Freight Management Systems
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Date:
BILL OF LADING
Page
SHIP FROM
Name:
Address:
City/State/Zip:
SID#:
SHIP TO
Name:
Address:
City/State/Zip:
SID#:
THIRD PARTY FREIGHT CHARGES BILL TO:
Name:
Address:
City/State/Zip:
SPECIAL INSTRUCTIONS
Bill of Lading Number:  
BAR CODE SPACE
CARRIER NAME:  
Trailer Number:
Seal Number(s):
SCAC:
Pro Number:  
BAR CODE SPACE
Freight Charge Terms: (Freight charges are prepaid unless marked otherwise.)
Prepaid Collect 3rd Party
(check box)
Master Bill of Lading: with attached underlying Bills of Lading
CUSTOMER ORDER INFORMATION
CUSTOMER ORDER NUMBER
# PKGS
WEIGHT
PALLET/SLIP
(CHECK ONE)
ADDITIONAL SHIPPER INFO
GRAND TOTAL
CARRIER INFORMATION
HANDLING UNIT
QTY
TYPE
PACKAGE
QTY
TYPE
 
WEIGHT
H.M.
(X)
COMMODITY DESCRIPTION
Commodities requiring special or additional care or attention in handling or stowing
must be so marked and packaged to insure safe transportation qith ordinary care
See section 2(e) of NMFC item 360
LTL ONLY
NMFC #
CLASS
 
 
 
GRAND TOTAL
 
 
Where the rate is dependant 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 this property is specifically stated by the shipper to be not exceeding
(dollar amount) per (weight)."
COD AMOUNT: $   
Fee Terms:     Collect:      Prepaid:   
Customer Check acceptable  
RECEIVED, subject to indiviually determined rates or contracts that have ben 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 lawfull charges.

______________________________________________________ Shipper
Signature

SHIPPER SIGNATURE / DATE
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 applicable regulations of the U.S. DOT.
Trailer Loaded:
Freight Counted:
 
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 U.S. DOT emergancy response guidebook or equivalent documentation in the vehical.
Property described above is received in good order, except as noted.
         
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