Form Op-097g - Straight Bill Of Lading - Original - Not Negotiable

OP-097G 11/11

Straight bill of lading—original—not negotiable

Place PRO label here.

DATE:

PRO. NO.

B/L NO.:

PAGE

SHIPPER NO.

TRAILER NO.

CONSIGNEE NAME AND ADDRESS

SHIPPER NAME

ADDRESS

CITY

STATE

ZIP CODE

DESTINATION CITY

STATE

ZIP CODE

ORIGIN CITY (IF DIFFERENT FROM ABOVE)

STATE

ZIP CODE

PHONE NO.

INVOICEE OR COD REMIT TO NAME (IF DIFFERENT FROM SHIPPER)

CUSTOMER NO.

STORE NO.

DEPT.

ADDRESS

P.O. NO.

CITY

STATE

ZIP CODE

SPECIAL INSTRUCTIONS

ATTN.

□

COD AMT $

□

COD FEE

CUSTOMER CHECK OK FOR COD AMOUNT?

PREPAID

COLLECT

Yes

NO. SHPNG

PKG

WEIGHT (LB)

CHARGES

UNITS

TYPE

DESCRIPTION OF ARTICLES, SPECIAL MARKS AND EXCEPTIONS

NMFC ITEM NO.

CLASS

SUBJ TO CORR

RATE

CARRIER USE ONLY

EMERGENCY CONTACT

SHIPMENT CHARGES PREPAID UNLESS

□

TOTAL

MARKED COLLECT: COLLECT

Phone:

Name:

Contract #:

CHARGES

NOTE (1) Where the rate depends on value, shippers must state specifically in writing the agreed or

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

declared value of the property as follows:

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

The agreed or declared value of the property is hereby specifically stated by the shipper to be not exceeding

If this shipment is to be delivered to the consignee without recourse on the consignor, the consignor shall sign

the following statement:

________________________________ per ______________________________________.

The carrier may decline to make delivery of this shipment without payment of freight and all other lawful charges.

Note: (2) Liability limitation for loss or damage on this shipment may be applicable. See 49

Signature of

U.S.C. §14706 (c)(1)(A) and (B).

consignor

Received subject to individually determined rates or written contracts that have been agreed on in writing between the carrier and shipper, if applicable, otherwise to rates, classifications and rules that have been established by the

carrier and are available to the shipper on request.

The property described above is in apparent good order, except as noted (contents and condition of contents of packages

It is mutually agreed as to each carrier of all or any of said property over all or any portion of said route to destination and as

unknown), marked, consigned, and destined, as indicated above which said carrier (the word carrier being understood

to each party at any time interested in all or any of said property, that every service to be performed hereunder shall be

throughout this contract as meaning any person or corporation in possession of the property under the contract) agrees to

subject to all the conditions not prohibited by law, whether printed or written, herein contained, including the conditions on

carry its usual place of delivery of said destination, if on its route, otherwise to deliver to another carrier on the route to said

the back hereof, which are hereby agreed to by the shipper and accepted for himself and his assigns.

destination.

I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name and are classified, packaged, marked and labeled/placarded and are in all respects in proper condition

for transport according to applicable international and national governmental regulations.

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SHIPPER COMPANY NAME

CARRIER

Trailer #

DATE

Trailer Loaded by:

Shipper

Driver

□

Driver: pallets said to contain

Freight Counted by: