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I l ll"u IYIt m iurdl luul l i Bill of Lading,nor a`wK or duplicate covering the property named herein and Is Shipper No. intended solely for filing or record. Carrier No. Page , of -- r Date (Name or carrier) i SCA ) On collect on Deinery srypmeny.me 4"=D-mow appear o ,e mnergnee's name On as nmennse prewdad Ir Item 430.Sec b Ft10iA: TO: r ` � — Shipper - Consignee l �' Street \ Street E ,, y � i � city ��r"ti�.��1 � mite Zip Ie q% City 1 State. Zip Gare C� 24 hr.Emergency Contact Tei Ne - Vehicle Route Number No.of Units HM Basle DESCRIPTION TOTAL QUANTITY WEIGHT CHARGES Proper Shipping Name,Hazard Class UN or NA Number,Proper Shipping Name. (Weight, Volume. (Subject to RATE (For Carrier &Container Type UN or NA Number,Packing Group or Hazard Class.Packing Group Gallons,etc.) Correction) Use On+yl PLACARDS TENDERED: YES O NO p REMIT C011Naas— [ Where the rate is depend-[an value ar eo metal. y ADDRESS SS t Y epe'bder th P- .recp,e I oOsig e remora rnu Ire rnplBate of this ADDRESS speGaicaW In raanq Ile apreee or raceanad vakre d the p^aF M as.lollwws 'The eansgnmem are!u.ly and aCGurasely ag,aed Or dedued wane of the props ry Is hereby spacr"y stator by',ha shipper to t---td' ash-abed above.oy the proper sMpp�ng /�/�D C.O D FEE- nenmeaceecling _ per name and are caesrlled, paceaged, ■V[V■ PREPAID C (2)Where mr applicable lwff pronsrnner specify a enalwab of me camels nabilq absent modlad end labelleWpla-rded,and are Ami: $ COLLECT Ll S a release or a tat-declarai by me shipper and the sleeper does nor re.ease in all r.spacis in former cmdilgn for _ _ - ihe carrer's aahiilly dr deciarC a 4atu9.Nin Garnets I,aday seal Dr Lrmled m Inc aslant transport accordmq to applicable Stele l'n section 7 or the c d es•M.a the shape ''s to be de.werW to the TOTAL provaM b'such pmvisuns..See NMFC Ilean 172 rnteroatbnaI and national gowmmanlal ..signer eerour recow on ma Gonsgnor.Jr.cnns.gra Bryn s'qa the CHARGES S fuiravmg sralmnenr iS}Commbrirns regWrtg spec+al a additional Garo a xcentgn n harirrnq or sto.nrg aeguauons, ne umier snarl nos meas aehwery of me snipmem«nlwul oay�mem o+ FREIGHT CHARGES must be so rrairkad ale packaged as m ensJre sale rransportai—See Snags 2fe)of Trawl mid at etM1e,iaWtul c-ai FREl0h 1 PREPAID Criag luu,t dla goo nam 380,ales of Ladmq..Freight eats arta Statements W Charges and Sengn 1qa)of ' GOO—Tonins and CgWNgn3 for a list Of 5reCh daaCIEE Signature is,aa„m wcaawwn rigs ei Decca ❑ homed RECIl%,ta a 4:ha G;essagatgfi9 aril rxnnr n gawp 9n ala date d ata issuai d rhat Boll of Lade+g, anger and da to a”Perry a'.any tuna nterase9d in al'm any said pronely dial very saivna to 00 Ine mpa prry describedoewe r aren aappt gouo —1 as order.0 —ad frontemrrni d s and crndlcM pednnod oharauPe nr shaa W Wblad b all the nal of larang terms ale candelas n the, the gowe'I+ebg tesla 01 packages unknown) mked ar ,is gratel and ra rthned as ewacalpd abowa When rate carne/ sdicdlion on me d®e of snpmere ;Ise• tri ramex Sang antlersari througrbul tris coronad as meaning arty parson or eoteonalion in Shipper hereby redares Mat hie m ranetutr win if the)morn,terms and crndihdra in the prise—d me proeady nope'me oonoact�agrees io carry to es utwal"—of delieney al Said Basi ¢veining classaYoaon and the surd terms and 0-111 ns are hereby agreed 10 by the shppar aril naaon,.1-•b We,oatendse ra dal)—to an.",Ramal on the.,to to said d-%%Wen II or inset acceRled lar hinge))an@ his assrcjru ally'agreed-to each caner of ell or try e',said It'no"y asst all ow"Pon on br sell rouse to dea. �1 SHIPPER CARRIE / r PER PER (�l' DATE Permanent poll-office address of shipper. STYLE F365-4 C 2003 LABELAASTFR 6 (800)621-5808 www.labelmasier.com PRINIiYp'JN RECtf.EEa PAPE'A reetmem uill,Sall Iva SQy INI(_