STRAIGHT BILL OF LADING - SHORT FORM - ORIGINAL - …

1 STRAIGHT BILL OF LADING - SHORT form - ORIGINAL - NOT negotiable Shipper's Order No. Rich Doss, Inc. - DOSR - (800) 654-7200 PO Box 4799 Santa Rosa, CA 95402 Affix Carrier Pro Sticker Here 12175 US DOT 1384069 Freight Charges are Prepaid unless marked here: CollectThird-Party PrepaidIf Third- party Prepaid please enter DOSS Acount Number :FROM:ConsigneeShipperStreetStreetDestin ationZipCityZipContact namePhone NumberPhone NumberTrailer of PackagesType of PackageDescription of articles, special marks, and exceptionsWeight(Subject to Correction)Class orRate NumberCarrier does not transport any type of Hazardous Material , failure to notify Carrier of material that was given to Carrier as hazardous, that is not packaged as such will result in local & federal government penalties as well as any incured costs by the carrier to rectify the hazardous freight. Remit to: COD Amount Chargeto be paid byThird/ShipperStreet City StateConsigneeNote - When the rate is dependant on the value, shippers are required to state specifically in writing the agreed of declared value of the areed or declared value of the property is hereby specifically stated by the shipper not to be exceeding per.

2 Subject to Section 7 of conditions 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, Per: NOTE: Liability Limitation for loss or damage in this shipment may be applicable. See 49 14706(c)(1)(A) and (B)Shipment governed by TERMS AND CONDITIONS on Rich Doss, Inc. Tariff 100 available at is to certify that the above-named materials are property classified, described, packaged, marked and labeled, and are in proper condition for transportation according to the applicable regulations of the Department of Transportation. PER: Special Instructions: SHIPPER:CARRIER:PER:DATE:PER:DATE: 2017 Rich Doss, Inc. All Rights Reserved form No. DOSS-BOLDOSS Account Number for Third-party Shipments:Total Weight of Shipment:By using this form you agree to all Terms & Conditions set forth by Rich Doss, Inc.

3 Guaranteed Shipment Initial here and check the box to add 25% to this shipment and guarantee delivery by 3:00 pm the next regular delivery day. See Terms & Conditions on Page 2 for more information or visit X_____ Yes, Guarantee This Shipment