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Straight Bill of Lading Short Form 1

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Straight Bill of Lading Short Form 1
Straight Bill of Lading Short Form 1
STRAIGHT BILL OF LADING
SHORT FORM
(ORIGINAL NOT NEGOTIATED)
BOL#:
Date:
Pro#:
PO#:
Shipper: Route#:
Trailer#:
Department#:
Consignee: Send freight bill to:
Freight Charges: Third Party (must be prepaid) Single Shipment: Yes No
# Packages HM Description of Articles Kind of Packaging Weight Class/Rate
TOTAL PCS:
TOTAL WEIGHT:
The agreed or declared value of the property is hereby specifically stated by the shipper to be not exceeding $ _______ per _______.
Liability limitations for loss or damage on this shipment may be applicable. See 49 U.S.C. 14706(c)(1)(A) and (8).
SPECIAL INSTRUCTIONS:
DATE: SHIPPER: CARRIER:
Shipper Certification:
This is to certify that the above named materials are
properly classified, described, packaged, marked, and
labeled, and are in proper condition for transportation
according to the applicable regulations of the DOT.
Carrier Certification:
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 document in the vehicle.
PER:
PER:
DATE: DATE:
PACKAGE NOS:
0
0.00
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Straight Bill of Lading Short Form 1