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Click to select dateBILL OF LADING SHORT FORM NOT NEGOTIABLEPage 1 of 1SHIP FROMBill of Lading Number:NameStreet AddressCity, ST ZIP CodeSID No.:BAR CODE SPACESHIP TOCarrier Name:NameStreet AddressCity, ST ZIP CodeCID No.:Trailer number:Serial number(s):THIRD PARTY FREIGHT CHARGES BILL TOSCAC:NameStreet AddressCity, ST ZIP CodePro Number:BAR CODE SPACESpecial Instructions:Freight Charge Terms (Freight charges are prepaid unless marked otherwise):Prepaid q Collect q 3rd Party qq Master bill of lading with attached underlying bills of lading.CUSTOMER ORDER INFORMATIONCustomer Order No.# of PackagesWeightPallet/Slip(circle one)Additional Shipper InformationYNYNYNYNGrand TotalCARRIER INFORMATIONHandling UnitPackageLTL OnlyQtyTypeQtyTypeWeightHM (X)Commodity Description 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 360NMFC No.ClassWhere 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: Collect q Prepaid q Customer check acceptable qNote: Liability limitation for loss or damage in this shipment may be applicable. See 49 USC 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 charges and all other lawful fees.Shipper Signature Shipper Signature/DateThis 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:q By shipperq By driverFreight Counted:q By shipperq By driver/pallets said to containq By driver/piecesCarrier Signature/Pickup DateCarrier acknowledges receipt of packages and required placards. Carrier certifies emergency response information was made available and/or carrier has the DOT emergency re

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