COMPLIANCE INFO_2023 - Laserfiche WebLink

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THISSHIP, �p q p i ii7 �'I�j must be legibly filled In,In Ink,In Indelible Pencil,or In S UIIP,NII GG Ohlll�ER Car bon,and releined by the Agent. Shipper's No. Carrier`a,�"�c,_r :i q�r;r t r.,•:' : - _. 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 rates,classifications and rules Thal have been established by the carrier and are available to Ilia shipper,on request;and all applicable stale and federal regulations; at date from Ilia 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 properly under the contract)agrees to carry to delivery at said destination,If on 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 said Properly 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 himsell and his assigns. TO: FROM: r _ Const nee SKY ENTERPRISE Shi er 'HAtNL DitVEkiEST .7, Street Street Destination _ Zip Origin Zi Route Delivering Carrier Vehicle Number U.S. DOT Hazmat Reg. No. Number • Type HM I.D. s Description of Articles of Packages Number NIA GRAINED USED CAL FILTERS R TRACTOrR RAk4,75 00 NV,RONMEiv t AE.SERVICE!, Remit COD to: SuUlea toe d liv r 0l coUie cns,if this COD FEE: shipment a to be delivered to the enor, the 1 -OD AMT. Address: without recourse on the consignor, the v consignor shelf sign the following statement. Prepaid EJa comer shall not make dellvery of Ihts City: State: Zip, shipment without payment of freight antl all $ Q OldCollect ❑$ liar lawful charges NOTE;Where Ilia rate Is dopendent on value,shippers are required to stale 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 staled by Ilia shipper to be not exceeding S Per (Slgnoturo of consignor) $ ❑Prepaid ❑Collect NOTE:Lie Ty Limitation for lose or damage In this shipment may be applicable.See 49 U.S.C. "DIRIVER'S 14706 e 1 A end B. SYSHIPPER ❑BYCARRIER This is to cerlily that the above-named materials are property classified,described,packaged,nmrkedand labeled,and aw in prupel condilion far Iranspodalion according to Iha applicable regulations ofthe Depamnenl of Transpodaliqu.Per SHIPPER:' CARRIED:_ PER: DATE: PER: DATE: EMERGENCY RESPONSE NAME OR CONTRACT NUMBER TELEPHONE NUMBER: OR OTHER UNIQUE IDENTIFIER: 969(Rev.3/17) rO•) ��Agent must detach and retain this Shipping Order and must sign the Original 0111 of Laming. i ,I