Bill of Lading


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BILL OF LADING- SHORT FORM-NOT NEGOTIABLE TLF Sales Order Number:

SHIP FROM

Carrier Name: Trailer Number: Serial Number:

SHIP TO

Pro Number:

THIRD PARTY FREIGHT CHARGES BILL TO

Special Instructions:

Freight Charge Terms: freight charges are prepared Collect 3rd Party Master Bill of landing with attached underlying bills of lading

CUSTOMER ORDER INFROMATION Customer PO no:

# of Packages Weight

Pallet/slip (check one) Y

N

Y

N

Y

N

Additional Shipper information

Grand Total CARRIER INFORMATION Handling Unit QTY

TYPE

Package QTY

TYPE

LTL ONLY WEIGHT

HM (X) COMMODITY DESCRIPTION

Where the rate is dependant on value, shippers are required to state specifically in writing the agreed or declared value of the property as follows; “The agreed or declared value of the property is specifically stated by the shipper not to be exceeding

COD Amount $— Fee Terms: Collect

————— Prepaid

Customer

NMFC # Class

check acceptable

______________per_______________ Note: Liability limitation for loss or damage in this shipment may be applicable. See 49 USC 14706©(1)(A) and (B) Sect.49 USC (code sign) 11707 also prohibits contractual limitations of time to give notice of claim to a period of less than nine months and to commence an action against the carrier to a period less than two years from the date the carrier disallows a claim. It contains indemnity provisions concerning the right of a carrier held liable to recover from the carrier over whose line or route the loss or injury occurred, etc. The ICC termination Act of 1995 incorporates such changes. See 49 USC (code sign) 11706 (Rail Carriers), 14706 (Motor Carriers and Freight Forwarders) (1995.)

Received, subject to individually determined rates or contracts that have been agreed upon in writing between the carrier and the shipper, if applicable, otherwise to the rates classifications, and rules that have been established by the carrier and are available to the shipper, on request, and to all applicable state and federal regulations

Shipper Signature/ Date This is to certify that the above named materials are properly classified, packaged, marked and labeled, and are in proper condition for transportation according to the applicable regulatory of the DOT.

The carrier shall not make delivery of this shipment without payment of charges and other lawful fees.

Shipper Signature: ______________________________________________

Trailer Loaded:

Freight Counted:

By Shipper

By shipper

By Driver

By driver pallets / pieces said to

Carrier Signature/ Pick-up Date Carrier acknowledges receipt of packages and required placecards. Carrier certifies emergency response information was made available and/or carrier has the DOT emergency response guidebook or equivalent documentation in the vehicle. Properly described above is received in good order, except as noted .