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
~~ ~ i ~ / ,
~ ~ .~
~ ~ JR.
Trucking
6379 Valmont Drive
Boulder, Colorado 80301
Phone [phone]
MATERIALS DIVISION
Dale
Material ~ ~~' ~-~
-- t-d m •-lu l~ ~
Code
Yard Pickup
Weighted by
Received by _
HARLEY
/~~~~/ //
~ `~ J R.
Trucking
6379 Valmont Drive
Boulder, Colorado 80301
Phone [phone]
MATERIALS DIVISION
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 at Customer's dlrection and signature. By
directing or taking delivery Inside curb line Customer agrees to hold harmless Keeter
Trucking Co. from all claims end liabilities for damages growing out of such delivery.
Time Loaded
Truck Number ~_
Driver
Customer >yam
Address
Material Charge
City Tax
Total
i,
Special Instruction
TICKET NUMBER KY 2 5 2 ~
Telephone Number
Delivery Access: Purchaser Is responsible to provide suitable ways or approaches to point
of delivery. Delivery inside curb line is only al Customers direction and signature. By
directing or taking delivery inside curb line Customer agrees to hold harmless Keeter
Trucking Co. from all claims and liabilities for damages growing out of such delivery.
Purchaser to sign here it delivery inside curb line
Date L-~ ~ -~
Material ~r ~
- ~ rl ,`D G~ ~t .
Code
~-,
Gross Wt. L~z~1Z-
~ a
Tare Wt.
Net Wt. > S
Tons ~ ~~, ~ J
Material Charge
Haul Charge
State Tax -
City Tax
Yard Pickup 7 Time Loaded /J '7 / Total
teighted by a~r~C Truck Nu/m'b/er' =J11-- Special Instruction _
Received by ~ Driver _!.(L~
TI•ET NUMBER ICY 2 5 2 5
Purchaser to sign here if delivery inside curb line