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1 STRAIGHT BILI OF LADING-ORIGINAL-NOT_NEG©TIABL.E <br /> Shipper's No. <br /> Caller gftftl Carrier=s No. <br /> RECEIVED,suh)eci to lndividuaky dalarmined rates or carrtraets shat haw peen agreed upon in writlap between the carrier and shipper,If appinble,Nherwi3a to thu rains,clamitiica beret and rules 11131 hava been <br /> established by the canter and are avallat"to the ahlpper,un raquesl;and all appkable state and federal reguktlnrna: <br /> 1 <br /> at date from <br /> the Property described below,to apparent good order,except as noted(contents and condition of contents of packages unknown),marked,0011 prod,and destined as ImEcaled below,which sold <br /> (the word company being tudennood thragfrout this mnbart as meaning any person or mrpamWn In pesaasslon of the property under the conWdd)agrees to carry to dekvwy at saki dooffnaticn,if on its <br /> route,or otherwise to deliver to another carrier on the route to said des n.hrM t is mtAuagy agraed as to each carrier of all or arty of said Property over an or any portion of said route to desf nation,and" <br /> s to <br /> par <br /> each ty at any time Interested In ell or any of said Property'that every ahag enica to be performed hereunder sbe subject to all the mndMk=Trot prohbfted by law,whether printed qr written,herein <br /> wnlalaed,incl the conditions on the beck haraof,whk;b ars hereby=nW to by the ilibipper aid led for himself and 1tLi <br /> TO: V15&� � r i SnIS' FROM. <br /> o : rxs�.L o33 i f�` df�C h4ci-o <br /> Consignee Shipper <br /> Street Street �i G Jit/ <br /> Destination zip Ori in - Zip �.� <br /> Route <br /> t Vehicle Number U,S. DOT Hazmat Reg. No. <br /> Delivering Cartier <br /> i <br /> D <br /> / / <br /> 1 <br /> 4 <br /> l <br /> Remit COD to: ie� 7 01 If COD FEE: -- <br /> m be WLn/ra9 14 the COD AMT: <br /> wahoat IV..... ern the oenaipnar, ih. <br /> Address. L� cwnic f m did Prepaid 0 <br /> CI State: ZI : / �a 3n.nl of tal(fh1 and oil $ Collect ❑ <br /> NOTE Where the rate is dependent on value,shif"re are required to slate specifically in writing TOTAL CHARGES, FREIGHT CHARGES: <br /> the agreed or dedarod value of the property.The agreed or deciared value o1 the pnrporty is _ c� <br /> hereby spedffcally staled by the shipper to be not exceed rig S per fspnanra m cc irryyq W Pre Id GGlleet <br /> tiLFTE:LFabi11t1f LlTntaton for lase or damage in this shipment may be appllcable.See 49 U.S.C. -a <br /> t4 e t 4 end i4 WP s 11 HY SWPER ®®YCARRIERMe Is to candy that W abova-mmed materials are prapedy classdted,&—mibed,packaged,marked <br /> and ldbefed.and aro fn peeper rond6on for nittipenattgn according to the applicahfe regWAaom efGfiNER`5te Department of Transportation.Per SIGMTLRESHIPPER' % Jr GA <br /> PER: DATE: PER: d I - . DATE: !?- <br /> EMERGENCY RESPONSE NAME OR CONTRACT NUMBER <br /> TELEPHONE NUMBER: OR OTHER UNIOU€IDENTIFIER: <br /> 29-Bt-S-C3 969(Rev.9/t 0) rI <br />