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ALTERNATE STRAIGHT BI OF LADING—SHORT FORM Shipper No <br /> Orog�nal—Not Negotiable Carrier No <br /> J`� Date <br /> (Name of Carder) <br /> TO <br /> Consignee C ROShipper <br /> f Street Street <br /> Destination Zip Code Origi <br /> Route <br /> Vehicl�No ��� <br /> C Shirr Kind of Packaging,Description of Articles Weight <br /> f Units Special Marks and Exceptions (Subject to RATE CHARGES <br /> Correction] <br /> I <br /> I I <br /> REMIT C 0—M FEE - <br /> COD TO PREPAID 0 TOTAL II <br /> ADDRESS COD AmtCOLLECT Q CHARGES <br /> Note—Where the rate is dependent on value shippers are Sublect to Section 7 of the conditions if this shipment is to be <br /> required to state specificatly on writing the agreed or declared value delivered to the consignee without recourse on the consignor the con FREIGHT CHARGES <br /> of the property stgr;:shall sign t fog tatem Check Appropriate Box <br /> The agreed or declared value of the property is hereby specifically The cBrrrer ma deli of this shipment witho�My <br /> stated by Etta shipper to be hot exceedinga m to enc ! <br /> f <br /> $ per ❑ Freight prepaid ❑ Collect <br /> (Signature of Consignor) <br /> RECElVEO subject to the classifications and lawfupy filed tariffs in effect on the date of the issue of this Bill of Lading the property described above in apparent good order except as noted(contents and condition of <br /> contents of packages unknown)marked consigned and destined as indicated above which said camer(the word carver being understood throughout this contract as meaning any person or corporation in possession of the <br /> Property under the contract)agrees to carrytoits usual place ofdelrvery at said destination don its route otherwise to deliver to another tamer on the route to said destination It is mutually agreed as to each carrier of dll or <br /> any of said property over all or any portion of said route to destination and es to each party at anytime interested in all or any of said property that every service Lobe performed hereunder shall be subfect to all the bill of lading <br /> terms and conditions in the governing classification on the date of shipment <br /> Shipper hereby certifies that he is famibarwith ail the bill of lading terms and cordit+ons in the governing classification and the said terms and conditions are hereby agreed to by the shipperand accepted for himself and his <br /> assigns <br /> SHIPPER CARRIER <br /> PER PER DATE <br /> TOPS®FORM No 3841 LITHO in U S& <br /> rl <br />