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3-PART STOCK FORM NO.B-3876 THIS SHIPPING ORDER must be legibly filled in,in Ink,in Indelible Pencil,or in Carbon,and retained by the Agent. Shipper's No.Z Carrier's Name: - Carrier's No. REC IVED,subject to the classifications and lawfully filed tariffs in effect on the date o the issue o 's Bi ading, n ; at (Date) O 1s FROM�I- U5`7 the property described below,m apparent jou orde 1x11 s notes contents and condi[ f ntenrs of packages unknown),marked,consigned,and destined as shown be ow,which said company(the worcl company being understood throughout this contract as meaningg any person or corp in ossession of the pro erty er the contract)agrees to carry to its usual place of delivery at said destination if on its own railroad,water hoe,highway togto or routes,or within the territory of its highway operation, fist to deliver to snot er c on the route to smd destination.It is mutual)yy agreed as to each carrier of ail or any of said property over all or any porLSbn of said route to destination,and as m each ppaarrl1a:yy at any time erested in all or any of said pro rty,that every service w be performed hereuntler shall be subject to all the terms and conditions of the Uniform Domestic Straight Bill of Lading set forth Sl)in the Cniform Freight Classification in effect on the date hereof,if this is a sail or rail-water shipment,or(2)in the applicable motor carrier classification or tariff if this is a motor carrier shipment. Shipper hereby certifies that he is familiar with all the terms and conditions of the said bill of lading,including those on the back thereof,set forth in the classification or tariff which governs the transportation of this shipment, and the said terms and conditions are hereby agreed to by the shipper and accepted for himself and his assigns. (Mail or street address for purposes of notification only.) Subject to Section 7 of conditions,if this ship- ment is to be delivered to the consignee without Consigned TO recourse on the consignor,the consignor shall on Collect on D very Shipment rte letters"COD"must appear before consignee's namea as o e provid Its Cit430.Sec 1 sign the following statement: The carrier shall not make delivery of this Deiin ' n _ S csttreel F� ( shipment without payment of freight and all City other lawful charges. County �� ,�aC3II VA State Zip Delivery Route Address* (*To be filled in only when shipper desires and governing tarif s provide r de., hereat) Signature of consignor.) Delivering Carrier Car or Vehicle Initials and No. C. O. D. Charges to be Paid by Collect on Delivery$ And Remit to ❑Shipper ❑Consignee If charges are to be prepaid, write or Street City Statel stamp here, "To be Prepaid." No. H.M. Kind of Package,Description of Articles, 'Weigh)(Subject Class Check Packages 9 P Special Marks,and Exceptions to Correction) or Rate Column Received S to apply in prepayment of the charges on the property described hereon. -- l Agent or Cashier Per (The signature here acknowledges only _ the amount prepaid) ( Charges Advanced: tIncw,ciners used for this shipment conform m the spe kaelun&set forth in the box maker's certificate thereon,and all other requirements of Rule 41 of the Uniform Freight Classification and Rule 5 of the National Motor 'If the shi ment moves between two ports by a carrier by water,the law requires that the bill of ladin shall state whether it is carrier's or shipper's Freight Classification." p g yetis weight. t Shippers imprint in lieu of stamp;not a part NOTE—Where the rate is dependent on value,shippers are state specifically in writing[he agreed or d value or the property. of bill of ladiu approved g pp by the Interstate The agreed or declared value of the property is hereby pecificatly et .d by the shipper to be o[a ding r Commerce Commission S er, l� Agent must detach and retain thig Shipping Order and must sign Permanent post-office 1 the Original Bill of Lading. address of shipper,