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IWAW <br />AFAV <br />e$ ! Iax CEMEX <br />CEMEX Construction Materials Florida, LLC <br />CEMEX One <br />Bay Crete <br />Kennedy Concrete <br />-11+t�11�t1�1[[rlrlr11111Jill <br />11�1[�rr[r[�nut'1',Ili[u�l[[ <br />INV2INS.A000379 <br />BLUE GOOSE CONSTRUCTION <br />PO BOX 14709 <br />FORT PIERCE FL 34979-4709 <br />N <br />INVOICE <br />Date: <br />031,0112018 <br />Invoice No: <br />9437245034 <br />Terms: <br />Net 15th <br />Payment Due On: <br />04115/2018 <br />Territory Manager: <br />-HAGENS, CURTIS <br />Job No: <br />14554530 <br />Legal Address: <br />400 WOODLAND DR. <br />Customer Job No. <br />1290 <br />Account N0: <br />3172586 <br />Account Name: <br />BLUE GOOSE CONSTRUCTION <br />For All inquiries Call: <br />833-675-7375 <br />Remit To: <br />CEMEX I PO Box 7301971 Dallas, TX 75373-0197 <br />PAGE 1 OF 7 <br />PO Number: 1290 DELIVERY ADDRESS: 400 WOODLAND DR., VERO BEACH, FL, 32961 <br />Ship Date Dellvary Ref # Product Code 1 Description Qty UOM Net Price By UOM Units Amount Freight FTX <br />03101@018 8078504689 36555793 1202749 ENVIRONMENTAL CHARGE 1,000 EA $20.00 1 PC 1.000 $20.00 $0.00 T <br />031016018 8078504689 35555793 1247818 FUEL SURCHARGE 1,000 EA $17.50 1 PC 1.000 $17.50 $0.00 T <br />03101!1018 8078504688 35555793 1557665 2500 REG 3.500 YD3 $99.50 1 YD3 3.500 $34825 $0.00 T <br />0310112018 8078504688 35555793 1571252 SERV,PAYLOAD,CHARGEOVER3-8,CUBICYA 1.000 PC $200.00 1 PC 1.000 $200.00 $0.00 T <br />03!016018 8078504688 35555793 1586055 SERV,CONCRETE HANDUNG FEE PER LOAD 1.000 EA $10.00 1 EA 1.000 $10.00 $0.00 T <br />03/016018 8078504688 35555793 1589831 MONOFIUUAENT2IBER 2.630 LB $6.67 1 LB 2.630 $17.54 $0.00 T <br />PO Subtotal 340 Yards 0.00 Tons $613.29 Material $0.00 Freight 1 $0.00 Other $4294 TaX • $656.23 Total <br />APPROVED 1290/6921 � <br />By Bryan Crain at 9:08 arra, Mar 26, 2018 ,�01 <br />.•Hartir>trararcrrrerarar>trararar>tr�ra,g ✓�� <br />«216202.6315 A 2161290 H 6921 <br />rtrar>arar�rarar�rerar a uNrarar>trrrei <br />3.50 Yards 000 Tons $0.00 Freight $0.00 Other $42-94 Tax 5058.231nvolce Total 1 <br />rw nivotss tncoWratea hareinby wfinw aBinap,wwA*UL,ainwue CraMArp1k&%M BAM. sa-- Stw mm 7erma erbcamiu e.smrs owownerdSsOers Oreucoo'a=#= pCV&M mass sod»sncns"iaa)as tukfsatfa@,eaets <br />invoke rAmermon awe, meas aeat, w*wahm Wss,nted hww tarpmeons sMpene were deivefed ssm3co:ed wW further ex M5* egM to PaY taacowaa, rad, this Aveemnt Uftmsf s1wBaw eaeY.e Paymnu. <br />