Bill Of Lading - Short Form - Not Negotiable
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1BILL OF LADING – SHORT FORM – NOT NEGOTIABLE
SHIP FROM
Bill of Lading Number:
Name:
Purchase Order Number:
Street Address:
City, ST, Zip:
Dugan Truck Line
SHIP TO
Carrier Name:
Name:
Trailer number:
Street Address:
Serial number(s):
City, ST, Zip:
THIRD PARTY FREIGHT CHARGES BILL TO
SCAC: DUBL
Name:
Pro Number:
Street Address:
BAR CODE SPACE
City, ST, Zip:
Freight Charge Terms
(Freight charges are prepaid unless marked otherwise):
Special Instructions:
Prepaid
Collect
3rd Party
Master bill of lading with attached underlying bills of lading.
Handling Unit
Package
Commodity Description
Commodities requiring special or additional care or attention in handling or
Qty
Type
Qty
Type
Weight
HM (X)
NMFC No.
Class
stowing must be so marked and packaged as to ensure safe transportation
with ordinary care. See Section 2(e) of NMFC item 360
COD Amount: $
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
Fee terms: Collect
Prepaid
Customer check acceptable
stated by the shipper to be not exceeding
_
______________
per
______________.
Note: Liability limitation for loss or damage in this shipment may be applicable. See 49 USC § 14706(c)(1)(A) and (B).
The carrier shall not make delivery of this shipment without payment of charges and
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,
all other lawful fees.
classifications, and rules that have been established by the carrier and are available to
Shipper Signature
the shipper, on request, and to all applicable state and federal regulations.
___________________________________________________________
Shipper Signature/Date
Trailer Loaded:
Freight Counted:
Carrier Signature/Pickup Date
By shipper
By shipper
___________________________________________
___________________________________________
Carrier acknowledges receipt of packages and required
This is to certify that the above named materials are
By driver/pallets said to contain
placards. Carrier certifies emergency response information
properly classified, packaged, marked, and labeled, and are
By driver
was made available and/or carrier has the DOT emergency
in proper condition for transportation according to the
By driver/pieces
response guidebook or equivalent documentation in the
applicable regulations of the DOT.
vehicle. Property described above is received in good order,
except as noted.
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