Bill of Lading

TRAILER/CAR NUMBER: __________________
BILL DATE: __________________

TO	FROM	

Consignee		Shipper	
Street		Street	
Destination		Origin	
City/State/Zip		City/State/Zip	
Route:		Special Instructions:	

FOR PAYMENT, SEND BILL TO	SHIPPER'S INSTRUCTIONS	

Name			
Company			
Street			
City/State/Zip			

NO. SHIPPING UNITS	TIME	DESCRIPTION OF ARTICLES
SPECIAL MARKS & EXCEPTIONS	WEIGHT	RATE	CHARGES	

						

						

	
REMIT C.O.D.	C.O.D. AMOUNT: $	C.O.D. FEE
PREPAID        
COLLECT      	
TO:

ADDRESS:
	If this shipment is to be delivered to the consignee without recourse on the consignor, the consignor shall sign the following statement:  The carrier shall not make delivery of this shipment without payment of freight and all other lawful charges.

(Signature of Consignor)	TOTAL
CHARGES $	
NOTE: W here the rate is dependent on value, shippers are required to state specifically in writing the agreed or declared value of the property. The agreed or declared value of the property is hereby specifically stated by the shipper to be not exceeding              $                                    per		Freight Charges are collect unless market prepaid 

CHECK BOX IF PREPAID     	
RECEIVED subject to the classifications and tariffs in effect on the date of the issue of this Bill of Lading, the property described above in apparent good order, except as noted (contents and condition of packages unknown), marked consigned and destined as indicated above which said carrier (the word carrier being understood through this contract as meaning any person or corporation in possession of the property under the contract) agrees to carry to its usual place of delivery as said destination.  If on its route, 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 to destination and as to each party at any time interested in all or any said property, that every service to be performed hereunder shall be subject to all the Bill of Lading terms and conditions in the governing classification on the date of shipment.  Shipper hereby certifies that he is familiar with all the Bill of Lading terms and conditions in the governing classification and the said terms and conditions.	
Shipper	Carrier	
Per	Per	Date:	
Mark with “X” or “RQ” if appropriate to designate Hazardous Material s Substances as defined in the Department of Transportation Regulations governing the transportation of hazardous materials. The use of this column is an optional method for identifying hazardous materials on Bills of Lading 172.201(a)(1) (iii) of Title 4 9. Code of Federal Regulations. Also when shipping hazardous materials, the shipper' s certification statement prescribed in section 172.204(a) of the Federal Regulations, as indicated on the Bill of Lading does apply, unless a specific exception from the requirement is pro vided in t he Regulation for a particular material.