BILL OF LADING

    EMAIL ADDRESS

    Customer Email Address

    SHIP FROM

    Contact Name:
    Contact Phone Number:
    Contact Email:
    Hours of Operation:
    Name:
    Address:
    City/State/Zip:
    SID#: FOB#:

    SHIP TO

    Contact Name:
    Contact Phone Number:
    Contact Email:
    Hours of Operation:
    Name: Location#:
    Address:
    City/State/Zip:
    SID#: FOB#:
    Bill of Lading Number:
    Bard Code Space:
    CARRIER NAME:
    Seal number(s):
    SCAC:
    Pro number:
    Bard Code Space:
    Freight Charge Terms: (freight charges are prepaid unless
    marked otherwise)
    Prepaid Collect 3rd Party
    Master Bill of Lading: with attached underlying
    Bills of Lading

    THIRD PARTY FREIGHT CHARGES BILL TO:

    Name:
    Address:
    City/State/Zip:
    SPECIAL INSTRUCTIONS:

    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 NMFC Item 360

    NMFC # CLASS

    GRAND TOTAL

    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 specifically stated by the shipper to be not exceeding"

    Per
    COD Amount: $
    Fee Terms:

    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 Signature

    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 regulations of the DOT.

    Trailer Loaded: Freight Counted:
     

    CARRIER SIGNATURE / PICKUP DATE

    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.