Straight Bill Of Lading - Short Form

STRAIGHT BILL OF LADING

SHORT FORM - ORIGINAL

NOT NEGOTIABLE

163 Bowes Road, Concord, ON, L4K 1H3, Canada • Tel: 905.760.2888 • Fax: 905.760.2040 •

Date

Bill of Lading No.

P.O. No.

Reference No.

Trailer No. : ______________________________

Seal No. : _________________________________

Shipper

Name:

Contact:

FreighT ChargeS

Address:

Phone:

Prepaid

City:

Province/State:

Postal/Zip Code:

(Bill Shipper)

CoNSigNee

Collect

(Bill Consignee)

Name:

Contact:

Freight charges will be collected unless marked prepaid.

Address:

Phone:

or

City:

Province/State:

Postal/Zip Code:

Third Party

iNVoiCe ChargeS To: (3

parTy)

rD

Name:

Account Code:

Spot Quote No. : __________________________________

Address:

C.o.D

City:

Province/State:

Postal/Zip Code:

Amount: $ __________________________________

rouTiNg

Prepaid

Name of Carrier:

Non-certified customer cheque

O.K.

SpeCial iNSTruCTioNS

Collect

°F

Protective Service

Temperature Required:

°C

AM

Appointment

Date:

Time:

Appointment by carrier

PM

Other Special Instructions:

No. of Packages

DG (X)

Description of Goods and Special Marks

Weight

KG

LB

DeClareD ValuaTioN

$

Maximum liability of $2.00 per pound unless declared

valuation states otherwise. A surcharge is applicable

when the declared value is in excess of $2.00 per pound.

Total linear Feet:

Dimensional Weight

Total No. Pieces:

Total Weight:

Dimensions:

_____________ X _____________ X _____________

0

0.00

_______________ *10 lb/cu.ft.

Length (Inches)

Width (Inches)

Height (Inches)

Received at the point of oRigin on the date specified fRom the consignoR mentioned heRein, the pRopeRty heRein descRibed, in appaRent good oRdeR, except as noted (contents and conditions of contents of package unknown) maRked, consigned and destined

as indicated below, which the caRRieR agRees to caRRy and to deliveR to the consignee at the said destination if its own seRvice Route oR otheRwise to cause to be caRRied by anotheR caRRieR on the Route to said destination, subject to the Rates and

classification in effect on the date of shipment. it is mutually agReed, that each caRRieR of all oR any of the goods oveR all oR any poRtion of the Route to destination and that any paRty inteRested in all oR any of the goods foR which any seRvice is to be

peRfoRmed heReundeR shall be subject to all the conditions not pRohibited by law, whetheR pRinted oR wRitten, including conditions on back heReof and in the diRectoRy of taRiff Rules #1 of Qta (heReinafteR called diRectoRy #1) which aRe heReby agReed by

the consignoR and accepted foR himself and his assigns.

See CoNDiTioNS oN reVerSe ThaT apply oN eaCh ShipmeNT TeNDereD.

Shipper

Consignee

Carrier

Driver Count

Date:

Date:

Date:

Signature:

Signature:

Driver Signature:

Date:

Delivery Driver No.:

Time In:

Time Out:

Delivery Driver Signature:

Delivered on BOL

MERCHANDISE THAT IS NOT PROPERLY CRATED IS SHIPPED AT OWNER’S RISK.

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