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e Copyright 19826I'Ah M1ed by: 1.HILLER 6 ASSOCIATES,INC. `e, <br /> Neenah,Wisconsin 54954.]]2-2018 <br /> "InternetloW publishers 0 yrvmpanani screw, — <br /> FOR HELP IN CHEMICAL EMERGENCIES INVOLVING SPILL,LEAK, <br /> FIRE OR EXPOSURE CALL TOLL-FREE 1-800-424-9300 DAY OR NIGHT - <br /> STRAIGHT BILL OF LADING <br /> ORIGINAL - NOT NEGOTIABLE Shipper's No. <br /> :ARRIER: (r CAC Carrier's /5- r <br /> TO: 71tR--onsignee F��C an/ _,Qr 4Street c S P.rtRrGp�aswe� �3inDestination / ' n a/ eqt Zip O'oz- Zip <br /> Vehicle <br /> route: Number /oaa. <br /> ND Kind of Packages,Descriplion of Arficles HAZARD JINE T LABELS REOUIRED <br /> li,pirg HM CLASS Nonober I to RATE <br /> /- Soo TA8 <br /> i- Gogo ata s8� 588 <br /> Remit C.O.D. to: C.O.D. FEE: <br /> Address: Sia iC <br /> Prepaid [:1City: Z,,4ea / States; �� Zip: DD Amt: $ Collect ❑ $ <br /> TOTE — Where the rate is dependent on value, shippers are required to state specifically inFREIGHT CHARGES <br /> vriting the agreed or declared value of the property.The agreed or declared value of the properly """'"°""^Pe11 n• .nw-.,..,,.,,rw,.• ..e,°an..w-wlrs..... <br /> hereby specifically stated by the shipper to be not exceeding a Per PREPAID [:1 COLLECT <br /> RECEbED,mbjen Io the elndllcatlon.mtl teriHs In efM1a on IM1e dna of Inup of th'n Bill of Lainp,the pracerrystlesxribedebove In epperenl paod ortler,a.cept as""ad konunu and condition of contents of ped,eg..unit...),, <br /> marked.[onn0neyd,.ted d.nlned n Indlgled abON whicM1 aid tattler pM1e word Carrier being untlaralolM IM,ruOhaut IMs C.rded n maening enY penan or carporelion In...OWpn of In.paparty under Iha[pnaRH Igreee to <br /> of Nif t 011 b'un IEelwori opatient, <br /> ati nt,Its w de pati�h my tlmeoutenmd In otherwise to <br /> deliver <br /> uianother carrier on the routs m said definition <br /> II is mmuelly agreed as to each terrier of ell or any ol,seta property�over ell a any qr len <br /> dauifkatlon on IM date oleM Wopeny.that every service to <br /> M performed hereunder shell be subject to all the bill of living Hrm.and 9onEItloM la the govnnhq <br /> piper <br /> shipper hereby cerdlle that he I.familiar with tll the bill of lading terms and conghlon.In the governing clen,baanan eM the s rd terms and aondinan.ate hereby.,,.ad to by he shipper and....pud far hlmeelf alta his <br /> T i.i.m nnay IMI tM Nxne�MmM meterii era pr[grly clO.Wndescribed-as <br /> -.an-end <br /> ubel.d.m In proper[pId111on Iw Inn.ceneu,m eo-ael„g m the iti 1.r.9we1- of me ' ' R • a ❑YES l❑ NO—MRNISHED RY CARRIER <br /> p.9.nmema?nnepon lien. . R E E DRMER SIGNATURE <br /> M <br /> 5HIPPER:/f7�-Sr`c` CARRIER: / <br /> PER: of. Qaee.e PER: <br /> DATE: /-S- DATE: /- -ow <br /> FORM 7f 9-01.8-A I3-PLY) <br /> evised 7/86 <br /> FOR HELP IN CHEMICAL EMERGENCIES INVOLVING SPILL,LEAK, <br />