NAME/COMPANY BILL THIRD PARTY FREIGHT …

1 SHIPPERFREIGHT CHARGES ARE prepaid ON THIS BILL OF LADING UNLESS MARKED COLLECTPLEASE NOTEMIDWEST motor express , 1058 - BISMARCK, ND 58502-1058(701) 223-1880 FREIGHT CHARGES:STRAIGHT BILL OF LADINGORIGINAL - NOT NEGOTIABLECOLLECTPREPAIDSHIPPER FEE:IS CUSTOMER'S CHECKACCEPTABLE FOR COD?YESPREPAIDCOLLECTNOATTN:CITY, STATE, ZIPROUTEHAZARDOUS MATERIALSEMERGENCY CONTACT NUMBER:"THIS IS TO CERTIFY THAT THE ABOVE NAMED MATERIALS ARE PROPERLY CLASSIFIED, DESCRIBED,PACKAGED, MARKED, AND LABELED AND ARE IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TOTHE APPLICABLE REGULATIONS OF THE DEPARTMENT OF TRANSPORTATION AND THE NATIONAL MOTORFREIGHT CLASSIFICATION AS SHOWN IN THE NMFC 100 SERIES."Carrier Liability: Shipments valued at more than $ per pound are of extraordinary value. Carriers maximum liability is$ per pound per package subject to $125, maximum total liability per shipment.

2 The agreed value on householdgoods. used machinery, or personal effects does not exceed ten cents per pound per article, unless otherwise (Signature of Consignor)AUTHORIZED SIGNATURE:DATE:EMPLOYEE CODE:TRAILER LAST NAME:AUTHORIZED SIGNATURE:* Mark ''X'' In "HM" Column For Hazardous Materials MIDWBOL Ver 11/29/2017or declared value of the property. The agreed or declared value of the property is hereby specifically statedby the shipper to be not exceedingSubject to section 7 of the conditions, it this shipment is to be delivered to the consignee without recourse onthe 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.$NOTE - Where the rate is dependent on value, shippers are required to state specifically in writing the agreedCARRIER midwest motor express , hereby certifies that he understands that all transportation by midwest motor express , Inc.

3 Shall be subject to the term and conditionsof the Bill of Lading contract shown in the NMFC 100 series, and the said terms and conditions are hereby agreed to by the shipper andaccepted for himself and his PRO LABEL HERETHANK YOU FOR USINGMIDWEST motor EXPRESSA cknowledges receipt of goods subject to carrier tarriffs, carrier rules,current contracts in force with above named shipper, and applicablestate and federal (FROM):CONSIGNEE (TO):ADDRESSADDRESSCITY, STATE, ZIPCITY, STATE, ZIPSHIPPER PHONE PHONE THIRD PARTY FREIGHT CHARGES TO:NAME/COMPANYADDRESSCITY, STATE, ZIPREMIT COD TO:ADDRESSNUMBERSHIPPINGUNITSHM *Kind of Packaging, Description of Articles, Special Marks and ExceptionsNMFC (LBS)Subject to Corrections