Date
|Date |Bill of Lading – Short Form – Not Negotiable |Page 1 of 1 |
|Ship From |Carrier Name: |
|Your Company Name |Trailer number: |
|Address | |
|City, State, Zip Code | |
|Ship To |Pro Number: |
|Haldex Brake Products |Bar Code Space |
|5334 Highway 221 South | |
|Marion, NC 28752 | |
|Third Party Freight Charges Bill to |Freight Charge Terms (Freight charges are prepaid unless marked otherwise): |
| |Prepaid θ Collect θ 3rd Party ξ |
|Haldex Freight Payables |Use UPS Freight or FedEx Freight, priority service |
|10930 North Pomona Avenue | |
|Kansas City, MO 64153 | |
|Handling Unit | |LTL Only |
|Qty |Type |
|Shipper Signature/Date |Trailer Loaded: |Freight Counted: |Carrier Signature/Pickup Date |
| |θ By shipper |θ By shipper | |
|This is to certify that the above named materials |θ By driver |θ By driver/pallets said to contain |Carrier acknowledges receipt of packages and |
|are properly classified, packaged, marked, and | |θ By driver/pieces |required placards. Carrier certifies emergency |
|labeled, and are in proper condition for | | |response information was made available and/or |
|transportation according to the applicable | | |carrier has the DOT emergency response guidebook |
|regulations of the DOT. | | |or equivalent documentation in the vehicle. |
| | | |Property described above is received in good |
| | | |order, except as noted. |
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