Uniform Straight Bill Of Lading - Short Form

UNIFORM STRAIGHT BILL OF LADING - SHORT FORM - NOT NEGOTIABLE

collect

PRO No.

TERMS:

(freight charges are collect unless marked prepaid.)

invoice no.

date

carrier

car or vehicle intials & no.

carriers no.

delivering carrier

special services

shipper no.

trailer no.

consignee name

address

shipper name

saturday delivery

sunday delivery

address

city

state

zip

construction p/u

city

state

zip

phone

fax

inside pickup

inside delivery

contact

phone

fax

lift gate service

email

contact

email

proof of delivery

customer no.

store no.

dept.

delivery appointment

po number

excess delcared

value insurance

due date

(subject to additional

charges.)

appointment time

special instructions

COD AMT:

hazardous materials contact number:

*If the shipment moves between two ports by a carrier by water, the law requires that the Bill of Lading shall state whether it is “carrier’s or shipper’s weight”. NOTE: Where the

rate is dependent on value, shippers are required to state specifically in writing the agreed or declared value of the property. The agreed or declared value of the property is hereby

specifically stated by the shipper to be not exceeding ______________________ per _____________________.

pieces

pkg

description of material, special marks, and exceptions

nmfc

class

weight

*The fiber boxes used for this shipment conform to the specifications set forth in the box maker’s certificate thereon, and all other requirements of Consolidated Uniform or National Motor Freight Classification.

ARTICLES SUBJECT TO RELEASED VALUE

THIS IS TO CERTIFY THAT THE BELOW-NAMED MATERIALS ARE PROPERLY CLASSIFIED, PACKAGED,

MARKED & LABELED & ARE IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TO THE AP-

NOTE (1) When the rate is dependent on value, shippers are required to state specifcally in writing the

PLICABLE REGULATIONS OF THE DEPARTMENT OF TRANSPORTATION. RECEIVED, subject to individually

agreed or declared value of the property. The agreed or declared value of the property is hereby specifi-

determined rated or contracts that have been agreed upon in writing between the carrier and the shipper, if applicable,

cally stated by the shipper to be not exceeding. NOTE (2) LIABILITY LIMITATION FOR LOSS OR

otherwise to the rates, classifications and rules that have been established by the carrier and are available to the shipper,

DAMAGE ON THIS SHIPMENT MAY BE APPLICABLE. SEE 49 U.S.C 14706 (C)(1)(A)&(B). **If

on request, the properly described above in apparent good order, expect as noted (contents & conditions of contents of

no value is shown above, shipment is subject to the lowest actual or released value provided in NMF 100

packages unknown), marked, consigned & destined as indicated above, which said carrier agrees to carry destination, if

Series or other pricing agreements effective between Shipper & carrier; shipments of household goods,

on route, otherwise or deliver to another carrier on the route to said destination. It is mutually agreed as to each carrier

personal effects or used articles are released to a $.10 per pound per piece. Carriers liability for loss or

of all or any said property, over all or any portion of said route to destination and as to each party at any time interested

damaged cargo is $5.00 per pound with a maximum of $500.00 per piece, subject to a maximum liability

in all or any of any said property, that every service to be performed hereunder shall be subject to all terms and condi-

of $100,000.00 per shipment, unless the Shipper/Consignee requests Excess Declared Value coverage

tions of the Uniform Bill of Lading set forth in the National Motor Freight Classification 100-X and successive issues.

as provided below, or unless a written agreement has been agreed upon between the said Shipper and

The shipper certifies that he/she is familiar with all the terms & conditions of the said bill of lading, including those

GLOBAL FREIGHT SOLUTIONS, Inc. NOTE (3) Commodities requiring special or additional care

on the back thereof & the said terms & conditions are hereby agreed to by the shipper & accepted to by the shipper

or attention in handling or stowing must be marked and packaged as to ensure safe transportation with

& accepted for himself / herself & his / her assigns. For Freight Collect Shipments. If this shipment is to be delivered

ordinary care. See Sec 2(e) of NMFC item 360.

to the consignee without recourse on the consignor, the consignor shall sign the following statement: The carrier may

decline to make delivery if this shipment without payment of freight & all other lawful charges. GLOBAL FREIGHT

declared value: _______________________________

SOLUTIONS, Inc. when acting as a third party logistics provider is not responsible for claims.

(please note that added value insurance can be purchased at an additional cost prior to shipping.)

_______________________________________

signature of consignee

shipper/consignee

carrier

authorized signature

date

authorized signature

date

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