Bill Of Lading -Shimons Express

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Date:	BILL OF LADING		Page 1 of 1
SHIP FROM
Name:		Bill of Lading Number :
Address:
City/State/Zip:
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:
Address:
City/State/Zip:		Freight Charge Terms:(freight charges are prepaid unless marked otherwise)

SPECIAL INSTRUCTIONS:		Prepaid____	Collect____	3rd Party____
		(checkbox)	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
			PALLET/SLIP (CIRCLE ONE)		Y	N
			Y	N
			Y	N
			Y	N
			Y	N
			Y	N
			Y	N
			Y	N
GRAND TOTAL

CARRIER INFORMATION
HANDLING UNIT		PACKAGE		WEIGHT	H.M. (X)	COMMODITY DESCRIPTION		LTL ONLY
QTY	TYPE	QTY	TYPE			Commodities requiring special or additional care or attention in handling or stowing must be so marked and packaged as to ensure safe transportation with ordinary care. See Section 2(e) of NMFC Item 360		NMFC #	CLASS









							Grand 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: “The agreed or declared value of the property is specifically stated by the shipper to be not exceeding per .”

COD Amount: $

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 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

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.

CARRIER SIGNATURE / PICKUP DATE

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 good order, except as noted.