| FREIGHT CHARGES | CARRIER: Phone: PRO:
|
| ü CONFIRMATION NO. QUOTE NO. | |
| DELIVERY TYPE | |
| ü | |
| SHIP FROM (SHIPPER) | SHIP TO (CONSIGNEE) |
|
|
*If unable to contact Consignee, please contact shipper |
| BILL 3RD PARTY FREIGHT CHARGES TO | COD |
|
COD FEE AMOUNT $ CUSTOMER CHECK
ACCEPTABLE | |
| SERVICES - AUTHORIZED SERVICES* | |
| | |
* Any services not shown above must be requested by, explained to, and paid for by consignee. Shipper will not be responsible for any demurrage, loading, or other charges not authorized in advance. | |
| OTHER
INSTRUCTIONS: | |
| CASES | PALLETS | HM |
DESCRIPTION OF ARTICLES,
SPECIAL MARKS, AND EXCEPTIONS |
NMFC | CLASS | WEIGHT | FAK | |
| NOTE: LIABILITY LIMITATION FOR LOSS OR DAMAGE IN THIS SHIPMENT MAY BE APPLICABLE. SEE 49 USC § 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. | |||
| SHIPPER
SIGNATURE/DATE ______________________________ |
TRAILER
LOADED BY q SHIPPER q DRIVER |
FREIGHT
COUNTED BY q SHIPPER q DRIVER/PALLETS q DRIVER/CARTONS |
CARRIER
SIGNATURE/DATE __________________________________ TRAILER #SKIDS |
| This is to certify that the above named materials are properly classified, packaged, marked, and labeled, and are in proper condition for transportation according to the applicable regulations of the DOT. | Carrier acknowledges receipt of packages and required placards. Carrier certifies emergency response information was made available and/or carrier has the DOT emergency response guidebook or equivalent documentation in the vehicle. Property described above is received in good order, except as noted. | ||