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ORIGINAL — NOT NEW.) I !ABLE
<br />Carrier No.
<br />Page
<br />
<br />of
<br />
<br />]an
<br />
<br />la _
<br />Dare )
<br />
<br />(Name of carrier) (SCAC)
<br />On Cokr.1 011 Delivery shipments, the letters 'COW must appear before consignee's n61110 Of as othenvise provided in hens 430, S00.1.
<br />TO:
<br />Consignee '1,./ET.A.L. 191,41:1,4-1ING 9DLUTli--q\I -7.:
<br />FROM,
<br />Shipper •-
<br />Street
<br />Street 1:325 E..' RNA/. ER.NE City '',-,A,;- ,',' ... State Zip Code
<br />City 77-0CKTCIN State Cei, Zip Code qr520 E
<br />24 hr. Emergency Contact Tel. No. ...
<br />-
<br />Route
<br />I Vehicle
<br />Number
<br />— ..-. .._
<br />No. of Units
<br />& Container Type HM
<br />BASIC DESCRIPTION
<br />UN or NA Number, Proper Shipping Name, Hazard Class, Packing Group
<br />TOTAL QUANTITY
<br />(VVeight, Volume,
<br />Gallons. etc.)
<br />WEIGHT
<br />(Subject to
<br />Correction)
<br />For Carrier RATE
<br />CHARGES
<br />(
<br />Use Only)
<br />74
<br />. J , f . rzil.I.7 . ; Ir.', '''Dr-I..a4 -P--i •-u.i..,cs vd kp.....;;. .
<br />7
<br />
<br />1.142.Q22, iaarre.s..?ve 47..it,--4 tov:ic... nod. lArmo'rnt.rri 4uor ,4 '..... ,
<br />. .
<br />4 /1 ;47?, ..._
<br />2.7 --.••014*— n4211141 filistitlYIPthit. _Lull Rifling ci4rfir isn 4,...,3'
<br />11...t : 4 182d . 9:22diLiri)',.4ticw, -8. .14-:.-.i. v,,
<br />. _...._.._
<br />e7 f4k CiLitTIS fctrneriy oontainitig Oardobona Addniv ...
<br />. Ntnr, kid. 9 F43 q
<br />iii 1, ' it
<br />'2-- R ilinleitiffir &urns erty con 1E iainin a aiiiiialaund :f.t 11 -1-/S- A, R ...... t.i,!-,1.27.,:.,.. cprroswe 1,..n.r,„:3 t.7.61....., ns.) s tt.:. ' '4,r-irt;':.'.:., '
<br />1
<br />PLACARDS TENDERED: YES CI NO I= REMIT
<br />Note — (1) Where the rate is dependent on value, shippers are required to stale
<br />the agreed or dedered vallue of the . follows, 'The sPecifiogy at eTtlecl ProFortY•
<br />I hereby declare that the °orients of this
<br />fully consignment are and accurately ADDRESS
<br />agreed or Oedared viiiiuo of the ProliortY la hereby specifically stated by the shigler to
<br />be not exceedng Per .
<br />described above by the proper shipping
<br />name and are classified, packaged, COD Amt: $
<br />C.00. FEE:
<br />PREPAID 0
<br />Where the applicable tariff provisbns spedly a limitation of the carrier's labety absent
<br />the does not release a release or a value declaration by the shipper and shipper
<br />marked sad labeirapplacerded, end are COLLECT rl
<br />the carders liability or declare a value, the carrier's kiddy shall be limited to the extent
<br />provided by such provisions. See NMFC Item 172.
<br />it all respects In proper condition tor
<br />transport according to applicable
<br />,i.m.tion., an, n.,,,ea, 90,.,erreno,"
<br />Sabred to Seaton 7 81 the wantons • ,I..f theosh, proem is to be delivered to the
<br />conagrrze.rhol recourse on th . co sign . the conamnor shall sign the
<br />TOTAL
<br />CHARGES $
<br />commodfies requiring special or additional care or attention In handling or stowing
<br />must be so marked and packaged as to ensure sale transportation. See Section 2(e) of
<br />Item 360, Bee of Lading, Freight Bits and Statements of Charges and Section I (a) ol
<br />widows. The carrier shall not rnake delivery of this shipment without payment of
<br />freight and as other lawful charges. FREIGHT
<br />
<br />FR H: i.CHARGE
<br />
<br />chargFREIGH
<br />T EP
<br />PR hese Check
<br />., S
<br />il
<br />the Contract Terms and Conditions for a lith of such articles. Signature (Sketewe of Con Wanen
<br />ex when box al
<br />' h!
<br />cept
<br />Nlscinckad 0 collect . _
<br />RECEIVED, subied 10 he dassrlicalions and tariffs in effect on Be data of the iSS100 of tNs BM of LPCF
<br />the properly described above in apparent good order. =Capt. noted (coolants and condition of ...-
<br />tents of redeye* unknown), marked, Consigned, end deigned as Indicated above %Mich said carrier
<br />(the word carrier being undendood throughout this oardied U meaning any person or corporaflor km
<br />poseession of the property under the contract) agrees le amy lofts toed pees of &leery at saki desti-
<br />nation. II cri donate, pitheads* to delver to another mirk" on the rade* slid destination It is mea-
<br />ner earned as to each carrier ol all or am of. said 010118,111 Meta Of ow edam of said route to dea
<br />tination and as to each party al any time interested In all or any said properly. that every service to
<br />be performed hereunder shall be subject to all the Wel lading terms and conditions in the goveming den-
<br />sification on the date of shipment.
<br />Shipper hereby certifies that he Is familiar with all the lading terms and conditions in the
<br />governing classification and Pre said terms and conditions are hereby agreed to by the shipper and
<br />accepted for himself and his assigns.
<br />SHIPPER CARRIER
<br />1 PER -00
<br />DATE
<br />PER
<br />1
<br />•
<br />STYLE F370-4 0 2012 LABELAASTER (BOO) 821-5808 www.labelmaster.com Permanent post-office address of shipper. 0
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