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THIS MEMORpNOUM Is an aclmowochimment that a bill oflading has been issued and is not Ute Original Bill of Lading, nor SHIPPER NO.
<br /> a copy or Motorcars, covering the property named headstand is intended solely for filing or record.
<br /> I IV
<br /> VF
<br /> - ;, y _ ; CARRIER NO.
<br /> _ ! . . r '�(, r . . . .. DATE
<br /> SCAC
<br /> ® FROM
<br /> :ONSIGNEE SHIPPER
<br /> is
<br /> TREET STREETA-TIrl
<br /> _- r, Na
<br /> IESTINATION 3 STATE ZIP ORIGIN - t f %STATE ZIP
<br /> tOUTE VEHICLE NUMBER O'S, 50 IV H4,1_/Frini Ni,
<br /> My gum
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<br /> ;� 59 b �r ,1 ;=1e . . I f� t , r. , c;.,ri 7 :,_ , : IFL
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<br /> A 'D Ifr � _ , h- ;ip ±
<br /> eb
<br /> !x i7 , r a H!ti.t a -.c V I ( v r,1 t Af El V10-de �y as (Gr,
<br /> tY /,76 ?� 5 . . ,( L`- � . . - ,
<br /> Et
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<br /> remit COD to: shipment is to he delivered th." �'aaala COD FEE:
<br /> ddress: g �efaoe�h ew �ger AMT:
<br /> The a shall neo make delivery, of hire
<br /> Prepaid ❑
<br /> ity: State: Zip: observerpa ma^' nf imight a e ouar $ Collect ❑
<br /> DTE: Where the rate is dependent on value, shippers are requiredW state specifically in writing the TOTAL CHARGES: FREIGHT CHARGES:
<br /> Ireed or declared value of the property. The agreed or declared value of the property is hereby dM..
<br /> ecifically slated by the shipperto be not exceeding $ Per (Statists of Consign $
<br /> or) ❑ Prepaid E] Collect
<br /> :GEIVED, subject to Individually delineator rates or wrands Ilial have been induced upon in vrtNng behoeen the wirier and shipper, g applicable, oNervnse to Ne rates, daerihratlons and mics that have been established by Ne tamer and are warlabh
<br /> Me shipper, on requesh and all applicable slate and reactor regulations; Ne Properly described above, in apparent med other, except as noted (coeloms and contlNon of contents of packages unknown), maM<ed, consigned, and desired! as Indiwtcv
<br /> ova whidr said company (Ne wood company being wMemlred throughout this contract as meaning any parson or cepototion in possession of Ne properly under Ne conhad) agrees to many be denary at said destination, if o^ its mute, orolhenvice it
<br /> liver to another carrier on Ne mule to said desdnanon. It is comedy agreed as to each comer of all or any of sold Property over ail or any potion of said mute to desfinabbn and as to each party at anytime Measured in all or any of said property Mat even
<br /> ce to he pedormetl hereunder shall be subject to all the con itions not prohibited by law,whether printed or cause, herein conather d, including the conditions on nee back hereof, which are hereby sound! to by Ne shipper and accepted for himself and hi:
<br /> signs.
<br /> )TE: Liability Limitation for loss or damage in this shipment may be applicable. See a U.S.C. 147016(c)(1)(A) and (B).
<br /> tis is to certify that the above-named materials are properly classified, described, packaged, marked, and labeled, and
<br /> 'e in pi ops r condlkipg; rAa �adap©sU %rie * llUI ralare12e 49
<br /> HIPPER: CARRIER:
<br /> / PER:
<br /> DATE
<br /> :
<br /> :AAERGENCV RESPONSP;? I r. . - r NAME OR rCORMTRACT ;�,tUNIEfix i3
<br /> 'ELEPHONE NUMBER: OR OTHER a1 f1 UE IDENWIER,
<br /> 1 -BLC-03 12267 (Rev. 9/10)
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