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STRAIGHT BILA OF LADING -ORIGINAL- NOT NEGOTIABLE Shipper's No. Carrier ff�Yiv ��=v�`��,�fni�v,�Y?C SCAC Carrier's No. RECEIVED,subject to individually determined rates or contracts that have been agreed upon in writing between the carrier and shipper,if applicable,otherwise to the rates,classirlcaIions and rules that have been established by the carrier and are available to the shipper,on request;and all applicable stale and federal regulations; at , date from 23 .25/ (he Properly described below,in apparent good ober,except as noted(contents and condition of contents of packages unknown),marked,consigned,and destined as indicated below,whic said company (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 route,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 Properly over all or any portion of said route to destination,and as to each party at any lime interested in all or any of said Properly that every service to be performed hereunder shall be subject to all the conditions not prohibited by law,whether printed or written,herein contained,including(he conditions on the back hereof,which are hereby agreed to by the shipper and accepted for himself and his assigns. TO: FROM: Consi nee u j.� J Shipper ,) , Street v' Street Destination zip Origin ✓ Zi q �r ` Route Delivering Carrier Vehicle Number U.S. DOT Hazmat Reg. No, ,.� + •�1 506M . _ _ __._.......----------___._.__... ............. - — — -- - - -- --- - - ..... _______.___..__.________�_-__-____..._.__ __-__�•�,�%�--5_-��_�;�-yrs-----.�2G. ire/ ...- - -------___._.__.____._.w_____-.-___-___ .__._ _ ..-......._._....._.._... _.-._.._..-----..... - _.. .�lal8.7 .__..__..... ...._....._...._.._........ ... ..... . _.... -.._._. . . Remit COD to: Subjer to sernan of ocndidens.if this shipment Is to be delivered to the consignoaMUD AMT: COD FEE' Address: without recourse on the consir. Iho consignor shall sign the Prepaid following gnong statemant: a The carder shall not make delivery of this p ❑ 6oity: State: Zip: shipment without payment of freight and all Collect ❑ D .,her lawful charges.OTE:Where the rate is dependent on value,shippers are required to slate specifically in writing TOTAL CHARGES: he agreed or declared value of the property.The agreed or declared value of the property is FREIGHT CHARGES: rereby specifically stated by the shipper to be not exceeding$ Per (Signature of Consignor) $ ❑Prepaid ❑Coltec; 'OTE:liability Limitation for loss or damage in this shipment may be applicable.See 49 U.S.C. .e 4706 o i A and(a), ,¢ s ❑BY SHIPPER BY CARRIER his is to certify that the above-named materials aro properly classified,described,packaged,marked not labeled,and are in proper condition for transportation according to the applicable regulations of ge e DRIVER'S to Department of Transportation. Per SIGNATURE: ;HIPPER:i�'/� CARR R; 'ER: DATE:T T��/ Pl R:sS ;t; '• i killW DATE: [y,!IFRGE C`a RESPON4c• AliVlE OR^O 11T?x C T HI, i1 BER �i�e OTHER ;.9 i�ul� .j lw l�E�lTl�i«�` 3L.S-C3 969(Rev.9/10)