Date:

BILL OF LADING

Page _______

SHIP FROM

 

Name:

Bill of Lading Number: ______________________

Address:

 

City/State/Zip:

BAR CODE SPACE

SID#:

FOB: o

 

SHIP TO

CARRIER NAME:� _______________________________

Name:

Location #: __________

Trailer number:

Address:

Seal number(s):

City/State/Zip:

SCAC:

CID#:

FOB: o

Pro number:

THIRD PARTY FREIGHT CHARGES BILL TO:

 

Name:

BAR CODE SPACE

Address:

 

 

City/State/Zip:

Freight Charge Terms: (freight charges are prepaid unless marked otherwise)

SPECIAL INSTRUCTIONS:

Prepaid ______

Collect _____

3rd Party _____

 

o

(check box)

Master Bill of Lading: with attached underlying Bills of Lading

CUSTOMER ORDER INFORMATION

CUSTOMER ORDER NUMBER

# PKGS

WEIGHT

PALLET/SLIP

(CIRCLE ONE)

ADDITIONAL SHIPPER INFO

 

 

 

 

Y

N

 

 

 

 

 

Y

N

 

 

 

 

 

Y

N

 

 

 

 

 

Y

N

 

 

 

 

 

Y

N

 

GRAND TOTAL

 

 

 

 

 

CARRIER INFORMATION

HANDLING UNIT

PACKAGE

 

 

COMMODITY DESCRIPTION

LTL ONLY

QTY

TYPE

QTY

TYPE

WEIGHT

H.M.

(X)

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 360

NMFC #

CLASS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RECEIVING

 

 

 

 

 

 

STAMP SPACE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GRAND TOTAL

 

 

Where the rate is dependent on value, shippers are required to state specifically in writing the agreed or declared value of the property as follows:

COD Amount:� $ ______________________

�The agreed or declared value of the property is specifically stated by the shipper to be not exceeding

 

__________________ per ___________________.�

Fee Terms:��� Collect:� ���� Prepaid: o

Customer check acceptable: o

NOTE� Liability Limitation for loss or damage in this shipment may be applicable.� See 49 U.S.C. � 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 freight and all other lawful charges.

_______________________________________Shipper Signature

SHIPPER SIGNATURE / DATE

Trailer Loaded:

Freight Counted:

CARRIER SIGNATURE / PICKUP DATE

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 to the applicable regulations of the U.S. DOT.

p� By Shipper

p� By Driver

p� By Shipper

p� By Driver/pallets said to contain

Carrier acknowledges receipt of packages and required placards.� Carrier certifies emergency response information was made available and/or carrier has the U.S. DOT emergency response guidebook or equivalent documentation in the vehicle.

 

 

p� By Driver/Pieces

Property described above is received in good order, except as noted.

 

Date:

SUPPLEMENT TO THE BILL OF LADING

Page _______

 

 

Bill of Lading Number: __________________

 

 

 

 

CUSTOMER ORDER INFORMATION

CUSTOMER ORDER NUMBER

# PKGS

WEIGHT

PALLET/SLIP

(CIRCLE ONE)

ADDITIONAL SHIPPER INFO

 

 

 

Y

N

 

 

 

 

Y

N

 

 

 

 

Y

N

 

 

 

 

Y

N

 

 

 

 

Y

N

 

 

 

 

Y

N

 

 

 

 

Y

N

 

 

 

 

Y

N

 

 

 

 

Y

N

 

 

 

 

Y

N

 

 

 

 

Y

N

 

 

 

 

Y

N

 

 

 

 

Y

N

 

 

 

 

Y

N

 

 

 

 

Y

N

 

PAGE SUBTOTAL

 

 

 

 

 

CARRIER INFORMATION

HANDLING UNIT

PACKAGE

 

 

COMMODITY DESCRIPTION

LTL ONLY

QTY

TYPE

QTY

TYPE

WEIGHT

H.M.

(X)

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 360

NMFC #

CLASS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PAGE SUBTOTAL

 

 

 

Date:

BILL OF LADING

Page

 

SUPPLEMENTAL BAR CODE AREA

SHIP FROM

Bill of Lading Number:

 

 

Name:

 

 

 

Address:

 

 

 

City/State/Zip:

 

 

 

SID#:

FOB: o

CARRIER NAME:

 

 

SHIP TO

Trailer number:

 

 

Name:

Location #:

Seal number(s):

 

 

Address:

SCAC:

 

 

City/State/Zip:

Pro number:

 

 

CID#:

FOB: o

 

 

 

THIRD PARTY FREIGHT CHARGES BILL TO:

 

 

 

Name:

 

 

 

Address:

Freight Charge Terms: (freight charges are prepaid unless marked otherwise)

 

 

City/State/Zip:

Prepaid _____

Collect _____

3rd Party _____

 

 

SPECIAL INSTRUCTIONS:

 

 

 

 

o

(check box)

Master Bill of Lading:� with attached underlying Bills of Lading

 

 

CUSTOMER ORDER INFORMATION

 

 

CUSTOMER ORDER NUMBER

# PKGS

WEIGHT

PALLET/SLIP

ADDITIONAL SHIPPER INFO

 

 

 

 

 

Y

N

 

 

 

 

 

 

Y

N

 

 

 

 

 

 

Y

N

 

 

 

 

 

 

Y

N

 

 

 

GRAND TOTALS

 

 

 

 

 

 

 

CARRIER INFORMATION

 

 

HANDLING UNIT

PACKAGE

 

 

COMMODITY DESCRIPTION

 

LTL ONLY

 

 

QTY

TYPE

QTY

TYPE

WEIGHT

H.M.

(X)

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 360

NMFC #

CLASS

 

RECEIVING STAMP AREA

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GRAND TOTAL

 

 

 

 

Where the rate is dependent on value, shippers are required to state specifically in writing the agreed or declared value of the property as follows:

������������� COD Amount:� $ ____________________

 

 

�The agreed or declared value of the property is specifically stated by the shipper to be not

 

exceeding _______________________ per ___________________________________.�

������� Fee Terms:����������� Collect:� ������������ Prepaid: o

��������������������� Customer check acceptable: o

 

 

NOTE� Liability Limitation for loss or damage in this shipment may be applicable.� See 49 U.S.C. � 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 freight and all other lawful charges.

_________________________________________________Shipper Signature

 

 

SHIPPER SIGNATURE / DATE

Trailer Loaded:

Freight Counted:

CARRIER SIGNATURE / PICKUP DATE

 

 

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 to the applicable regulations of the U.S. DOT.

p� By Shipper

p� By Shipper

p� By Driver/pallets said to contain

Carrier acknowledges receipt of packages and required placards.� Carrier certifies emergency response information was made available and/or carrier has the U.S. DOT emergency response guidebook or equivalent documentation in the vehicle.

Property described above is received in good order, except as noted.

 

 

_______________________________

p� By Driver

p� By Driver/Pieces

_______________________________________

 

 

 

Date:

 

SUPPLEMENT TO THE BILL OF LADING

 

 

Page ���..

 

 

 

SUPPLEMENTAL BAR CODE AREA

 

 

 

����������� Bill of Lading Number: ____________________

 

 

 

 

 

 

CUSTOMER ORDER INFORMATION

 

 

CUSTOMER ORDER NUMBER

#� PKGS

WEIGHT

PALLET/SLIP

(CIRCLE ONE)

ADDITIONAL SHIPPER INFO

 

 

 

 

 

Y

N

 

 

 

 

 

 

Y

N

 

 

 

 

 

 

Y

N

 

 

 

 

 

 

Y

N

 

 

 

 

 

 

Y

N

 

 

 

 

 

 

Y

N

 

 

 

 

 

 

Y

N

 

 

 

 

 

 

Y

N

 

 

 

 

 

 

Y

N

 

 

 

 

 

 

Y

N

 

 

 

 

 

 

Y

N

 

 

 

 

 

 

Y

N

 

 

 

 

 

 

Y

N

 

 

 

 

 

 

Y

N

 

 

 

 

 

 

Y

N

 

 

 

 

 

 

Y

N

 

 

 

PAGE SUBTOTAL

 

 

 

 

 

 

CARRIER INFORMATION

 

 

HANDLING UNIT

PACKAGE

 

 

COMMODITY DESCRITPION

LTL ONLY

 

 

QTY

TYPE

QTY

TYPE

WEIGHT

H.M.

(X)

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 360

NMFC #

CLASS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PAGE SUBTOTAL