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O1'12~98 ~IO\ ll:~i F:~l 50S ~89 f~6~ <br />FOSS Eti~'IRO~fE~TL <br /> ~t . -t-.-: -- .•-~ <br /> <br />. ..-:~- ._'•' 'f 2'~`JC."'^'_~J,l • ` . . <br />.. <br />~. T- : . .a^.=T~ <br />--,-- . ' _ ~ i - • <br />~a; DA ~Y'TI~HEET ~ - <br /> <br />~:~:~ ~- WI:LKINS ~RUGKING C~. ~ <br />~ -~ 339 N.Cotumbia ~ Port{and, Oregon'97217 - <br /> _ (503} 2~~=3D00 <br />- <br />_ "~ Fax (503).283-2~54 <br /> <br />Driver _ Date ~.-~~ ~ ` ~_ ~ ~ <br />~ <br />` toNY~rd <br />~ <br />t <br />- ?ruck Na l _ ~ 4 <br />:~ <br />Trail~~ No. f~ Capacity ~~-.~- <br />~ <br /> per hour / ton / yard /,other <br />Rate $ <br />Gortt~actor or Emqloyer <br />Address <br />.~ G~y . ! _ ~` <br />dob Location - <br />Lunch Tirne Finished <br />Time Started : <br />-HAULE~ FROM NAULEQ TO LOADS T~ME <br />MAT~RIAL <br />~ ~s ~ G J~J.. ...._ _ t ' , <br />._-:--- <br />:f <br />, _ <br />, ~ <br />:~ ~ ; <br />_ -~ <br />Drive~s Signature • - ; ~ <br />' SO~~ay ai_ths moPthlolloy+in~ the date hereot _~ <br />-~}6 account O,us and paYaae-0n ~e ntarastshatl ~ccrue ~tthe rate of 18~'o pe~ <br />q-~~Ir si ndti(es her9W d~S 1. <br />`TYie parUOZ eipress~Y ~9ree bY.. 9 <br />annum on alt past ~ue acmun~ <br />lf this aocount is placed In the i~ands ot an aao ees an ooNec4onhcos~ eve~ sih ugh no swa~~~o' <br />," <br />pay Su6 ConGactor?E(i~P~oY~s reasonable sIIOrney <br />is Gled o~ ~~ a~tDUnt; h~eV~r, it gult or ace"on is 1T9d',-Qie amount otsuch reasor{able aRomey fees shel <br />De tited by ihe cfluR materiaLs, teMd~s. and r9~onak+9 p~oht under Oreyon Revisec <br />A lien may be daimed 1of ~~r, <br />StaNl9s. ChsPt~r BT + " <br />resentative acknowledges receipt oi copy and sign ilies same to be 1 <br />ContractorlEmp-oYerAep . - <br />correct b}~ his signature below: , <br />~ __-----------___ <br />--------- <br />Signature <br />'-- -yot respans~bla.lor dama e caused b,y deUvery rnsid~ wrb line. <br />~ u~C~+~o2 <br />