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to ^`°,' .,� b �s..` T <br /> =z.. . _ <br /> STRAIGHT ILLIll LADING <br /> ORIGINAL-NOT NEGOTIABLE Shipper's NO. — <br /> CARRIER: <br /> is <br /> Carrier's No. <br /> CARRIER: SCAC Date <br /> C®sigreet ' `• Y� FR®IUI: rte. 1/" sg : /'� <br /> 1 d Shipper 1 ,� fir" P1, <br /> Street Street <br /> Destination `' I "' � Zip ��w <br /> Origin ,ti Zip <br /> Route <br /> q2_1 Solr-- Vehicle Number U.S. DOT Hazmat Reg.No. <br /> �u ®® •® .- <br /> e, r,"l <br /> 1 1 <br /> i <br /> 0 <br /> ) u <br /> j <br /> Remit C.O.D.to: C.O.D. Amt: C. 0. D. FEE: <br /> Address: Prepaid <br /> City: State: Collect $ <br /> Zip: <br /> NOTE-Where the rate is dependent on value,shippers are required to state specific-ally in writing Sub, llo$ un]ollhs scr IIF hpmenl L-Io usdeReredlothe—gneebahoutameursaonme FREIGHT CHARGES o <br /> the agreed or declared value of the property. The agreed or declared value of the property Is rte° IFn a k ld+,ery cl this sh ng sla'emerl <br /> hereby specifically stated by the shipper to be not exceeding $ Per pmoollsAhcnlpa>mamonre.gnlandelamerlanmich rges PREPAID COLLECT <br /> (Signal eel Con.,gno0 ' <br /> 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 Where the applicable tariff provisions specify a ; <br /> rules that have been established by the carrier and are available to the shipper,on request;and all applicable state and federal regulations;the Properly described below,In apparent good order, limitation of the carrier's liability NMFC Item 172), <br /> except as noted(contents and condition of contents of packages unknown),marked,consigned,and destined as indicated below which said company(the word company being understood if there is no release or value declaration by the <br /> If roughout this contract as meaning any person or corporation in possession of the property under the contract)agrees to carry to delivery a(said destination,if on its route,or otherwise to shipper,and the shippei does not declare a value ".: <br /> deliver to another carrier on the route to said destination.It is mutually agreed as to each carrier of all or an of said Property over all or an or release the carnets lability,that liability shall <br /> Y p y y portion of said route to destination and as to each be limited to the extent provided by NMFC Item ;a <br /> P <br /> arty at any lime 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 172"California intrastate shipments must comply <br /> contained,including the conditions on the be."hereof,which are hereby agreed to by the shipper and accepted for himself and his assigns. with NMFC Item 173. <br /> NOTE Liabl Illy Limitation for Ions or damage In th le shipment may be applicable.See 49 U.S.C.14706(e)(1)(A)snd(B). } <br /> This <br /> to can ty that the above-named materials are properly classified,described,packaged,marked and labeled and ar <br /> h proper couddlon lir transportation according to the applicable regulations of the Department of Transportation. r ® YES NO-FURNISHED BY CARRIER i <br /> Par , . ® e DRIVERS SIGNATURE: <br /> SHIPPER: fv �J i^E rte �✓ ✓u: ARRIER: <br /> g-3 <br /> PER'' DATE: PER: DATE: / <br /> 4 ENdER�EDVCY RESPOP➢SE rr��y f- 4Monitored at all times a Hazardous Material is in transportation r <br /> I o�.�EPHONE 6�UMBER ( t✓�) ��� including storage incidental to transportation(172.604). <br /> ri r a � •� ;� � ® ' ' ®® t _ alt; ; <br /> ' E <br /> I <br /> I <br /> F <br /> i <br /> : <br /> 4 <br /> Y <br /> E <br /> E <br />