STRAIGHT BILL OF LADING
ORIGINAL -- NOT NEGOTIABLE
Shipper No:
_________________________
Carrier No. ___SALIX
2____________
Page 1 of 1
__Overpass Truck Lines
_______
Date ________________________
Name of Carrier
(SCAC)
On Collect on Delivery shipments, the letters "COD" must appear before consignee's name & or as
FROM:
otherwise provided in item 430, Sec 1.
Shipper: Overpass Truck Lines Terminal #4
TO:
Defense Depot Richmond
Consignee:
8000 Jefferson Davis Highway
118 Oakgrove Lane
Street:
Street:
Richmond
State: VA
Zip Code: 23297
Garrisonville
State: VA Zip Code: 22463
City:
City:
24 hr. Emergency Contact Tel. No. 800-851-8061
Route
Vehicle
Number:
No. of Units &
BASIC DESCRIPTION
TOTAL QUANTITY
WEIGHT
RATE
CHARGES
HM
Container Type
Proper Shipping Name, Hazard Class, Identification Number
(Weight, Volume,
(Subject to
(For Carrier
(UN or NA), Packing Group, per 172.101, 172.202, 172.203
Gallons, etc.)
Correction)
Use Only)
10 Drum
RQ
Xylenes, 3, UN1307, PG II
2082 L
3 Roll
Paper, Printing Newsprint
2070 lb
1 Drum
X
205 Kg
Calcium Resinate, 4.1, UN1313, PG III
40 Cyl
X
Nitrogen, Compressed, 2.2, UN1066
363 Kg
Placarded: Dangerous
REMIT C.O.D.
PLACARDS TENDERED: YES X
NO
TO ADDRESS:
I hereby declare that the contents of the
Note - Where the rate is dependent on value,
C.O.D. FEE:
COD
Amt: $
consignment are fully and accurately described
shippers are required to state specifically in
PREPAID
above by proper shipping name and are
writing the agreed or declared value of the
COLLECT $
classified, packed, marked and labeled, and are
property.
in all respects in proper condition for transport
by z Rail z Highway z Water (DELETE NON-
The agreed or declared value of the property is
TOTAL
Subject to Section 7 of the conditions, if this
APPLICABLE MODE OF TRANSPORT)
hereby specifically stated by the shipper to be
shipment is to be delivered to the consignee
CHARGES:
$
according to applicable international and
not exceeding
without recourse on the consignor, the
national governmental regulations.
consignor shall sign the following statement:
FREIGHT CHARGES
The carrier shall not make delivery of the
shipment without payment of freight and other
FREIGHT PREPAID
Check box if charges
lawful charges.
are to be
except when box at
collect
right is checked
____________________________________
__________________________Signature
$ ________________per ______________
(Signature of Consignor)
RECEIVED, subject to the classification and tariffs in effect on the date of the issue of this Bill of
any portion of said route to destination and as to each party at any time interested in all or any said
Lading, the property described above in apparent good order, except as noted (contents and
property, that every service to be performedhereunder shall be subject to all the bill of lading terms
condition of contents of packages unknown), marked, consigned, and destined as indicated above
and conditions in the governing classification on the date of shipment.
which said carrier (the word carrier being understood throughout the contract as meaning any person
or corporation in possession of the property under contract) agrees to carry to its usual place of
Shipper hereby certifies that he is familiar with all the bill of lading terms and conditions in the
delivery at said destination, if on its route, otherwise to deliver to another carrier on the route to said
governing classification and the said terms and conditions are hereby agreed to by the shipper and are
destination. It is mutually agreed as to each carrier of all or any of, said property over all or
accepted for himself and his assigns.
SHIPPER
CARRIER
PER
PER
DATE
Permanent post-office address of shipper
Figure 2-4. Typical Commercial Shipping Paper, Road or Rail
