HTML Preview Bill Of Lading Front page number 1.
Date:
STANDARD TRUCKLOAD BILL OF LADING
Page _______
SHIP FROM
Name: Bill of Lading Number: ______________________
Address:
City/State/Zip:
BAR CODE SPACE
SID#: FOB:
SHIP TO CARRIER NAME: _______________________________
Name: Location #: __________ Trailer number:
Address: Seal number(s):
City/State/Zip: SCAC:
CID#: FOB: Pro number:
THIRD PARTY FREIGHT CHARGES BILL TO:
Name:
BAR CODE SPACE
Address:
City/State/Zip: Freight Charge Terms: (freight charges are prepaid
unless marked otherwise)
SPECIAL INSTRUCTIONS:
Prepaid ______ Collect _____ 3
rd
Party _____
_____
(check)
Master Bill of Lading: with attached
underlying Bills of Lading
CUSTOMER ORDER INFORMATION
CUSTOMER ORDER NUMBER # PKGS WEIGHT PALLET/SLIP
(CIRCLE ONE)
ADDITIONAL SHIPPER INFO
Y N
Y N
Y N
Y N
Y N
GRAND TOTAL
CARRIER INFORMATION
HANDLING UNIT PACKAGE
COMMODITY DESCRIPTION
QTY TYPE QTY TYPE
WEIGHT
H.M.
(X)
Commodities requiring special or additional care or attention in handli ng or stowing must be so marked
and packaged as to ensure safe transportation with ordinary care.
RECEIVING
STAMP SPACE
TOTAL
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:
COD Amount: $ ______________________
“The agreed or declared value of the property is specifically stated by the shipper to be
not exceeding _________________ per ___________________.”
Fee Terms: Collect: ___ Prepaid: ___
Customer check acceptable: ___
NOTE Liability Limitation for loss or damage in this shipment may be applicable. See 49 U.S.C. §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
the terms and conditions set forth on the reverse side hereon as well as to all applicable state and
federal regulations.
The carrier shall not make delivery of this shipment without payment of
freight and all other lawful charges.
__________________________________________________
Shipper Signature
SHIPPER SIGNATURE / DATE Trailer Loaded: Freight Counted: CARRIER SIGNATURE / PICKUP DATE
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.
__ By Shipper
__ By Driver
__ By Shipper
__ By Driver/pallets said to contain
___ By Driver/Pieces
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 apparent good
order, except as noted.