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Decatur Concrete Recycling Aggregate Material <br /> y A Div of Mid America Sand&Gravel Delivery Ticket <br /> 2750NJasper DecaturlL 217-875-4235 <br /> Stupe Inspected <br /> Shipped FrortDecatur Unassigned Stock 51155-02 <br /> Ticket# Date Time <br /> SoldTot1133 62579 2/1/2012 12:54 <br /> BARR 6 ROBINSON SEWER AND <br /> Job ID:888 MISC. JOB <br /> CITY OF DECATUR BALTIMORE <br /> Carrier:BARR7 <br /> Product# Description Quantity Price Amount <br /> 41 CA7-11 1'WHITE ROCK 14.47 Ton <br /> Tax <br /> Loads: 4 Accum. Amount: 60.03 Ton Total <br /> Gross Weight 4 9, 620 lb i <br /> Tare Weight 20,680 lb <br /> Net Weight 28, 940 lb <br /> By signing this Delivery Ticket,Driver,individually and as authorized agent of his/her employer,(i)assumes full res pons ibi lity for determing the proper qua <br /> and weight of materials for transport,and(i)agrees to indemnify and hold Nlid America Sand and Gravel Co.harmless from all claims 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 /> 2750 N Jasper Decatur IL 217-875-4235 <br /> Shipped Fron Decatur State Inspected <br /> Sold To: 41133 Unassigned Stock 51155-02 <br /> BARR & ROBINSON SEWER AND Ticket# Date Time <br /> Job ID: B88 MISC. JOB 62579 2/1/2012 12:54 <br /> CITY OF DECATUR BALTIMORE <br /> Carrier; BARR7 <br /> Product# Description Quantity Price Amount <br /> 41 CA7-11 1'WHITE ROCK 14.47 Ton <br /> Loads: 4 Accum. Amount: 60.03 Ton Tax <br /> Gross Weight 49,6201b Total <br /> Tare Weight 20,6801b <br /> Net Weight 28,9401b <br /> By signing this Delivery Ticket,Driver,individually and as authorized agent of his/her employer,(i)assumes full responsibility for determing the proper quar <br /> and weight of materials for transport,and(i i)agrees to indenmify and hold Mid America Sand and Gravel Co.harmless from al I clai ms for peroperty damage <br /> personal injury(i ndlucing death)arising in any manner out of the transportation or delivery of the materials descri bed on the face hereof,including costs of <br /> defense and attorney's fees. <br /> I Hauled By: _ Received By: <br /> Sign Full Name. No Initals <br />