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. ..-1-11 1--11.,..1 1-1-1-.-1-1,- ..I Shipper No i nis Snipping uraer Carb6n,and retained by the agent Carrier No. Date Page of (Name of carder) (SCAC) On collect on Delivery shipments,the letters-COD"must appear befori i consignee's name or as otherwise provided in Item 430,Sec I FROM TO: Shipper Consignee Street ILI 1111� State Zip Code Street city City State, Zip Code 24 hr.Emergency Contact Tel.No. Vehicle Route I Number BASIC DESCRIPTION TOTAL QUANTITY WEIGHT CHARGES to No.of Units HM Proper Shippi ig Name,Hazard Class LIN or NA Number,Proper Shipping Name, (Weight, Volume, (Subject RATE (For Carrier &Container Type UN or NA Nimniber,Packing Group or Hazard Class,Packing Group Gallons,etc.) Correction) Use Only) PLACARDS TENDERED: YES =1 •NO =1 REMIT C.O.D.TO Note (1)Where the rate is dependent on value.shipp Im are required to state I hereby declare that the contents of this ADDRESS specifically in writing the agreed or declared value of the;roperty,as follows:"The consignment are fully and accurately C.i FEE rty is hereby specificall) stated by the Shipper to d scribed above by the proper shipping PREPAID C3 agreed or declared value of the property eme and are classified, COD Amt: $ COLLECT 0 $ no packaged, benotexceeding___per — . (2)Where the applicable tariff provisions specify a limitation of �e_carrier's liability absent marked and labelled/placarded,and are or a value declaration by the shipper and the sitipper does not release in all respects in proper condition for o delivered to the TOTAL :,is limited to the extent !r.P.rt according to applicable Subject to Section 7 of the conon,if this shipmenglee release I consignee withow mcotini,on th,11—iglo, the 1—g hii is,th. CHARGES S the car or's liability or dectare a value, carder's liability Sh If I international and national governmental following statement- a d a shipment without payment of FREIGHT CHARGES provided by Such provisions See NIvIF dHern 172. regulations. The shall not make delivery Of this(3)Commodities requiring special or additional care or aftent on in handling or stowing FREIGHT PREPAID Check box 11 charges must be so marked and packaged as to ensure safe transpor allon.See Section 2(e)of freight and all other lawful charges. are to be S I(a)of collect item 360.Bills of Lading,Freight Bills and Statements of Ch irgas and action I except when box at Ei the Contract Terms and Conditions for a list of such articles. Signature (Signature 01 Consignor) nght is checked RECEIVED.subject to the classification and tariffs in effect on the date of the issue of this Bill of Lading, fination and as to each party at any time interested in all or any said property,that every Service to be led(contents and condition of con- Performed hereunder shall be subject to all the bill of lading ands and conditions in the governing clas. the property described above in apparer good order,except as no ation on the date of shipment. lents of packagers unknown),marked,c risigried,and destined as indicated above which Said carrier silic Shipper hereby certifies that he is familiar with all the lading terms and conditions in the the word carrier being understood thro ghoul this contract al;meaning any person or corporation in possession of the property under the con ract)agrees to carry to its usual place of delivery at said desti- governing classification and the said terms and conditions are hereby agreed to by the shipper and nation,it on its route.otherwise to delive to another carder on the route to said destination.It is mutu- accepted for himself and his assigns. .11Y agreed as to each earner of all ora y of,said property over all or any portion of Said route to des- CARRIER C SHIPPER / PER.– PER DATE Permanent post-office address of shipper, PRINTED ON RECYCLED PAPER STYLE F365-3 C 2003 LABEJ�`IASTER 0 (800)621-5808 www.labolmaster.com �) USING SOYBEAN INK SOY INK„