2014-10-07_REVISION - M1995008

• Permit No: M1995008
• IBM Index Class Name: Revision
• Doc Date: 10/7/2014
• Doc Name: Request for Surety Reduction
• From: Fremont Paving and Redi-Mix, Inc.
• To: DRMS
• Type & Sequence: SR1
• Email Name: TAK
• Email Name: TC1
• Media Type: D
• Archive: No

• �H'K�YIS'K�V�i�l'1`C°K°, UK'U(ma'Nu-, inc.
CANON CITY COLORADO
ALBUQUERQUE, NEW MEXICO - ,net'` 7 Y
ROAD MATERIAL
DIRT GRAVEL SAND
e� AAYBRos nlucKorG � j`: �r,�,` ,,•' ' -
BID ANY JOB . . . LARGE OR SMALL - _ 0 0 r': ^H„„'F'1,;,:''t•;
BELLYDUMP WORK &END DUMP
BILL TO:
TRUCK NO. TRAILER NO. DATE
/ f START TIME:
FROM: [,{�-7! HOURS: C
STOP TIME: FUEL: C
LOAD TIME JOB NO. TICKET NO. NET WEIGHT
J( C2 Ll y�"/ /, 1/ 74
/ tt�x%+<
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ti
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PRETRIP INSP. POST TRIP INSP.
AUTHORIZED
SIGNATURE r
DRIVER
A periodic FIN CE CHARGE annual percentage rate of 24%)will be applied to any past due balance.
Customer will be responsible for any and all collection fees, if incurred.