lb <br /> By signing this Delivery Ticket,Driver,individually and as authorized agent of his/her employer,(i)assumes full responsibi lity for determ ing the proper quar <br /> and•weight of materials for transport,and(ii)agrees to indemnify and hold Mid America Sand and Gavel Co.harmless from al l clai ins for peroperty damage <br /> personal injury(indlucing death)arising in any manner out of the transportation or delivery of the materials described on the face hereof,including costs of <br /> defense and attorney's fees. <br /> Hauled By: _ Received By: <br /> Sign Full Name. No Initals — <br /> Decatur Concrete Recycling Aggregate Material <br /> A Div of Mid America Sand&Gravel Delivery Ticket <br /> 2750N Jasper DecaturlL 217-875-4235 <br /> Shipped Fron Decatur State Inspected <br /> Sold To: 41133 Unassigned Stock: 51155-02 <br /> BARR 6 ROBINSON SEWER AND Ticket# Date Time <br /> Job ID: 888 62559 2/1/2012 07:13 <br /> CITY OF DECATUR BALTIMAOR <br /> Carrier: BARR7 <br /> Product# Description Quantity Price Amount <br /> 41 CA7-11 1'WHITE ROCK 15.90 Ton <br /> Loads: 1 Accum. Amount: 15.90 Ton Tax <br /> Gross Weight 52,5401b Total <br /> Tare Weight 20,7401b <br /> Net Weight 31,8001b <br /> By signing this Delivery Ticket,Driver,individually and as authorized agent of his/her employer,(i)assumes full responsibi lity for determing the proper quar <br /> and weight of materials for t7ansport,and(i i)agrees to indemnify and hold Mid America Sand and Gavel Co.harmless from all claims for peroperty damage <br /> personal injury(indlucing death)arising in any nklnner out of the transportation or delivery of the materials described on the face hereof,including costs of <br /> defense and attorney's fees. <br /> Hauled By: Received By: <br /> Sign Full Name. No Initals — <br />