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3-PART STOCK FORM NO.B-3876 STRAIGHT BILL,OF LADING— SHORT FORM ORIGINAL—NOT NEGOTIABLE Shipper's No. Carrier's Name: Carrier's No. REC IVED,subject to the classifications and lawfully filed tariffs in effecton the ate of he issue of s 1 ding, at (Date) 0 19 FR0Wis AA '� A �1 1)5-e7 [he property descn ed be ow,in-5—parent goo order,•xcep s noted contents and co diti f c tents of packages unknown),marked,consigned,and destined as show b ow,which s~atd company(the word c�ompauy being understood - tbroughout this contract as meanieg any person or cog in session of the prop rty m ler the contract)agrees to carry to its usual place of delivery at said destination jf on its own railroad,water Ime,highway route or routes,or within the territory of its lughway operation, e [o deliver to another carri on the route to said destination.It is mutually agreed as w each carrier of ath or any of said property over all or any portion _ of said route[o destination,and as to each party at any time rested in all or any of said prop y,that every service to be Performed hereunder shall be subject to all the terms and conditions of the Uniform Domestic Straight Bill of Lading set forth(1)in the Uniform Freight Clarification in effect on the date hereoY,tf this is a rail or nu water shipment,or('L)in the applicable motor carrier classification or tariff if this ia.a motor carrier shipment. ShlFPer hereby certifies that he is familiar with all the terms and conditions of the said bill of lading,including those on the back thereoff.set forth m the clarification or tariff which governs the transportation of this shipment, an[ the sand teens 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- Consigned TO ment is to be delivered to the consignee without recourse on the consignor,the consignor shall On Collect on D er Shipments letters"COD"must appear before consignee's nartre o as of provide Item 430.Sec.t. sign the following statement: q\w1y\` ^' The carrier shall not make delivery of this Destin n Street ��C c N YZ y shipment without payment of freight and all Celt shier lawful charges. County fir\(%4' a h► State_(_, Zip V - e roery ,_ Route Address* (*To be filled in only when shipper desires and governing tariffs provide fol dery ereatt n ('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 'barges are is be prepaid, w or Street City State ei.unp here, 'To be Prepaid." No. H.M. Kind of Package,Description of Articles,Special Marks.and Exceptions "Neigh(Subject Class Check Packages to Correction) or Rate Column - Received S to apply in prepayment of the charges on the property described hereon. Agent or Cashier Per (The signature here acknowledges only the amount prepaid.) Ch.,ges.Advanced: ontainers used for this shipment conform to the s set forth in the L box maker's certficate thereon,and all other requirements of Rule 41 of the Uniform Freight Gasification and Rule 5 of the National Motor 'If the shipment moves between two ports by a carrier by water,the law requires that the bill of lath shall state whether it is carrier's or a Freight Classification.' NATE—Where the rate is dependent on value,shi peer's weight. t Shipper's imprint N lieu of stamp;not a pate peers are req' state specifically ul writing the agreed or de d value of the property. of bill of lading approved by the Interstate The agreed or declared value of the property is hereby � ctfically ata d by the shipper to he ding Commerce Commission &ShierXA, ! Agent Permanent post-office address of shipper, Per