BILL OF LADING CENTRAL TRANSPORT BILL OF LADING

BILL OF LADING

Date:

CENTRAL TRANSPORT BILL OF LADING Page ___

Name:

Address:

City/State/Zip:

SID#: Name:

SHIP TO

FOB:D

DOCK/TERMINAL PICKUP.?

Location #: _____

Address:

City/State/Zip:

CID#: Name:

FOB: THIRD PARTY FREIGHT CHARGES BILL TO:

Address:

Bill of Lading Number:----------

BAR CODE SPACE

CARRIER NAME: Trailer number: Seal number(s): SCAC:

Pro#:

AR CODE SPACE

City/State/Zip: SPECIAL INSTRUCTIONS:

Freight Charge Terms:

Prepaid__

Collect

3rc1 Party __

CUSTOMER ORDER NUMBER

D

(check box)

CUSTOMER ORDER INFORMATION

# PKGS

WEIGHT

PALLET/SLIP

/CIRCLE ONEl

y

N

y

N

Master Bill of Lading: with attached underlying Bills of Lading

ADDITIONAL SHIPPER INFO

y

N

y

N

y

N

GRAND TOTAL

HANDLING UNIT

(CTN, DRUM, PALE, ETC)

QTY TYPE

PACKAGE

(SKID, TOTE, CRT, ETC)

QTY TYPE

WEIGHT

CARRIER INFORMATION

H.M. UN/ID (X) NUMBER

DESCRIPTION OF ARTICLES, SPECIAL MARKS AND EXCEPTIONS

(If Hazardous Materials - Proper Shipping Name)

LTL ONLY NMFC# CLASS

GRAND TOTAL

Where the rate is dependent on value, shippers are required to state specifically in writing the agreed or declared *vTahlueeaogfrteheedporropdeee araesdfvolaloluweso: f the property is specifically stated by the shipper to be not exceeding

per

COD Amount: $

Fee Terms: Collect: D Prepaid: D Customer check acceptable: D

NOTE Liability Limitation for loss or damage in this shipment may be aoolicable. See 49 U.S.C. D 14706(c)(1)(A) and (8).

tRhEeCcEarIrVieErDa,nsdubseipcpt etor,iinfdaivpipdluicaallbyled,eotethnnerinweisdertaotethseorractoens,trcalcatssstihficaat thioanvseabnedenrualegsretheadtuhpaovneinbewernitiensgtabbeltiwsheeednby 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

apTachccisokrais9imteogdc,temortatiheetahdpaapt nltihcdaelbaalbebeorleveegdu,nlaaantmidoenadsremoifanttheperrioarlscOraTrc.eonpdroitpioenrlliocrltarsasnisfipeodr,tation

D By Shipper D By Driver

D ByShipper D By Driver/pallets said to

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

contain

D By Driver/Pieces

Property described above Is received In good order, except as noted.

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