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0 s 0 • 0 r s i • 0 0 . w -4 0 Copyrighl2010 J-J.KELLER&AS=ATES,INCA Neenah,Viii•USA•{Wo)327.6068•bkeaer.com•Ponied In Iha Vnaad States STRAIGHT BOLL OF LADING-dRIGIHA�-HOT NEGOTIABLE Shipper's No. I �.• Carrier_P �� I�r s�n 5 ��pt/SCAC Carrler'S•NO.1 the rates.claSSd calbns and ruses that have been RECEIVED,subject to ino Ily determined rates or cont, that have been agreed upon in wrring between the cameo r1d shiPP4r.i!applicable,olhefwf5l k- estahrc4hed by She carnen and are available to the shipper,on reQuesl:and all applicable Stale and federal regulations, - r I J � rom a at �BD0 L,AJ — 4, l�► LICJEi1_' data ^' r u mown].marked.cans goad.and desti Indicated beiav+,which said CvmpgpY the Property oescnbed below,m apparent good order,except 'noted(contem condition o!conlents of packages under the contract)agrees to Carry to delivery al said desarratlon,+f an its tthe ward corroany being understood Ihroughoul this contract as meaning any person or corporation in possession of the property over all re any p r of said roue to destination,and as to rMABeach.or❑Ihe h party ata y hmeemerested in all or aner lo another y on 1he of said Pn B to That evtnation.MI is ery service to mutually 11y rfoormedgreed ag to each hereunder�shallf Of all OF any of saild be sub W to all thepropaq m dit ons not prohlbiled by law.*he primed W wrl-n-bora'" CanWried.including the contdlpom on the back hereof,Which e hereby agreed 1114 the performed hopper and accepted for himself and his assigns TO: -� FROM: Consignee I r ❑ or Street 307,01 041ve Street (] Destination Zi Origin l Zf Route Delivering Carrier Vehicle Number U.S.DOT Hazmat Reg.No. Weig Class orhti Number and Type 1. • HM ' D. of Packages NumbL 7-7 Remit COD to: s ei.fl a�t� roM6 K �. COC FEE: 5riIft VI�t to hoe tlN�rored to the conuq�IM CSD AMT: elmvw r r,e on,ne cvna�gnvr, me Address: g,s ems'I, , Id �slax ,fit Prepaid El City_ State: +h•y nen,w,owul veymem ane aII Coll@Ct $ o.br Ix.ew en.ry., ^NOTE Where voe fele ss d[;Pendent alua s are required Ie state SpeCiticalty in writing OTAL CHARGES.• GHT CHARGES: Phe 89,616 of clamed Iralue of Iha Pr The agreed of declared value al the PrOParry Is rrerat?y 5PNA CO14 Staled by 11.: er to tie nd edmg S Per �s,a�wre or ca��cnnrr ❑Prepaid ❑Cd lw pCiTE:Wabildy L-- r low ar l visas In thin ftlllpc<t may be applicable.See 49 ULS.C. td'1 c 1 A a BY SHIPPEA ❑SY CABRIEg alai Nw saorwwmrd rtulwlrY ue❑nq,elly r] aha po} demarked ! DRVER'S wm acCPrdiIyI 101cable requalions e1 Orr d TII4WW 1• Pm f SIGNATURE; SHIPPER: Tyrf` L'�rl - �--+�� CARRIER: S v DATE 7 ` PER: DATE: -/ 7 PER EMERGENCY RESPONSE NAME DR CONTRACT HUMBER TELEPHONE NUMBER: DR OTHER UNIQUE IDENTIFIER: 436(Rev.9110)