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C Copyright 2010J.J.KELLER&ASSOCIATES,INC.6,Neenah,WI•USA•(800)327-6868•ljkelleccom•Printed In the United States - <br /> STRAIGHT BILL OF LADING-ORIGINAL-NOT NEGOTIABLE <br /> Shipper's No. <br /> CarrierII 252 ; T 24�Q17tZT SCAC Carrier's No, ` $ <br /> RECEIVED,subject to individually determined rates or contracts that have been agreed upon in writing between the carder and shipper,if applicable,otherwise o the rq_les,classifications and rules that have been <br /> established by the carder and are available to the shipper,on request;and all applicable state and federal regulations; <br /> at ``��r��i„� ��1�I� J r:—.,�, date - IJ.- (( from <br /> the Property described below,in apparent good order,except as nolied(contents and condition of contents of packages unknown),marked,consigned,and destined as indi to slow,which said company <br /> (the word company being understood throughout this contract as meaning any person or corporation in possession of the property under the contract)agrees to carry to delivery at said destination,if on its <br /> route,or otherwise to deliver to another carrier on the route to said destination.It is mutually agreed as to each carder of all or any of said Property over all or any portion of said route to destination,and as to <br /> each parry at any time interested in all or any of said Property that every service to be performed hereunder shall be subject to all the conditions not prohibited by law,whether printed or written,herein <br /> contained,including the conditions on the back hereof,which are hereby agreed to by the shipper and accepted for himself and his assigns. <br /> TO: FROM: <br /> Consignee rV\ Shipper — •� <br /> Street I JC Street $ 5 <br /> Destination C:A ZiP CfD7 2 Origin -7 Zi5 <br /> tj <br /> Route , <br /> U r'& <br /> Delivering Carrier Vehicle Number U.S. DOT Hazmat Reg. No. <br /> Number and Type I.D. <br /> DescriptionoiPackages HM Number <br /> EsT <br /> NON- 1­�-1zaRi�OUS L. 1 tUli � X Y,,sa0 �u(I <br /> I L c l e_ <br /> 1-z-S J O� <br /> �9isa <br /> Remit COD to: Sublect to section 7 of conditions. I Ih.s <br /> shipment Is to delivered to the consignee COD AMT: COD FEE: <br /> s: wllhout recourse r, the <br /> conal nor shell elfin Ute lollowing wmeme ❑ <br /> City: State: �„a earner Gwll not make deiwery of this re aid <br /> Zip <br /> : shipment wllhoul payment of freight and it <br /> NOTE:Where the rate is dependent on value re required to state specifically in writing other lawful charges Collect <br /> the agreed or declared value of the eny.The agree d value of the property is TOTAL CHARGES: <br /> hereby specifically stated by the per to be not exceeding $ FR CHARGES: <br /> NOTE:Liability Limits or lose or damage in this shipment may be applicable. <br /> 14706 c1 A an U.S.C. 'g""lure of consigrwr) ❑Prepaid Collect <br /> ,s <br /> This is m Vial the above-named materials are properly classified,descdbed,packaged.marked .s '' e IPPBR�e gY an led,and are in proper condition lot transportation according to the applicable regulations of CARRIER <br /> a s 1 DRIVER'S <br /> Department of Transportation. Per —1 gEVVV <br /> SIGN E: <br /> SHIPPER: "' CARRIER: £iPl1 / 9e <br /> PER: T DATE: -7 b–(9 PE DATE: — <br /> EMERGENCY RESPONSE Qq I <br /> �A��TELEPHONE NUMBER: OU/ l� _,0�OOR OTHER UNIQUE IDENTIFIER: <br /> 136(Rev.9/10) <br />