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V Copyright 2010 J.J.KELLER&ASSOCIATES,INC.@,Neenah,WI•USA•(800)327-6868.2keller.com•Printed In the United States STRAIGHT BILL OF LADING—ORIGINAL_=NOT NEGOTIABLE— -- Shipper's No. 10039—+q — Carrier �R a .� SCAC Carrier's No. RECEIVED,subject to individually determined rates or contracts that have been agreed upon In writing between the tallier and shipper,if applicable,otherwise to the rates,classifications and rules that have been established by the carrier and are available to the shipper,on request;and all applicable state and federalre lati at , date "fir' from the Party desctibed below,N apparent good order.ea pl as noted(comnerts and condition of contents of o�ckaq�unlmown),coshed,cansVwd.and dasthed as indicated below which said comp'"(tire word company being understood through"M contract a meankV any person o corpomeon In possession d the propady under so contract)eryaea to tarty-to iv ry at saW destMatbn,g on ih route,or othenriss to deliver to another carder m the roula to said"Inadw.it is mutually agreed as to each tarda of N or any of said Propend over A a any pwtian of sold cote to decttretbn and as lo each parry at any time Merested N eg or any d saki Property that every savke to be performed hereunder shag be suttiact to all the mndtbr,e not prchlEgsd by few, whether printed or wr@ar,tareh conWned trrclu6=the condticns on the beck hereof,which ere he+eby spread b by the sNPPar and accepted for hknsetl and Itis assigns. TO: FROM: Consignee � �� _y� Shipper ` 1 �50 'porgy 1 �-- yS `1 S 1 C)10 iLw�� ► S�- Street Street Destination :56C',C' %..j C)A Zip q 0 k Origin 5 r-a (,to, zip P o Route DeliveringL�.j Carrier ( Nu loan ' A . °umbe,a'Number and Type I.D. ti Description e of Packages HM Number 41 subject to section 7 of conditions,it gds COD FEE: Remit COD to: shipment Is to be delivered to the consignee 1 _OD AMT. without recourse on the consignor,the v Address: oonagnor shag sign ms fogawing alalemertb Pre aid The carrier shag not rtWca defNery N tide �/ p City: State: Zip: shipment without payment of Ire=end all �I d` !/J other lawful charges. Collect CDlie El$ NOTE:Where the rate Is dependent on value,shippers are required to state specifically in writing TOTAL CH S: F EIGHT CHARGES' the agreed or declared value of the property.The agreed or declared value of the property Is hereby specifically stated by the shipper to be not exceeding$ Per (signature of Consignor) re aid ❑Collect NOTE:Liability Limitation for loss or damage in this shipment may be applicable.See 49 U.S.C. go t•. 14706 c 1 A B. PLACARDS ., s BY SHIPPER O BY CARRfER This Is to certify that the above-named tedals a Orly classified,described,packaged,marked and labeled,and are In roper condi( for tra o on according to the applicable regulations of DRIVER'S the Department of Tie p eti .Per SIGNATURE: SHIPPER: CARRIER: PER: n DATE::& �� PER: ' DATE: EMERGENCYRESPIONER TELEPHONE NUMBER'SE - 4-4-OLA OR OTHER UNIQUE IDENTI NAME OR CONTRACT FER: � �0 9-BLS-A3 431(Rev.9/10) GROSS 321001h GROSS 77520 1b 11'?:=11(iHh1 03/13/2013 09:55AM 10ff3112013