Page of
On Collect on Delivery shipments, the letters“COD” must appear before consignee’s name or as otherwise provided in Item 430, Sec.1.
TO:
Consignee
Street
City, State, Zip Code
Route
No. of Units
& Container Type
Shipper No.
Carrier No.
Date
Vehicle
Number
FROM:
Shipper
Street
City, State, Zip Code
24 hr. Emergency Contact Tel. No.
BASIC DESCRIPTION
(Name of carrier) ( SCAC)
TOTAL QUANTITY
(Weight, Volume,
Gallons, etc.)
WEIGHT
(Subject to
Correction)
CHARGES
(For Carrier
Use Only)
RATE
HM
ATTENTION SHIPPERS! FREIGHT CHARGES ARE PREPAID ON THIS BILL OF LADING UNLESS MARKED COLLECT.
PLACARDS TENDERED: YES
_
NO
_
REMIT
C.O.D. TO:
ADDRESS
C.O.D. FEE:
PREPAID ■
COLLECT ■ $
Note — (1) 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: “The
agreed or declared value of the property is hereby specifically stated by the shipper
to be not exceeding __________________ per __________________.
(2) Where the applicable tariff provisions specify a limitation of the carrier’s liability
absent a release or a value declaration by the shipper and the shipper does not
release the carrier’s liability or declare a value, the carrier’s liability shall be limited to
the extent provided by such provisions. See NMFC Item 172.
(3) Commodities requiring special or additional care or attention in handling or
stowing must be so marked and packaged as to ensure safe transportation. See
Section 2(e) of item 360, Bills of Lading, Freight Bills and Statements of Charges
and Section 1(a) of the Contract Terms and Conditions for a list of such articles.
I hereby declare that the contents of this
consignment are fully and accurately described
above by the proper shipping name and are
classified, packaged, marked and labelled/
placarded,
and are in all respects in proper
condition for
transport according to applicable
international and national governmental
regulations.
Signature
Subject to Section 7 of the conditions, if this shipment is to be
delivered to the consignee without recourse on the consignor, the
consignor shall sign the following statement:
The carrier shall not make delivery of this shipment without
payment of freight and all other lawful charges.
(Signature of Consignor)
RECEIVED, subject to the classifications and tariffs in effect on the date of issue of this Bill of Lading, the property
described above in apparent good order, except as noted (contents and condition of contents of packages unknown),
marked, consigned, and destined as indicated above which said carrier (the word carrier being understood throughout
this contract as meaning any person or corporation in possession of the property under the contract) agrees to carry to
its usual place of delivery at said destination, if on its route, otherwise to deliver to another carrier on the route to said
destination. It is mutually agreed as to each carrier of all or any of, said property over all or any portion of said route to
destination and as to each party at any time interested in all or any said property, that every service to be performed
hereunder shall be subject to all the bill of lading terms and conditions in the governing classification on the date of
shipment.
Shipper hereby certifies that he is familiar with all the lading terms and conditions in the governing classification and
the said terms and conditions are hereby agreed to by the shipper and accepted for himself and his assigns.
SHIPPER
PER
CARRIER
PER
DATE
COD
Amt: $
TOTAL
CHARGES $
FREIGHT CHARGES
FREIGHT PREPAID
except when box at
right is checked
Check box if charges
are to be
collect
STRAIGHT BILL OF LADING
ORIGINAL — NOT NEGOTIABLE
Permanent post-office address of shipper.
Proper Shipping Name, Hazard Class
UN or NA Number, Packing Group
UN or NA Number, Proper Shipping Name,
Hazard Class, Packing Group
or
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