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DATE: BILL OF LADING PAGE
SHIP FROM
Name:
Address:
City/State/Zip:
Contact:
SHIP TO
Name:
Address:
City/State/Zip: (FINAL STOP)
Contact:
FREIGHT CHARGES BILL TO
Address:
SERVICE INSTRUCTIONS:SPECIAL INSTRUCTIONS:
Company Logo Here
BOL #:
Carrier Name:
Trailer Number:
Seal Number(s):
SCAC:
PRO #:
BAR CODE SPACE
Freight Charge Terms:
CARRIER INFORMATION
HANDLING UNIT PACKAGE WEIGHT H.M. DIMS COMMODITY DESCRIPTION
*Commodities requiring special care... See NMFC Item 360		 LTL ONLY
QTYTYPEQTYTYPENMFC #CLASS
Grand Total
ACCESSORIAL SERVICES
REQUESTED FORCODEDESCRIPTION
   
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:
"The agreed or declared value of property is specifically stated by the shipper to be not exceeding per ."

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 / DATE
This is to certify that the above named materials are property classifled, described, packaged, marked, and labeled, and are in proper condition for transportation according to the applicable regulations of the U.S. DOT.
X
Trailer Loaded:
Freight Counted:
CARRIER SIGNATURE / PICKUP DATE
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.