Fillable Form Otc-199 - Ups Freight (Upgf) printable pdf download

CUSTOMER SERVICE 1-800-333-7400

STRAIGHT BILL OF LADING - SHIPPING ORDER NOT NEGOTIABLE - DOMESTIC

DATE

UPS Freight (UPGF)

CONSIGNEE (TO)

SHIPPER (FROM)

On collect on delivery shipments, the letters "COD" must appear before

consignee's name or as otherwise provided in item 430, Sec. 1 of UPGF 102.

STREET ADDRESS

ZIP ( REQUIRED)

ZIP (REQUIRED)

CITY

STATE

CITY

STATE

P.O. NUMBER

STORE #

COUNTRY

BILL OF LADING NUMBER

STORE #

COUNTRY

CONSIGNEE PHONE #

CONTACT NAME

SHIPPER PHONE #

CONTACT NAME

DELIVERY SERVICES

PICK-UP SERVICES

Liftgate

Inside Delivery

Limited Access

Notification Before Delivery

Residential

Sort/Segregate

Liftgate

Inside Pickup

Limited Access

Protect from Freezing

BILL TO

REMIT C.O.D. CASH / CHECK TO

NORDSTROM C/O VERACTION

ADDRESS

3400 PLAYER'S CLUB PKWY, STE 300

IF NOT CHECKED, BOTH ARE ACCEPTABLE

FEE COLLECT UNLESS OTHERWISE MARKED

CITY

STATE

ZIP (REQUIRED)

COD FEE

CONSIGNEE CHECK

PREPAID

COLLECT

MEMPHIS, TN

38125

ACCEPTABLE

COD SHIPMENTS GOVERNED BY UPGF 102 RULES ITEM 430

COD AMT $

CERTIFIED CHECK

FREIGHT CHARGES ARE PREPAID UNLESS OTHERWISE MARKED

OR CASH

Prepaid

Collect

Third Party Prepaid

CHECK ONE:

Section 7 signature is not valid on Guaranteed Services. Guaranteed Services are subject to the terms, conditions and limitations set forth in the UPGF 102 Rules Tariff.

GRAM

LTL GUARANTEED SERVICE REQUESTED (if box is checked)

GRTD

LTL GUARANTEED A.M. SERVICE REQUESTED (if box is checked)

By checking this box, you request UPS Freight to deliver this shipment on the

By checking this box, you request UPS Freight to deliver this shipment by 12 PM

standard day of service and agree to pay all fees associated with this service.

on the standard day of service and agree to pay all fees associated with this service.

FOR FREIGHT COLLECT SHIPMENTS

Special Instructions

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. UPS Freight may decline to make delivery of

this shipment without payment of freight and all other lawful charges.

Consignor Signature ___________________________________________________________________________

DESCRIPTION OF ARTICLES, WEIGHT, NMFC & CLASS ARE SUBJECT TO CORRECTION

NO.

PKG

DESCRIPTION OF ARTICLES & SPECIAL MARKS

WEIGHT (lbs.)

NMFC NO.

CLASS

PCS.

TYPE

FILL IN PRODUCT DESCRIPTION BEING SHIPPED, USE NMFC # IF POSSIBLE.

TOTAL CUBE:

Mark with an "X" to designate hazardous materials as defined in title 49 of the Code of Fed. Reg.

HAZARDOUS MATERIAL EMERGENCY CONTACT INFORMATION BELOW:

CONTACT NAME: ____________________________________ CONTACT PHONE # ________________________________ CONTRACT #___________________________________

CARRIER LIABILITY

RECEIVED, subject to individually determined rates or contracts that have been agreed

Note (1) Where the rate and carrier's liability 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

upon in writing between the carrier and shipper, if applicable, otherwise to the rates,

specifically stated by the shipper to be not exceeding__________per___________."

classifications and rules that have been established by the carrier and are available to

Note (2) CARRIER LIABILITY for loss or damage will be the lesser of: (1) the actual invoice value of the article(s)

the shipper, on request,** the property described above, in apparent good order, except

lost, damaged or destroyed; or (2) the amount determined from the applicable limited liability provisions of the

as noted (contents and condition of contents of packages unknown) marked, consigned,

NMFC; or (3) the limits provided by contract, if applicable; or (4) carrier's governing tariffs unless Excess Declared

Value Coverage* is specifically requested along with the amount of coverage needed in writing on the bill of

and destined as shown above, which said carrier agrees to carry to destination, if on its

lading at the time of shipment and applicable charges are paid. Carrier's UPGF 102 series rules tariff** is

route, or otherwise to deliver to another carrier on the route to destination. Every

incorporated herein by this reference; please carefully review the tariff to determine the applicable limits of

service to be performed hereunder shall be subject to all conditions not prohibited by

liability for the type of article(s) being shipped.

law, whether printed or written, herein contained, including conditions on the back

*Certain articles are subject to a limited declared value, with a choice of rates under the tariff; please review the

tariff provisions before stating a value. SHIPPER REQUESTS EXCESS DECLARED VALUE COVERAGE IN THE AMOUNT

hereof, which are hereby agreed to by the shipper and accepted for itself and its

OF $______________

assigns. Where a third party bill to or broker exists, carrier holds both the shipper and

Note (3) Commodities requiring special or additional care or attention in handling or stowing must be so marked

consignee liable for freight charges.

and packaged as to ensure safe transportation with ordinary care. See Sec. 2(e) of NMFC Item 360.

TRAILER

LINEAR FEET

NUMBER:

OF SHIPMENT:

SEAL # APPLIED:

PLACE CARRIER

SHIPPER LOAD /

CONSIGNEE UNLOAD

PRO LABEL HERE

** Now available at - UPGF 102 Series Rules Tariff - Electronic Bill of Lading

UPS Freight shall have no liability or responsibility whatsoever in connection with this bill of lading

if the shipper did not tender the shipment to UPS Freight or its agent.

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 Department of Transportation.

UPS Freight

Firm name:

Carrier:

Driver:

Signed By:

Date received:

UPS Freight resp. piece count:

UPS Freight COPY

OTC-199 (Rev 01/13)

Form Otc-199 - Ups Freight (Upgf)

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