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►of ► <br />1[ff111id1111L� <br />Concrete Pumping inc. <br />P.O. Box 274 La Mirada, CA 90637 cell: (562) 846-9203 <br />www.citipump.com (Serving all of Southern California) <br />► wflia# 0945 <br />PEA GRAVEVRGCK PUMP <br />562-846.9203 <br />CUSTOMER r — JOB 1 PO• NO <br />Pill <br />ADDRESS -CITY, STATE, ZIP <br />U C.O.D. ❑ OPEN U10 DAY CREDIT <br />JOB DESCRIPTION <br />ARRIVE AT JOB . . . ... . .. . .. . .. . . <br />START PUMPING]. .. .. .. .. . <br />FINISH PUMPi'ING . . . .. . . . . . . . ... .. . . .. . . . <br />f <br />LEAVE JOB .. , . . . . . . 7 �.. .. . <br />SETU' . . ..{. <br />f <br />}-{OUR .. "1 �? ....... <br />NUM. OF oVES .. .... ............ .. . . <br />PEA GRAVEL [ GEL) EXTRA HOSE . . . . . . . . . . . . . . <br />ROCK (150FT:) EXTRA HOSE .. .. .. .. . , .. . . . . . <br />ENVIRONMENTAL FEE . . . . . . . . .. .. .. .. . <br />FUEL. ..... ................. <br />OTHER CHARGES .. . .. . .. .. .. ..... .. .. . .. . w <br />TOTAL <br />COMMENTS / NOTES <br />'Customer must furnish water on the site and a place to clean out. in the event of equipment <br />failure, we assume no responsibility for concrete, standby time time, labor or any other charges. <br />'The undersigned has read the terms and conditions an the reverse side of this invoice and agrees <br />to its contents. <br />ACCEPTED and AUTHORIZED BY: <br />Thank you for using £ITIPII►IIP Concrete Pumping inc. <br />