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Date: 10 06 AIIIIIIII& BILL OF LADING A111111116 Page: 1 <br /> SHIP FROM <br /> Name: STORE 4277 Bill of Lading Number: 00000000291895 <br /> Address: 5757 PACIFIC AVE <br /> City/State/Zip: STOCKTON,CA-95207 BARCODE SPACE <br /> SID# FOB <br /> SHIP TO Carrier Name: CENTRAL TRANSPORT INTL <br /> Name: GENCO/KMART 8362 Location#: 62 Trailer Number: <br /> Address: 350 HANSON WAY Seal Number(s): <br /> City/State/Zip: WOODLAND,CA-95776 SCAC: CTII <br /> CID# FOB Pro Number: 555-339532-4 <br /> THIRD PARTY FREIGHT CHARGES BILL TO <br /> Name: GENCO <br /> Address: 1400 Lombardi Avenue,Suite 204 <br /> City/State/Zip: Green Bay,Wisconsin 54304 Freight Charge Terms:( freight charges are prepaid unless marked otherwise ) <br /> SPECIAL INSTRUCTIONS: Prepaid Collect ® 3rd Party <br /> GENCO PALLET RATES TO APPLY Master Bill of Lading with attached underlying Bills of Lading <br /> CUSTOMER ORDER INFORMATION <br /> DOCUMENT NUMBER #PKGS WEIGHT #PALLETS ADDITIONAL SHIPPER INFO <br /> 019203-1 16 300 1 <br /> 019203-2 27 450 1 <br /> Batteries Wet, Filled With Acid Haz Class 6 150 <br /> 1ea-4 03 <br /> GRAND TOTAL 43 900 2 <br /> CARRIER INFORMATION <br /> HANDLING UNIT PACKAGE WEIGHT H.M. COMMODITY DESCRIPTION. LTL ONLY <br /> QTY TYPE QTY I TYPE (X) HM BATTERY,WET, FILLED WITH ACID NMFC# CLASS <br /> 2 PALLET 43 CTN 900 HAZ CLASS 8 ID#UN2794 PACKING GROUP PGIII <br /> EMERGENCY RESPONSE PHONE NUMBER 1-800-424-9300 <br /> RECEIVING <br /> STAMP SPACE <br /> 2 1 PALLET 1 43 1 CTN 900 IGRAND TOTAL <br /> WrIere the rate is dependent on value,s ippers are regwre to state specifically in writing the agreed or declared COD Amount: <br /> value of the property as follows: Fee Terms: <br /> "The agreed or declared value of the property is specific ally stated by the shipper to be not exceeding_per_." Collect Prepaid Customer check acceptable <br /> RECEIVED,subject to individually determined rates or contracts that have been agreed upon in writing between the The carrier shall not make delivery of this shipment <br /> carrier and shipper,if applicable,otherwise to the rules,classifications and rules that have been established by the without payment of freight and all other lawful charges. <br /> carrier and are available to the shipper,on request,and to all applicable state and federal regulations. X Shipper Signature <br /> SHIPPER SIGNATURE/DATE TRAILER LOADED: FREIG HT COUNTED: CARRIER SIGNATURE/PICKUP DATE <br /> This is to certify that the above named materials are properly By Shipper By Shipper Carrier acknowledges receipt of packages and required placards. <br /> classified,described,packaged,marked and labeled,and Carrier certifies emergency response information was made available <br /> are in proper condition for transportation accordingto the By Driver/Pallets By Driver <br /> and/or carrier has the DOT emergency response guidebook or equiv- <br /> applicable regulations of the Department of Transportation. By Driver/Pieces alent documentation in the vehicle. <br /> X Shipper Signature X Carrier Signature <br /> Property described above is received in good order,except as noted. <br />