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STRAIGHT BILL OF LADING-ORIGINAL-NOT NEGOTIABLE Shipper's No. Carrier /c'r7(-)1, " A51yC,1.12P%01&-f ty ` 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 rales,classifications and rules that have been established by the carrier and are available to the shipper,on request:and all applicable stale and federal regulations; at , date from the Properly described below,in apparent good order,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 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,lion 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 sold 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 , n s Q J r 1 Shi er ' c Street Street 11 1--e y 1�aL Destination Z u Zi Ori in I G Zi 4S�Z Route Delivering Carrier Vehicle Number U.S. DOT Ha?mat Rey.No. ------------ -MENNEN �. 25 Remit Subject to Section 7 0l Conditions,it this w®® FEE: Remit COD to: shipment Is to be delivered lC the consigneeCOD , edlhoul recourse on the consiCgnor, the AMT, Address: consignor shall sign the following statement: Prepaid ❑ The carrier shall not make delivery of this th City. State: Zip: shipment without payment of freight and all Collect El$ other lawful charges. 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 loss or damage In this shipment may be applicable.See 49 U.S.C. 14706 c 1 A and(BI. ., ,, e ❑BY SHIPPER BY CARRIER This Is to certify lhat the above-named materials are properly classified,described,packaged,marked @ a DRIVER'S .and labeled,and are In proper condition for transportation according to the applicable regulations of SIGNATURE, the Department of Transportation.Per SHIPPER: CARR i PER: DATE: ��_ PE DATE: 14 -EMERGENCY RESPONSE NA OR CO ACT UMBER TELEPHONE NUMBER: OR THEIR UNIQUE I!ENTIFIER: 29-BLS-C3 969(Rev.9/10)