Transcription of Uniform Straight Bill of Lading
1 (To be printed on white paper) Uniform Straight bill OF LADINGORIGINAL NOT NEGOTIABLERULESNATIONAL MOTOR freight CLASSIFICATION 100-ZCarrier s Pro No. _____Shipper s bill of Lading No. _____Consignee s No. _____Carrier s Code (SCAC)_____Name of Carrier _____RECEIVED, subject to individually determined rates or contracts that have been agreed upon in writing between the carrier and shipper, if applica-ble, otherwise to the rates, classifications and rules that have been established by the carrier and are available to the shipper, on request:From _____ Date _____Street _____ City _____ County _____ State _____ Zip _____the property described below, in apparent good order, except as noted (contents and condition of contents of packages unknown) marked, consigned, and destined as shown below,which said carrieragrees to carry to destination, if on its route, or otherwise to deliver to another carrier on the route to destination.
2 Every service to be performed hereunder shall be subject toall the conditions not prohibited by law, whether printed or written, herein contained, including the conditions on the back hereof, which are hereby agreed to by the shipper and accepted forhimself and his to _____On Collect on Delivery Shipments, the letters COD must appear before consignee s Street _____City _____ County _____State _____ Zip _____Delivering Carrier _____ Trailer No. _____Additional Shipment Information_____Collect on Delivery $ _____ and remit to: _____Street _____ City _____ State charge Shipper Tto be paid by Consignee of Package, Description of Articles, Special Marks and Exceptions(Subject to correction)Weight(Subject toCorrection)Class orRate Ref.
3 (For )Cube(Op-tional) freight charges are PREPAID unless marked BOX IF COLLECTTFOR freight COLLECT SHIPMENTS:If this shipment is to be delivered to the consignee, without recourseon the consignor, the consignor shall sign the following statement:The carrier may decline to make delivery of this shipment withoutpayment of freight and all other lawful (Signature of Consignor)-Mark X to designate Hazardous Materials as defined in DOT (1) Where the rate is dependent on value, shippers are required to state specificallyin 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 notexceeding _____ per _____.
4 NOTE (2) Liability Limitation for loss or damage on this shipment may beapplicable. See 49 14706(c)(1)(A) and (B).NOTE (3) Commodities requiring special or additional care or attention in handling or stowingmust be so marked and packaged as to ensure safe transportation with ordinary care. SeeSec. 2(e) of NMFC Item if problem en route or at delivery _____ (for informational purposes only)Name Fax No. Tel. freight bill to: _____Company Name City Street State ZipShipper _____ Carrier _____Per _____ Per _____ Date _____Shipper CertificationThis is to certify that the above-named materials are properly classified,described, packaged, marked and labeled, and are in proper condition fortransportation according to the applicable regulations of the _____ Date _____Carrier CertificationCarrier acknowledges receipt of packages and required placards.
5 Carrier certifies emergency response information was made available and/or carrier has the DOT emergency response guidebook or equivalent document in the _____ Package Nos. _____Date _____
