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Dili UI 1_dwny,nor a copy or duplicate,covering the property named herein,and is Shipper NO. intended solely for filii,n or record. Carrier No. Page of Date (Name of tamer) (SCAC) On Collecl on Delivery shipments,the letters"COD'must appear before consignee's name or as otherwise provided in Item 430,Sic 1. FROM: TO: Shipper Consignee Street Street City State Zip Code City State, Zip Code .. — 24 hr ErnFrraern v Con1:�d Tel fel^ _- Route Vehicle Number No.of UnitsHM BASIC DESCRIPTION TOTAL QUANTITY WEIGHT CHARGES Proper Shipping Name,Hazard Class UN or NA Number,Proper Shipping Name, 8 Container Type or (Weight. Volume, (Subject to RATE (For Carver UN or NA Number,Packing Group Hazard Class.Packing Group Gallons,etc.) Correction) Use Only) I PLACARDS TENDERED: YES O NO D REMIT Note—(1)Where the rate is dependent on value,shippers are required to state C.O.D.TO: I hereby declare that the contents of this ADDRESS speafically in writing the agreed or declared value of the property,as follows:The consignment are fully and accurately agreed or declared value of the property is hereby specifically stated by the shipper to described above by the proper shipping COD C.O.D.FEE: be not exceeding per name and are classified, packaged. PREPAID ❑ (2)Where the applicable tariff provisions specity a limitation of Me tamer's liability absent marked and labolletl/placarded,and are Amt: $ COLLECT ❑ $ a release or a value declaration by the shipper and the shipper does not release in all respects in proper condition for the comers liability or declare a value.the earners liability shall be limited to the extent transport according to applicable Subject to secbm]of the condiiions,it she smpmodl is to be dowered to the TOTAL provided by such provisions.See NMFC Item 172. international and national govemmenlal consigned without recourse on the consignor,the consignor shall sign the CHARGES $ (3)Commodities requiring special or additional care or attention in handling or stowing regulations. fall The9e statement: not make dolrvery of this shipment without payment of must be so marked and packaged as to ensure safe transportation.See Section 2(e)of begin and all other lawful charges d FREIGHT CHARGES item 360,Bills of Lading,Freight Bills and Statements of Charges and Section 1(a)of FREIGHT PREPAID Check box it charges the Contract Terms and Conditions for a list of such articles. wexcept when box at are to be Signature (Signer—.1Cogn«i right ischecked ❑ coiled RECEIVED,subject to the classifications and tants in effect on the date of the issue of this Bill of Lading. tinalim and as to each party at any ume interested in all or any said property,that every service to be the property described above in apparent good order,except as noted(convents and condition of con- performed hereunder shall be subject to all the all of lading terms and conditions in the governing clas- tents of packages unknown),marked,consigned,and destined as indicated above which said carrier sification on the date of shipment. (the word tamer being understood throughout this contract as meaning any person or corporation in Shipper hereby certifies that he is familiar with all the lading terms and conditions in the possession of the property under the contract)agrees to carry to Its usual place of delivery at said desti- governing classification and the said terms and conditions are hereby agreed to by the shipper and nation,if on its route,otherwise to deliver to another carrier on the route to said destination.It's mutu. accepted for himself and his assigns. ally agreed as to each carrier of all or any of,said property over all or any portion of said route to des- SHIPPER _ CARRIER PER PER 4 DATE Permanent post-office address of shipper. —u— STYLE CF365-4 0 2003 LABELMASTER 0 (800)621-5808 www.labelmaster.com