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On . • Zip Code NG - SHOI IT I 1114M A anta76 9013. 9(114 T-31i4 ' '1841, 3843 Antrio.i , ffegotiable nate Ac3 t..m. Cnrrier) L_ FROM: Shipper Street \ 4 Vt. eill of Lading No Shipper No. ( ;al r LOC\15110 if LADING - RI inn 1- In! lt" .e: Vehicle No. — SCA7----- 4.14ki Kind of Packaging, Description of Articles 1-^",0a" r'""o'ring 'f -''''I Special Marks and Exceptions stn,..ng rmlot ,nnrl,r1 er.1 orteeenz onre. See Secoon '2le) ''' ,31tirrnil r.tri ee mention e oa,yluon ry. Weight poc.1,9,41 55 rn er.sure see transno,..nor, mg iSubject to \ Rate or Class of lvlatAnnv Moor Frenfts17Ovtwocnonn, wpm au, Correctionl' CNA 6WA 0 A.)- , • \ \ i 1 \ 1 *If the shipment moves between two ports by a carrier by water, the law requires that the bill of lading state whether weight is 'carrier's or shipper's weight . REMIT C.O.D. TO: ADDRESS C.O.D. \ C.O.D. FEE: \TOTAL PREPAID 0 Amt. $ COLLECTID $ CHARGES: S Note—Where the rate is dependent on value, shippers are required to state specifically in writing the agreed or declared value of the property, Th The agreed or declared value of the property is hereby specifically stated by the shipper to be not exceeding $ per Subject to Section 7 of the conditions, if this shipment is to be delivered to the consignee without recourse on the consign e consignor shall sign the following statement. The carrier shall not k deliver.; of this shipment with payment o '' f freight and all other charges. W ‘Cl OZ\ FREIG1- Check AD ' 0 Freic (Signature of Consignor) 0 calk , subject to the classifications and lawfully filed tariffs in effect on the date of th issue of this Bill of Lading, the property described above in apparent good order. entept and condition of contents of packages unknown), marked, consigned, and destined as indicated 'above which said carrier (the word carrier being understood throughout this cor,tract as r or corporation in possession of the property under the contract-) agrees to carry to its usual place of delivery at said destination, if on its route, otherwise to deliver to another carrier c 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 arid as to each party at any time interested in ll , erty. that every service to be performed hereunder shall be subject to all the terms and conditions of the Uniform Domestic Straight Bill of Lading set forth (1) in Uniform Freight Classif the date hereof, if this is a rail or a rail-water shipment or (2) in the applicable motor carrier classification or tariff, if this is a motor carrier shipment. Shipper hereby certifies t.hat h the terms and conditions of the said bill of lading, set forth in the classification or tariff which governs the transportation of this shipment, and the said terms and conditions are here shipper and accepted for himself and his assigns. 1 I _ Mark wrth 'RD' if epee:pride, to ckeagnate Hazardrs re Materials as definer! in the U.S. Department of Trarisportatioe Regulations governing the trarisportation of hazard run materials The use of this column is an optional method for identifying hazardous materials on Bills of Lading per 172.201(a)(1) fili) of Title 49 Code of Federal Regulations Also when chipping hazardous materials, the shipper's certification statement ,prescribed in section 172 21341a1 of the Federal Regulations, as indicated an the Bill of Lading do apply, unless a specific exception from the requirement is provided in the Regulation for a particular material. The format and content of hazardous item list is the respaesialrei of individual corn-I Note: Liabilio puny interpretation of requirements as described In 49 reit., A Federal Regulations or damage 172, Subpart C-Shipping Papers. Such description consi_s ol the foitowing per See Lions 172.201 (Hazardous Material Table) and Sections 172.202 aei 172 203 may be af Proper shipping name, hazardous class. UN dentiheation numhsr. pacing graup I United Stat and subsidiary classfesl. 147G6tc (1 CARRIER PER SHIPPER PER This is to certify that the above named materials are properly classified. packaged. Carrier acknowledges receipt of packages and any required placards. Carrier certifies erne' marked, and labeled, and are in proper condition for transportation according to the tion was made available and/or carrier has the U.S. Department of Transportation ernerg applicable regulations of the U.S. Department of Transportation, or equivalent documentation in the vehicle. Property described above is received in good i Scanned with CamScanner