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�� �� p�t f� is an acknowledgement that a bill or lading ha.been Issued and 4 not ttw Original 8111 al Lading•not a copy -- <br /> f� Jr'� tjf t,+lf or dupll0a!a,covering the property named heroin,antl Y intended nobly for filing or record. <br /> Shipper's No: <br /> x <br /> SCAC Carrier . . ;t a . r ' -,��.� �t ; `, tom'{ I��, Carrier's No. <br /> RECEIVED,subject to individually determined rates or contractdthat Kave been agreed upon in writing between the carrier and shipper,if applicable,otherwise to the rates,classifications and rules that have been <br /> established by the carrier and are available to the shipper,on request:and all applicable state and federal regulations; <br /> at <br /> prpporty do—bed below.n , date from <br /> appOrcnt good ower.CXcept i noted(contents Ord con6uon of contont;W padngm unknown),r a wd.conJgnod,-W dcsened as Indlemod bebw,which said cortparry Ithe wow company being urWpn:lo0d dv0ugnoN the <br /> contract as moaning any Po�or COWMIbn n pr.-o0 pion of the property uMOr the Oo9-1)agrees to=my to dok eq at saW daadnaton.U on iM mWO•W othendso 10 tl�uw`r to another cuYOr On the route b said destutaaon U is mutually ad Ihro as o each <br /> rarrbr Ol aU W any W cdd property own oU or wry portion W=W roub b Omtmilon mW os b each parry m any tore IniorO-ted if aU or a y W said Fopony trot awry cervm to bo ponOrmW heroundor chaa bo subloct to aU'-it""I nm pmtibbtl by law• <br /> whOthW pnnWd o`wr,non,Mrok,mntanod.Indutluto the eorWluons on tnp bade heroof.wnieh aro hereby agreed t0 by rho shipper and=Owed for hlmcoU and n4•aeclgr>;, It- <br /> TO: .3t ` L �..,;c . ,.,.; c..: FROM: <br /> Consignee Shipper <br /> Street =i Street <br /> Destination <br /> :` Zip '14s Origin Zip �- <br /> Route <br /> Delivering Carrier Noor us.00Thw�n t -i <br /> Rog.Number l <br /> -.r 1,2�1ik •- <br /> �C>= t- - !�t ,t;t? 1 ,, r-• .C•,�`�._s�'� �{� �� -�`l`lC- L;.C; � ' j Lj..` I < <br /> ✓ �t - h 1�.,rr 1: ll.t� J ,�• .1t �Gti c [~c ? <br /> f !��-I 4 l h _� L �r <br /> � f <br /> -e <br /> t a <br /> r a <br /> i <br /> Remit COD to: $ublad to Soction 7 Of condtfloos.it[ht. <br /> shipment o o bo dcllwrhe to the concignW CODAMT <br /> COD FEE: <br /> Address: wuhoit retours0 On the consignor, the <br /> constr�rlor;lollsegn,he 101Zing GfabmenC <br /> City: Tne cu W snail wt make.10.1 Z",of U G $ Prepaid ❑@@ . <br /> State: Zip: chipmont wItho.1 payment of Irolgnt and all Collect ❑�p <br /> cenw i.Mul char os <br /> NOTE:Where the rate is dependent on value,shippers are required to state specifically in writing <br /> the agreed or declared value of the property.The agreed or declared value of the property iTOTAL CHARGES: FREIGHT CHARGES: <br /> hereby specifically stated by the shipper to be not exceeding$ Per (sicnaturo a CnnnlryWn $ El Prepaid !Collect <br /> NOTE:UabiA u d(S lon for loss or damage in this shipment may be applicable.Seo 49 U.S.C. .n <br /> This is to Certify that the above-named materials are properly classified,described,pat ,gsd, PLACARDSt ❑BY SHIPPER ❑BY CARRIER, <br /> markod and labofed,end are in proper condition for fransponarion according to rho applicable REQUIREDDRNER'S <br /> rcgufaflw,s of the Department of Trans po;W1wn.Per ]SIGNATURE: <br /> SHIPPER:ri. ' r <br /> _ _ CARRIER: : <br /> PER: DATE. - PER: K, DATE r ,i <br /> EI4tErGEfdCY ®NSE <br /> :SAME C r CONTRACT NUMBER <br /> f ELEPHCNE NUMBEF, r• <br /> w <br /> CROTiPER"UNIQUE IDENTIFIER- <br /> eALS- <br />