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t f r ( f r I r It f f f <br /> Copynght 2017 J J.Keller&Msociales.Inc •Neenah.WI•JJKellertom r(8001327.6B68 r Printed in the USA <br /> � 11 <br /> STRAIGHT BILL OF LADING-ORIGINAL-NOT NEGOTIABLE <br /> Shipper's No. 1-21-4 <br /> Carrier n1► SCAC <br /> AECEIVEq,subleci to indnrklus6y determined rates m Cdnlnl Inas have been Carrier's No. <br /> es>mClrahed by the tamer and are avaermi a hhe shi upon in writing between the carrier and sthipper,It applica6l9,atherwase 1d the rates,classilicatiw[s and rales the[have been <br /> peer,can request;and all applicama slate and federal rogulations; <br /> at date from T +mss <br /> sherP pparty decry bed below,hn apparent good older,01Mas noted( sole and Corhdotion PI conlen$al packages unknpwn),rnarkBd,consigned.and desk <br /> (the word company being understood Wwoughoul this contract as memmh ng any person or gn neo a6 indicated below,which Bald,iTonicompany <br /> Fwe,to otherwise 10 deliver m anohher ramer on the route 10 said destination It is mutua y agreed <br /> a ut r 1 a property under to centradr agrees to carry t01 said to l said deinatio. ii a its <br /> each Party at any SNha Interggted m call Of any 01 said p that evo �`a9 as to each carrier d ell a any a!58itl Property near 81I or edit pprlrbn W&81d route to destinalidn,and as to <br /> Y ry sgrvice to be Performed thererandlsr Shall be subiac9 to all the Coeddlons riot"tiled by law,whOther printed or written.herein <br /> ° .uhGuehng Vh0 canddiprhs on the back hereof.whips are bare agreed!o by the shipper and accepted to himself and his asshgne. <br /> T°' <br /> FROM: <br /> Cgnsi nee Shiver C <br /> Street 1`] t street [ <br /> #3estinatiort Zi 9 a 1 Oftin zip —? <br /> Route <br /> Deliverirsg Carrier Vehicle Number U.S.OCT Hazmas Reg.No. <br /> � l 4 <br /> SO4-t 1b <br /> Remit CO ❑. q".11 7 o 30 tm nor A n CDD FEE: <br /> rhiPmenr rP re e.n.eraa ro�.cros.0'. CVD AMT: <br /> w room r.cowra nn trio o.rlgnar,hhr <br /> Address: '""mow r����,"""; Prepaid ❑ <br /> Cit State: Zi 9AIP-4 wnhcW"ympnh r 'o <br /> MMr WNW rr. Q- <br /> NOTE Wn"the rale hs dependant i[ally in wnhng T� �$• <br /> tha agreed or decla The agreed or declared value of be Pnopedy;5 FREIGFkT CI'iARGES• <br /> naretrY spec staled by the snapper to be d ng E Per ti r Pr id Collect <br /> HOTEc t �EtnYhUrm Sa love w damrhpe in!Ma ahrpnhent,rtiayyy�pplkabk.See 3Y U.S.C. •e <br /> :..:rAty ftst rr.hvrr+wbe nubnels an prap.nN Oheealw.E.dmlcrhbon,ueckagen r •e s SY St11PPER SY CARRIER <br /> -u,r.cc un i.t+e' o+d err M proper cniwnron kx Ira trot_•r scrrrn�n.t h,�!.c=p[+a,Hlrr � ! 6RlV <br /> ,nr�.+h_.., +nr�y.•rr.wnr W irdre5p[Atd6on oar /LJ 516t1A <br /> SHIPPER. ham'' � CARRIER; �^5 <br /> PER: DATE: 8 PER: DATE: � � <br /> EMERGENCY RESPONSErf� / NAME OR CONTRACT NUMBER � <br /> TELEPHONE NUMBER: O /�,7�3 ' 6D 60 OR OTHER UNIQUE IDENTIFIER: <br />