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Bill of Lading - Short Form

SHIPPER
CONSIGNEE
CARRIER INFORMATION
SHIPMENT DETAILS
Qty Type Description Weight H.M. NMFC # Class Pallet (Y/N)
Y N
Y N
Y N
Y N
TOTALS:
C.O.D. & DECLARED VALUE
Fee Terms
NOTE: Liability limitation may apply. See 49 U.S.C. - 14706(c)(1)(A) and (B).
TRAILER LOADED:
FREIGHT COUNTED:
SHIPPER CERTIFICATION

This certifies that materials are properly classified, packaged, marked, and labeled, and are in proper condition for transportation according to DOT regulations.

CARRIER CERTIFICATION

Carrier acknowledges receipt of packages and required placards. Carrier certifies emergency response information was made available and property is in good order.

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.