STRAIGHT BILL OF LADING
ORIGINAL - NOT NEGOTIABLE		 SHIPPER NO.: ______________
CARRIER NO.: ______________
DATE: ______________
(Name of Carrier)
TO: Consignee FROM: Shipper
On "Collect on Delivery" shipments, the letters "COD" must appear before consignee's name
or as otherwise provided in item 430, Sec. 1
Street Address Street Address
Destination Zip Code City, State Zip Code
Route: Vehicle Number:
No.
Shipping
Units		 HM Kind of Packaging, Descriptions of Articles,
Special Marks and Exceptions		 Hazard
Class		 I.D.
Number		 Packing
Group		 Weight
(Subject to
Correction)		 Rate
               
               
               
               
               
               
               
               
               
Remit C.O.D. To:   Address C.O.D. Amt:   $ C.O.D. Fee:
Prepaid $
Collect		 Total Charges:   $
    Note - Where 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 or not exceeding


$__________________   per _______________		     Subject to Section 7 of the conditions, if this shipment is to be delivered to the consignee without recourse on the consignor, the cosignor shall sign the following statement.

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

_____________________________________________
(Signature of Consignor)		 FREIGHT CHARGES

FREIGHT PREPAID
(for fewer than 4 cylinders)

CHARGES TO BE COLLECTED
(for 4 or more cylinders)
    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 contents of packages unknown), marked, consigned, and destined as indicated above which said carrier (the word carrier being understood throughout 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 at 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 overall or any portion of said route to destination and as to each party at any time interested in all or any of 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 are hereby to by the shipper and accepted for himself and his assigns.
Shipper

Per		 Carrier

Per