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C <br /> t <br /> STRAIGHT SILL OF LADING / <br /> C K , Shipper's No. &T <br /> { k <br /> ORIGINAL- NOT NEGOTIABLE <br /> Carrier's No. <br /> CARRIER: `1r <br /> SCAC Date <br /> 65 <br /> F -pj �v G �ROIVI: f'�r✓�"p <br /> ,✓L <br /> TO: r�o✓'� — Shipper <br /> Dvwe- <br /> Consignee 91Street ��:c. <br /> ZipStreeZip Origin <br /> Destination Vehicle.num�e� <br /> w <br /> I <br /> U.S.DOT Hazmat Reg.No. MSI <br /> Route: <br /> E <br /> m X r 077 �'I t✓2�YZ1 �'r'� zt7�s^ <br /> AIR <br /> w <br /> � E <br /> f l di Aewws / <br /> to <br /> < / <br /> Remit C. to: C.O.D. Amt: P eCid®• FEE: �� <br /> i z O.D. p <br /> F , Address: Collect $ €� <br /> Clry State: <br /> Zip: FREIGHT CHARGES r <br /> O . Sublet to Batten]of the cardnbro.d ins shipment¢Ie ba daWered to the coralgnes without reWume on the <br /> m NOTE-Where the rate is dependent on value,shippers are required to state specifically in writing w igno ,.enat:gntnemoowngaaemanr <br /> the agreed or declared value of the property. The agreed or declared value of the property is Th.carne,shdlm make del eryor[asipnentwn out payzn!afhe�h;enEa oNe lawNchergu PREPAID COLLECT <br /> .a hereby spec'fically stated by the shipper to be not exceeding $ Per signzture of Con ignor) p <br /> betweenp g limitation of the tamer's liability NMFC Item 172), <br /> w RECEIVED,subject to individually determined rates or contracts that have been agreed st and alupon in lla applicable a state and federal and <br /> lithe Probe otherwise <br /> bedtbefow,anapparent c good orderations d, I re isWhere enopreleasse or value declaration bySpecif the <br /> rules that have been established by the carrier and are available to the shipper,on reque PP shipper,and the shipper does not declare a value <br /> ff 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 or release the carrier's liability,that liability shall <br /> 1. Y throughout this contract as meaning any person or corporation In possession of the property under the contract)agrees to carry to delivery at said destination,If on its route,or otherwise to <br /> deliver to another carriers the route to Bald 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 be limited to the extent provided by NMFC Item <br /> with NMFC Item 173. <br /> parry at any time interested in all or any o'b said Property that every seryice 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 ack hereof,which are hereby agreed to by the shipper and accepted for himself and his assigns. <br /> N <br /> NOTE:Ltablllty,Ltmhation for Ion or damage In this,spe iy l may be applicable.See ge,mark d and llabelej and(am ., '1 YES 0 NO-FURNISHED BY CARRIER <br /> fr This is to certify that the above-named materals ere properly classified,desalted,Department <br /> marked and labeled and are , _ , I <br /> L M In propercondition fortmnsPsnatnr accordingto the epplicableregulationsdthe Department ofTransportatan. ! ' FV` DRIVERS SIGNATURE' <br /> 3 y� Per ` <br /> s i O SHIPPER: CARRIE <br /> DATE: <br /> PER: <br /> DATE: <br /> Monitored at all times the Hazardous Material is in transportation <br /> �g EMERGENCY RESPONSE including storage incidental to transportation(172.604). <br /> TELEPHONE NUMBER: (fix ) — <br /> `x er 1 "11 <br /> t <br /> . ro rll: M ' <br />