Bill of Lading

Ship From:

SID#:
FOB

Ship To:

Location No:
CID#:
FOB

Third Party Freight Charges - Bill To:

Date:  
Bill of Lading No:  
BARCODE SPACE
Carrier Name:  
Trailer No:  
Seal Number(s):  
SCAC:  
Pro No:  
BARCODE SPACE

Freight Charge Terms (prepaid unless marked otherwise)

Prepaid      Collect      3rd Party
Master BOL: w/attached underlying BOLs

Special Instructions:

Customer Order Information
Customer Order No. # Pkgs. Weight Pallet/Slip (Y/N) Additional Shipper Info
Totals
Carrier Information
Handling Unit Package Commodity Description LTL Only
QTY TYPE QTY TYPE Weight H.M. (X) Commodities requiring special or additional care or attention in handling or stowing must be so marked and packaged as to ensure safe transportation with ordinary care.

See Section 2(e) of MNMFC Item 360

NMFC No. Class
Totals

Where the rate is dependent 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 sepcifically stated by the shipper to be not exceeding

FOB."

COD Amt. $

Fee Terms:CollectPrepaid

Customer Check Acceptable

NOTE: Liability Limitation for loss or damage in this shipment may be applicable. See 49 U.S.C. - 14706(c)(1)(A) and (B).

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, 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.

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

Shipper Signture

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 regulations of the DOT.

Shipper Signature

Date

Trailer Loaded

By Shipper

By Driver

Freight Counted

By Shipper

By Driver/pallets said to contain

By Driver/Pieces

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

Carrier Signature

Pickup Date