BILL OF LADING

Bill of Lading Number:

SHIP FROM

SHIP TO

THIRD PARTY FREIGHT CHARGES BILL TO:

SPECIAL INSTRUCTIONS:

Custom Order Info:

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GRAND TOTAL:

CARRIER INFORMATION

Carrier Info:

Handling Unit

Package

LTL ONLY

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GRAND TOTAL:

RECEIVING STAMP SPACE

Agreed or declared value of the property: per .

GRAND TOTAL

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