Motor Carrier Straight Bill Of Lading - Long Form

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Packaging provided by Shipper conforms to specifications of manufacturer and is accepted by

Carrier as complying with Carrier requirements to transport goods hereunder in good order.

MOTOR CARRIER STRAIGHT BILL OF LADING - LONG FORM

ORIGINAL - NOT NEGOTIABLE

Shipper's No.

NAME OF CARRIER:

Received, subject to agreement of a shipment specific rate, if none exists, then as otherwise agreed between shipper or broker/third party and carrier, and , if none exists, then as contained in applicable motor carrier tariffs maintained subject to 49 USC §13710(a).

at

From

LAKESIDE FOODS, INC.

The property described below, in apparent good order, except as noted (contents and condition of contents of packages unknown), marked, consigned, and destined as indicated below, which said carrier agrees to

carry to destination or otherwise to deliver to another carrier on the route to said destination.

Broker or Third Party routings. Any contract or other arrangement for payment for carrier's transportation by a motor carrier broker, freight forwarder, consignee or other party than Shipper/Consignor shall be without

recourse to Shipper as provided under Section 7 of this bill of lading except that Shipper shall have no payment or indemnity obligations in any event.

Shipper and Carrier certify that each has read the terms of this bill of lading and each is familiar with those terms and conditions, including those on the back hereof, that each is bound by those terms, and that each

waives any rights under the Interstate Commerce Act pursuant to 49 USC §14101(b), the Uniform Commercial Code or other statute or regulation (to the extent allowed) that infringe or modify such terms and

conditions.

Consigned to

Destination _________________________________________ State _______________________________________________________________________________________

(Mail or street address of consignee - for purposes of notification only.)

Delivering Carrier_____________________________________________________________ Trailer No. _________________________ Seal No. _________________________

CASES

DESCRIPTION

WEIGHT

Subject to Section 7 of

Conditions of applicable bill of

lading, if this shipment is to

be delivered to the consignee

without

recourse

on

the

consignor, the consignor shall

sign the following statement:

The carrier shall not make

delivery

of

this

shipment

without payment of freight

and all other lawful charges.

________________________

(SIGNATURE OF CONSIGNOR)

Freight Charges are prepaid

unless arranged by Broker or

other Third Party or subject to

Section7.

Value of Property shall be

FULL VALUE unless carrier

and Shipper or Broker/Third

Party

agree

to

liability

limitation for loss, damage or

delay as follows:__________.

Election of less than FULL

VALUE subject to 49 USC

§ 14706(c)(l)(A)&(B).

Pallet Type ____________ Pallets In _____________ Pallets Out ____________

Temperature control, Special Handling or Stowage Requirements:

Temperature Control, minimum

˚F, maximum

˚F

Special Handling or Stowage

Carrier Receipt For Shipment

Consignee Receipt For Shipment

(Name)

(Date & Time)

(Name)

(Date & Time)

LAKESIDE FOODS, INC.,

Permanent post-office address of shipper: 808 Hamilton St., Manitowoc, WI 54220