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10 a 0 0 * • • • 0 ! • . * • • 0 <br /> 0 Copyright 2010J.J.KELLER&ASSOCIATES,INC @,Neenah,WI•USA•(BDO)327-6868•jjketler.com•Printed in the United States <br /> STRAIGHT BILL OF LADING-ORIGINAL-NOT NEGOTIABLE <br /> Shipper's No. <br /> Carrier , S CAC <br /> Carrier's No. -Y5S <br /> (!A <br /> RECEIVED.sub act t�i all determined rates ocontracts �have been agreed upon in writing between the carrier And shipper,if applicable,otherwise to`e rates,classifications and rules that have bee <br /> established by the carrier and are available to the shipper,on request;and all applicable state and federal regulations; <br /> at BDo I A J . SG41,674-1 W //U/�.t_, date 7- 17—►moi from L <br /> and destine as indicated below,which said'company <br /> the Property described below,in apparent good order,except as noted(content nil condition of contents of packages u known),marked,consigned, roes to carry to delivery at said destination,if on its <br /> to <br /> (the word company being understood throughout this contract as meaning any person or corporation in possession of the property under the contrail)a9 <br /> mute,or otherwise to deliver to another carrier on the route to said destination.It is mutually agreed as to each carrier of all or any of said Property over all or any portion of said route d oaWann her <br /> each party 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, printed <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 /> Consi g nee I to �� ems' Shipper . <br /> Street Street <br /> Destination z P 7 Ori in l Zip /.3 <br /> Route <br /> Delivering Carrier Vehicle Number U.S. DOT Hazmat Reg. No. <br /> Number and Type <br /> of Packages HM Nu er MINE= <br /> nF�eeew M ii�-6 (f--/ <br /> a a <br /> r, subject to section t of condih°n=..f Inle COD FEE: <br /> r'temlt COD tO: shipment to rs delivered had <br /> e tc Ina conalfgthe COD AMT: <br /> without re rse on the consignor,the <br /> Address: cone ^°r°" °'°°w.nge191°"""': Prepaid ❑ <br /> The carver shelf ke delivery of this �Iv <br /> City: State: shipment wdnoul payment i ht end ell $ Coilec <br /> other lewlul charges. <br /> OTE'YJr,ere the rate Is dependent alue,s are required to state specilically in writing -,TOTAL CHARGES• GHT CHARGES: <br /> the agreed or declared value of the pr The agreed or declared value of the property is Is�gnawre of Consgnon <br /> hereby specdfceny stated by the er to be no eeding $ Per ❑Prepaid Collect <br /> NOTE:L4allo LimAa or loss or damage in this s ant may be applicable.See 49 U.S.C. BY SHIPPER <br /> 14706(cN1)(A)an •a '' ❑BY CARRIER <br /> ma,i"e aw+e-named materials are property Gassrbed,de ckaged,marked <br /> p • DRIVER'S <br /> a.,d d anU era m r condition for bans nation according to the applies a regulations of SIGNATURE: <br /> epamr�m el frarsprxmnon Per ^/ 7� <br /> SHIPPER: G�A �T . �Tht�/�-1 CARRIER: .S v <br /> PER: napDATE: 7-Z7'1!�F PER: DATE: Z- 7 <br /> EMERGENCY RESPONSE NAME OR CONTRACT NUMBER <br /> TELEPHONE NUMBER: OR OTHER UNIQUE IDENTIFIER: <br /> 436(Rev.9/10) <br />