Bill Of Lading Form
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1GS1 Standard BOL: for complete GS1 BOL Guideline Information
BILL OF LADING
Page _______
Date:
SHIP FROM
Name:
Bill of Lading Number: ______________________
Address:
City/State/Zip:
BAR CODE SPACE
SID#:
FOB:
SHIP TO
CARRIER NAME: _______________________________
Name:
Location #: __________
Trailer number:
Seal number(s):
Address:
City/State/Zip:
SCAC:
CID#:
Pro number:
FOB:
THIRD PARTY FREIGHT CHARGES BILL TO:
Name:
BAR CODE SPACE
Address:
City/State/Zip:
Freight Charge Terms:
(freight charges are prepaid unless marked collect)
rd
SPECIAL INSTRUCTIONS:
Prepaid ______
Collect _____
3
Party _____
Master Bill of Lading: with attached
underlying Bills of Lading
(check box)
CUSTOMER ORDER INFORMATION
CUSTOMER ORDER NUMBER
# PKGS
WEIGHT
PALLET/SLIP
ADDITIONAL SHIPPER INFO
(CIRCLE ONE)
Y
N
Y
N
Y
N
Y
N
Y
N
GRAND TOTAL
CARRIER INFORMATION
HANDLING UNIT
PACKAGE
COMMODITY DESCRIPTION
LTL ONLY
QTY
TYPE
QTY
TYPE
WEIGHT
H.M.
Commodities requiring special or additional care or attention in handling or stowing
NMFC #
CLASS
must be so marked and packaged as to ensure safe transportation with ordinary care.
(X)
See Section 2(e) of NMFC Item 360
RECEIVING
STAMP SPACE
GRAND TOTAL
COD Amount: $ ______________________
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: Noting a value is not a request for Additional Cargo Liability under OD Rules 100, Item 574.
Fee Terms:
Collect:
Prepaid:
“The agreed or declared value of the property is specifically stated by the shipper to be not exceeding
Personal/company check NOT acceptable:
__________________ per ___________________.”
NOTE - Liability Limitation applies. See OD Rules 100, Items 574 and 594.
The carrier shall not make delivery of this shipment without payment of
RECEIVED, subject to the rates, classifications and rules that have been established by the Carrier and are available on request
to the Shipper (Shipper defined in 49 U.S.C.A. § 13102(13)(c)), and to all applicable state and federal regulations. Shipper 1)
freight and all other lawful charges.
warrants it has read all applicable contract(s) or Carrier’s applicable tariff(s) and the limitation of liability provisions set forth
_______________________________________
therein; and 2) has actual knowledge of and accepts the applicable contract or tariff terms, including the limits on carrier liability.
Shipper Signature
Carriers’ tariff(s), including OD Rules 100, take precedence in the event of any terms or conditions conflicts.
Trailer Loaded:
Freight Counted:
SHIPPER SIGNATURE / DATE
CARRIER SIGNATURE / PICKUP DATE
This is to certify that the above named materials are properly classified,
Carrier acknowledges receipt of packages and required placards. Carrier
By Shipper
By Shipper
described, packaged, marked and labeled, and are in proper condition for
certifies emergency response information was made available and/or
transportation according to the applicable regulations of the U.S. DOT.
carrier has the U.S. DOT emergency response guidebook or equivalent
By Driver
By Driver/pallets said to contain
documentation in the vehicle.
By Driver/Pieces
Property described above is received in good order, except as noted.
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