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I <br /> Soer's No.--v— ----- -- `. <br /> ;arrier Clr�/ �P aI <br /> ECAC Carrier's No. <br /> IECtlemedRIED.subject to Sur a d are determined to rates or centrads that have been egged upon is and federal <br /> between the n carder and shipper,if applicetAo,otherwise to she rates,classifications and leas Pat have sees <br /> steblished by discerner and are available to the shtr+per.on request;and all applicable stale andfedeml regulatlona; <br /> 2-2 -�C> <br /> it date from <br /> the Property described below,in apparent good order,except as nosed(ccnlonis and condition of contents of packages unknown),-marked,consigned,and destined as:indicated below,which said company <br /> (the word company being understood throughout this contract as meaning any person of corporation in possession of the property under the contract)agrees to rely to delivery at said destination,it on its <br /> route,or otherwise to deliver to another carrier on the mute or aid destination.It is muNaly agreed as to each carrier of all or any of said Property over all or any porton of said route to destination,and as b <br /> each parry at any time interested in all or any of said Prppery that every service"t be performed hereunder shell be subject to ail the conditions not prohibited by law,whether printed or wdgoq retain <br /> contained,including the conditions on the bac*hereof,which era hereby agreed io by the shippor and necapted for himself and his assigns. <br /> FROM: <br /> Shi er C- <br /> ZV <br /> itreet {� ( / /BGG Stre t —�� J <br /> )estinatio % !N rev Zip Zi <br /> ?outs <br /> )elivering Carrier Vehicle Number US,DOT Hazmat Reg.No. <br /> lrrlberanc!Type� ID ��'6escription of Articles <br /> OfPac%ages Num' b'er3emit COD tots"a°at°s°gion70 °r`°°°°°'""I' <br /> mripmeco <br /> at tw W deMmee to Me cordCOD FEE: <br /> ¢,. COD AMT: <br /> without ourse on rhe c Ign he <br /> yddress: crnm <br /> "Wants folawirre eywn c <br /> Rn. a de en me a d. ave w um <br /> Prepaid ❑ <br /> "ity: State: Zip: hnm,el will t aeymeet t t Ig t ea ea <br /> mheriawlcfclvl Collect ❑$ <br /> IOTE:where the rate is dependent on value,shippers are required to state specifically In writing TOTAL CHARGES: FREIGHT CHARGES. <br /> to agreed or declared value of the property.The agreed or declared value of the property is CC <br /> Surtsey specif cisly stated by Me shipper to be not exceeding $ - Per (Slgnafters f Cornianor) W Prepaid Collect <br /> 4TB6Mi l.lato l Lhnitegon for loss or damage in this shipment may be applicable.Sere,49 U.S.C. • -s <br /> e 1 A and B. BYSHIPPER []DYCARRIER <br /> l <br /> his is to certify that the above:-named materials a props i classified,described,packaged,marked _ <br /> nd IabeleQ mA are.kr p r condition fa ran rragon Ming to the app!iceble regulations of Me • s <br /> lepadmenl of Trane a' n Per 'r' l SI AT E: <br /> SHIPPER: CARRIER: ri <br /> 'ER: DATE: __--_._ PER: DATE:2— 2— <br /> EMERGENCY RESPONSE Monitored at all tjolleer theH ardous Natt:rial is in transportatirn <br /> 'ELEPHONE NUMSER! l } including storage inciden io transporcadori(1726iM). <br /> 0 <br />