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7h!s Shipping Order Must be legibly filled In,In Ink Indelible Pencil,or In Carbon,and retained by the agent Shipper No. Carrier No. Page�_ of Date (Name of carrier) (SCAC) On Collect on Delivery shipments,the letters'COD'must appear before consignee's name or as otherwise provided in Item 4,10,Sec.I. _ TO: Shipper/T �C�/lJZ Cd Consignee Street P$ �'• �L Ci4kState4�_ Zip Code�2� Cit State, � _ Zip Code ill 24 hr.Emergency Contact Tel.No. Route Vehicle Number No.of Units H MBASIC DESCRIPTION TOTAL QUANTITY WEIGHT CHARGES &Container Type Proper Shipping Name,Hazard Class UN or NA Number,Proper Shipping Name, (Weight, Volume, UN or NA Number,Packing Group or Hazard Class,PackingGroup g (Subject to RATE (For Carrier P Gallons,etc.) Correction) Use Only) r��L.-... r�� _�!� !/f//�� .f// � n�,:.�.!— ' 'J•/i� •v f /.�.�s — —+.,.Wit r PLACARDS TENDERED: YES D NO O REMIT i C.O.D.TO: Note--(1)Where the rate is dependent on value,shippers are required to state I hereby declare that the contents o1 this ADDRESS specifically In writing the agreed or declared value of the property,as follows:'The consignment are '--fly and accurately ,tee agreed or declared value of the property is hereby specifically stated by the shipper to described above by Bye pmper.shipping be not exceeding- _per_ name and are clesslfiod. packaged. '�qj C.O.D.FEE: (2)Where the applicable tariff provisions specify a limitation of the carrier's liability absent marked and labelled/platy,.^d and are COD Amt: $ PREPAID 0 a release or a value declaration by the shipper and the shipper does not release in all respects!n p!opet ronalYnn for COLLECT h the carni es liability or declare a value,the tamer's liability shall be limited to the extent transport accordin; to appiicri is Subject to Secsat 7 of ti,e conditions,If this shipment is to be delivered to the TOTAL —1 g F provided by such provisions.See NMFC Item 172. international and national govemmental rons�gnee withcot recourse on the consignor,the consignor shall sign the. CHARGES a _ follow g slalement: m Commodities d and special or additional sere or abandon n handling or stowing regulations. The ismer shall not make delivery of this shipment without payment of FREIGHT CHARGES Item be so marked and packaged as to ensure safe transportation.See Section 2(e)of freight and 61I other lawlul charges. Item 36G,Bills 01 Lading,Freight Bilis and Statements of Charges and Section 1(e)of FRF.IGIR FRF.ltAiO Ghsrx boxacharges the Contract Terns and Conditions for a list of such articles. _-__ Signature -- — ..cont when pox at, r—, are to be ISlnnature of Consignor) tight is chookod LJ o Allot RECEIVED,subject to the classihcalions and tarias in effect on the date of the Issue of this Big of Lading, lination and as to each party at any I,me interested in all or any said property,that every service to be the property described above in apparent good order,except as noted(contents and cgnd hon of car performed hereunder shall be subject to all the bill of lading terms and conditions in the governing clas- tents of packages unknown),marked,consigned,and destined as indicated above which saki carver stricabon on the dale 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 deal!. governing classification and the said terms and conditions are hereby agreed to by the shipper and nation,If on its rase,otherwise to deliver to another carrier on the route to said destination.11 Is mute- accepted for himself and his assigns. ally agreed as to each carder of all or any of,said property over all or any portion of seed mule to des- SHIPPER 1 Z_�p I - CARRIERc� PER PE - I DATE /Z Permanent post-office address of shipper. /�'► _ , STYLE F365-3 0 2003 LABELNIA5TER Of, (800)621-5808 www.labelmaster.com