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This Memorandum is an acknowledgment that a Bill of Lading has been Issued and is not Original Bill of Lading,nor a copy or duplicate,Covering the property named herein,and is Shipper No. intended solely for filing or record. ADVANCED CREWCAL TRANSPORT, INC. Carrier No. Page Of Date 1x1211"17 {Name of tamer} 1f(SCAC) Or m Je6"ry shipments.oto letters'COD'must appear before coneipnae's name or as otharwise prowled h Item 430.Sec-,. FROM: honk y� U•a M&d a^'hwd Dn d 1 NO) TO: iR9f " Ur ifld School tient==i Shipper Consignee 2211 W ,D..JA� ve Street ImnWca CA Street j� City State Zip Code City State Zip Code 24 hr.Emergency Contact Tel.No. Route Vehicle Number No.of Units H M BASIC DESCRIPTION TOTAL QUANTITY WEIGHT CHARGES &Comainer Type UN or NA Number.Proper Shipping Name,Hazard Class,Pecking Group (weight,VDlun]e, (SUoject to RATE ro Camlc• Gallons,etc.) Correction) JSe Or,:yl PLACARDS TENDERED: YES » NO O REMIT Note—(t)where the rate is ceperrdem on value.shippers are required b I herahy,declare that the tomenta d this stare C.O.D.TO. specifically in wng rmthe spread or hr clattered vee of ld the Property,as brra"The consigrmenl are fully and atturelaiy ADDRESS agreed or declared value d dte Property a hereby sp�ly stated by the sh�par to _ be not exceeding pa"_* � described above by the proper 5hippnppackaged, -- C.O.D.FEE (2)Whm,om.applicabla lartfl PrDyialDme spotlly a lmrmtion of the tamers habil ebsert name and are classified, packaged. cob--,----.. - PREPAID ❑ - r'f' maAed and labelletllplecarded,and ereAmt: N a release or a value tleclaration by the shipper and the shipper does not raiser - COLLECT❑ $ the Camara liability Dr declare a,aloe,the ranters limWity she]oe IimHad to dee etdem In all ort according s proper mappAC for transport naito applicable Subirrd m S.mm 7 or tt+a-an tnena.'1f.g,a i,j e n. g a aetvered m me TOTAL (3)C etl by saes ragwrrons.See.0,O hem 1TL V,la/lmon al end national govemmertal "'ui1eW_ arm m Ina w�ap.ror.try cmNgna ehNi Sign the CHARGES $ m t be SO ma u rl and g spatia a a0�ral ase m aaarmon in handling io etorrrng regulffiions. �Theg=llh"s1men-as nor mat.dslW of the sh mem witnoui must be so rrwtad and packaged as bnd SO Wets a of charges Sea ecton tie)of ry rP Payment or Rem contract ctlT r as and,Freight sus arta uher]r,�d charges antl Seceon 1(a)or Ireigrn arch]at,ar igrvlye charges. FREIGHT CHARGES RIEIGFTT pITEPruD t7sor cre]d*rges the Corstrect 7emr end Cprrdrlbr*a for a fiat d ntGt asides. Signature etart""ra`bas at Fi eat Se�prrewe a Coi.i(<grP V"is of wired RECEIVED,subject to the classifications artl*ft it elfeC on the date of the Issue of dais ai-of t.adI ng, tinalion and as to each parry al any time Interested in all or any said property,that every service In me Property descnbDd above in apparerd good aft,*wept as noted(conterrts and condition of con- be performed hereunder stint be s to di the blll d Adn leans and gprotions in the p tent.of patla as uniarwn).marked,wed,and destined as indiralyd soave.1h-h mid vainer u6lerl g pwamn des, {the worn tamer tnFq lattlareloptl o,rorghoul Iltfe rnNaR as rreanstp emY parson or corporation In sinmadon on the date of shllrnant- posseseon of tits property Inder Yrs mriraGy aper b carry to les uerrl phew d dekyey et sob des#- Shipper herody cadltes that he S familiar with all ire ladirrp Mrrrtc and conditions in the rvllor.H m is rade,arlrrwlm to tlefrer b anof]tie tinter m ate mea b nitl dastlradm.h�s muar gwem:g dasmhcatlm and the sea terrrn and mndtort]are Hereby gaetl ro by a,a ahippu and ally agreed as to each carrier Of SH a airy o!,Wed pmmperty,aver al Or Wry,porion of said route to der acceptedhirrrseM and hes assigns, F ,ER U3ntK3 Udii("_S :tK"DktF1Ct rSSO ifigh) CARRIER AdvanCW Cher!" Tran$W., Irm. PERi V DATE Permanent post-office address of shipper. STYLE P375-3 02Dt2 LABEAASTU it r600;621-5808 www,labolmaster.com veel'*ED ON r-cCVCIEe MiFR m1:D WIrN QP usws soyervur we SOY INiC