Laserfiche WebLink
I Clio IYICIYIVf7HIVIJUlY1 <br /> is anacknowledgement that s bill of lading ham been Issued and is not the Original dill of Lading,not Shipper's No. <br /> a copy Pr duplicate,covering the property named herein,and Is Intended solely for filing or record. <br /> Carrier's No. <br /> CARRIER: r1 �� <br /> 1' ��--' i IF'* ''" y} V SCAC Date `�- Z J -- <br /> ��-/ <br /> r; ..� FROM: <br /> <" nsignee , , �:TO- ' f%CO �fig I­ i= �..� Shipper �r -, S ! )' <br /> y� 1 <br /> Street �` t �P I 1 �^,t Street 6x <br /> Destination 1 [ Zip Origins Zip `I <br /> Route: Vehicle Number U.S. DOT Hazmat Reg. No. <br /> Number of WEiGHT <br /> .. <br /> ShippingD- . . <br /> Units HM I correction) <br /> _...1... . __... <br /> L <br /> _.....-„ ..... ...... .. .................. _.... . . ._... .-... ,,._,. ...__._-_•_.......... .. <br /> "f <br /> Remit C.O.D. to: COD 112f;4�0 D. FEE: TOTAL CHARGES: <br /> Address: Prepaid t ❑ $ <br /> City: State: Zip: AMT: $ ' <br /> 'if the shipment moves between two ports by a carrier by water,the law requires that the Subject to Secton 7 of conditions II IMs shipment is to be delivered to the consignee without FREIGHT CHARGES <br /> hill of lading shell state whether it is'carrier's or shippers weighl'. recourse on the consignor,the consignor shell sign the following statement <br /> Note,-where the rate Is dependent on value,shippers are required to state specifically In The carrier ahall not make delivery al this shipment without payment of trelght and alt other tawlul FREIGHT PREPAID <br /> writing the agreed or declared value of the property. charges. ,. Except when CHECK BOX <br /> The agreed or declared value of the property Is heretty specifically staled by the shipper box at right it charges are <br />' to be not exceeding per (Signature of Consignor) <br /> Is checked 11 la be collect <br /> RECEIVED,subieat to the classifications and tariffs In effect on the date of this BIII of Lading,the property described above In apparent good ander,except as noted(contents and condition of contents of packages unknown), <br /> marked,consigned,and destined as Indicated above,which said company(the word company being understood throughout this contract as meaning any person or corporation In possession of th4Tperry under the <br /> contract)agrees to carry to its usual place of delivery at saki destination,If an Its own road or Its own water tine,otherwise to deliver to another carder on the route 10 said destination.It Is mutualty agreed,as a each carrier of <br /> all or any of said property over all or any portion o1 said route to destination,and as to each party at any time interested In all or any said property,that every service to be performed hereunder shall be subject to all the <br /> conditions not prohlbdad by law,whether printed or written,herein contained(as specified In Appendix B to Pert 1035)which are hereby agreed to by the shipper and accepted for himself and his assigns, <br /> This is to certify that the above-named materials are properly classified,described, packaged,marked and labeled and <br /> ..?re in proper condition for transportation accordingto theapplicable regulations of the Department of Transportation. PER: <br /> `= IPPER: r. t! CARRIER: l <br /> PEA:. b ATE:' PER: t DATE: <br /> EMERGENCY RESPONSE MONITORED AT ALL TIMES THE HAZARDOUS MATERIALS IS IN TRANSPORTATION, <br /> TELEPHONE NUMBER: iNCLUDIN0 STORAGE INCIDENTAL TO TRANSPORTATION(172BA). <br /> 3 -BLS-Ca <br /> (REV.ares) <br />