COMPLIANCE INFO_PRE 2019 - Laserfiche WebLink

Home Browse Search

TO Consignee: rnurvl oulppel LdJi%3, ix'r%. F+C4 io Street Destination Zip Code Emergency Response Phone No. Route: Vehicle No. Z -oG Z lluu rn o o.0 h Aping HIM Kind of Package, Description of Articles, Special Marks and Exceptions °weight flub.to Cort.) RATE ✓ CHARGES O ' - a ��:;{.,.P J;,t'iTC "at,! ACIC ltattte.X`es 0 REMIT C.0 D, C.D.D. FEE: TOTAL " C.O.D.TO: Al PREPAID ❑ $ CHARGES: $ ADDRESS COLLECT ❑ >If the shipment moves between NOTE: Where the rate is dependent on value. Subject to Section 7 of conditions, if this shipment two parrs by a carrier by water, me shippers are required to state specifically In writing is to be delivered to the coni@nee without recourse FREIGHT CHARGES law requires that the bill of lading rhe agreetl or declared value of the property. on the consignor, the consignor shall sign the shall state whether ¢ is "carrier's The agreed or declared value of the property is following statement Check Appropriate 90X: or shipper's weighC. hereby specifically stated by the shipper to be not The terrier shall not make delivery of this shipment exceeding without payment of freight and all other charges. g per ❑ Freight prepaid ❑ Collect [Signature of Consignor) RECEIVED, subject to the classifications and lawfully filed tariffs In effect on the date of the issue of receipt by the carrier of the property described in the Original Bill of Lading, the property described above in apparent good order, except as noted(contents and condition of contents of packages unknown), marked, consigned, and destined as indicated above.which said carrier(the word carrier being understand throughout this contract as meaning any person or corporation in possession of the property under the contract)agrees to carry to its usual place of delivery at said destination. if on its route, otherwise to deliver to another carrier on the route to said desionation. It is mutually agreed as to each carrier of all or any of. said property over all or any portion of said route to castration antl as to each party at any time interested in all or any of said property, that every service to be performed hereunder shall be aublect to ail the terms and conditions of the Uniform Domestic Straight Bill of Lading set forth[1)in Uniform Freight Classifications in effect on the date hereof. if this is a rail or a rail-water shipment,or[2)in the applicable motor carrier classification or tariff if this is a motor carrier shipment Shipper hereby certifies that he is familiar with all the terms and conditions of the said bill of lading set forth in the classification or tariff which governs the transportation of this shipment.and the said terms and conditions are hereby agreed to 6y the shipper and accepted for himself and his assigns. Tis is w certify that the above named materials are properll," assified, described, packaged. marked and labeled and are in proper condition for transportation, according to the able regulations of the Department of Transportation:" Shipper, Per + Mar{,with"X"to designate Hazardous Material as defined In TIG@ 49 of Federal Regulations. - " `t For further details on TRANSPORTING may.,, HAZARDOUS MATERIALS see Federal FORM No.3841 Regulations 49 CFR, Part 172. Printed o the U.S.A.