GENERAL41129

• Permit No: M1983141
• IBM Index Class Name: General Documents
• Doc Date: 3/18/1992
• From: JOY KEETER
• To: BILL YORK FEIRN
• Media Type: D
• Archive: No

HARLEY
~~ ~ / ~ l
~ `~ v J R.
Trucking
6379 Valmont Drive
Boulder, Colorado 80301
Phone [phone]
MATERIALS DIVISION
r~
Customer
Address
Telephone Number
TICKET NUMBER KY 2 5 2 2
Delivery Access: Purchaser is responsible to provide suitable ways or approaches to point
of delivery. Delivery inside curb line Is only at Customer's direction and signature. By
directing or taking delivery inside curb line Customer agrees to hold harmless Keeler
Trucking Co. Irom all claims and liabilities for damages growing out of such delivery.
Purchaser to sign here if delivery inside curb line
Date _ I - I I ` `l ~C
Material t~l~ ~
~17'I ~nG,~,
Code
Yard Pickup
Weighted by
Received by l
Gross Wt. ~
Tare Wt. ~_ ~ - ~~)
Net Wt. % ~~ ~~
Tons ~ `~ ~ I
Time Loaded _
Truck Number ~ 13
Driver ~,c' -~
Material Charge
Haul Charge _
State Tax
City Tax
Total
Special lnstructi
/'
HARLEY
I / / ~ 7 ~ ~ ,
~ v`-' `~ v J R.
Trucking
6379 Valmont Drive
Boulder, Colorado 80301
Phone [phone]
MATERIALS DIVISION
Date
Material U~~
k/ /7') ~ G,~~
Code
Yard Pickup
Weighted by o
Received by
ET NUMBER KY 2 5 2 4
IM ._ .. __
Customer
Address
Telephone Number
Delivery Access: Purchaser is responsible to provide suitable ways or approaches to point
of delivery. Delivery inside curb line is only et Customer's direction and signature. By
directing or taking delivery inside curb line Customer agrees to hold harmless Keeler
Trucking Co. from ell claims and liabilities for damages growing out of such delivery.
Time Loaded ~-7 ~
Truck Nunnm~~ber ~_
Driver l~0~
Material Charge
City Tax
Total
Speciallnstruction '
Purchaser to sign here if delivery inside curb line