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STRAIGHT BILL OF LADING -ORIGINAL-NOT NEGOTIABLE Shipper's No. Carriers nj4e-� SCAC Carrier's No. RECEIVED,subject to individually determined rates or contracts that have been agreed upon in writing between the carrier and shipper,if applicable,otherwise to the rates,classifications and rules that have been established by the carrier and are available to the shipper,on request;and all applicable state and federal regulations; n at , date fro G'�L �322�5 the Property described below,in apparent good order,except as noted(contents and condition of contents of packages unknown),marked,c igned,and destined as indicated below,w Ich said company (the word company being understood throughout this contract as meaning any person or corporation In possession of the property under the contract)agrees to carry to deliveryal said destination,Kon Its route,or otherwise to deliver to another carrier on the route to said destination.It Is mutually agreed as to each carrier of all or any of said Property over all or any portion of said route to destination,and as to each party at any time interested in all or any of said Property that every service to be performed hereunder shall be subject to all the conditions not prohibited by law,whether printed or written,herein contained,including the conditions on the back hereof,which are hereby agreed to by the shipper and accepted for himself and his assigns. TO: FROM: Consignee V e-o.-P/. .i7 1 Shipper e ,9tel? cam. Street Street 1 r ~it Destination :;1p Zi e�dy 5—te%l Origin Zi S Route Delivering Carrier Vehicle Number U.S. DOT Hazmat Reg. No. ez -....... _.. ----- -.-.... s/ris �� Remit COD t0: Sub)ecl to Section 7 of conditions,it this COD FEE. shipment is to be delivered to the consign.. / -®® AMT: A ,.1 wilhoul recourse on the consignor, the v ddress: consgnor shag sign the to]owing statamen Prepaid ❑ The carrier shall not make delivery of this City: State: Zip: shipment lchrge payment of height and all � Collect ❑ other lawful charges. �P NOTE:Where the rate is dependent on value,shippers are required to state specifically in writing TOTAL CHARGES: FREIGHT CHARGES: the agreed or declared value of the property.The agreed or declared value of the property is hereby specifically stated by the shipper to be not exceeding $ Per (Signature of Consignor) $ ❑Prepaid ❑Collect NOTE:Liability Limitation for foss or damage in this shipment may be applicable.See 49 U.S.C. Ma p 14706 c 1 A and(8).t .e .. 9 ❑BY SHIPPER ❑BY CARRIER This is to certify that the above-named materials are properly classified,described,packaged,marked and labeled,and are in proper condition for transportation according to the applicable regulations of P ® DRIVER'S the Department of Transportation.Per SIGNATURE: SHIPPER: �rC>.f ' • pCAR ER�=:w TPER: DATE: DATE: ;t h r =,MIHt IGENCY RESPONSE _NAME OR CONTRACT NUMBER id�Wr.-.Rs,-tt�ME F"'U LSEER: i�tSJ,� ��Jc� � OR OTHER UNIQUE IDENTIFIER: 1-BLS-C3 969(Rev-9/10) T