Uniform Straight Bill of Lading: Rules

NATIONAL MOTOR FREIGHT CLASSIFICATION 100-Z
RULES
(To be printed on white paper)
UNIFORM STRAIGHT BILL OF LADING

Carrier’s Pro No. ________________________
ORIGINAL—NOT NEGOTIABLE Shipper’s Bill of Lading No. ________________
Consignee’s Reference/P.O. No. ____________
Name of Carrier ___________________________________________________________ Carrier’s Code (SCAC)___________________
RECEIVED, subject to individually determined rates or contracts that have been agreed upon in writing between the carrier and shipper, if applica-
ble, otherwise to the rates, classifications and rules that have been established by the carrier and are available to the shipper, on request:
From __________________________________________________________________________________ Date _________________________
Street _______________________ City ________________________ County ___________________ State ________________ Zip __________
the property described below, in apparent good order, except as noted (contents and condition of contents of packages unknown) marked, consigned, and destined as shown below,
which said carrier agrees to carry to destination, if on its route, or otherwise to deliver to another carrier on the route to destination. Every service to be performed hereunder shall be subject to
all the conditions not prohibited by law, whether printed or written, herein contained, including the conditions on the back hereof, which are hereby agreed to by the shipper and accepted for
himself and his assigns.
Consigned to _______________________________________________________________________________________________________________
On Collect on Delivery Shipments, the letters “COD” must appear before consignee’s name.
Destination Street ____________________________________________________________________________________________________________

City ___________________________________________ County ___________________________________State ________________ Zip __________
Delivering Carrier ____________________________________________________________________ Trailer No. _______________________________
Additional Shipment Information_________________________________________________________________________________________________
Collect on Delivery $ ________________________ and remit to: _______________________________________ C.O.D. charge Shipper T
Street ___________________________________________ City __________________ State ________________ to be paid by Consignee T
Handling Packages - Kind of Package, Description of Articles, Special Marks and Exceptions Weight Class or Cube
Units No. HM (Subject to correction) (Subject to Rate Ref. (Op-
No. Type Correction) (For Info. tional)
Type Only)
- Mark “X” to designate Hazardous Materials as defined in DOT Regulations. Freight charges are PREPAID
NOTE (1) Where the rate is dependent on value, shippers are required to state specifically unless marked collect.
in writing the agreed or declared value of the property as follows: CHECK BOX IF COLLECT T
“The agreed or declared value of the property is specifically stated by the shipper to be not FOR FREIGHT COLLECT SHIPMENTS:
exceeding _______ per _______.”
If this shipment is to be delivered to the consignee, without recourse
NOTE (2) Liability Limitation for loss or damage on this shipment may be on the consignor, the consignor shall sign the following statement:
applicable. See 49 U.S.C. § 14706(c)(1)(A) and (B). The carrier may decline to make delivery of this shipment without
payment of freight and all other lawful charges.
NOTE (3) Commodities requiring special or additional care or attention in handling or stowing
_________________________
must be so marked and packaged as to ensure safe transportation with ordinary care. See (Signature of Consignor)
Sec. 2(e) of NMFC Item 360.
Notify if problem en route or at delivery __________________________________________________________ (for informational purposes only)
Name Fax No. Tel. No.
Send freight bill to: _____________________________________________________________________________________________________

Company Name City Street State Zip
Shipper ___________________________________________________ Carrier ____________________________________________________

Per _____________________________________ Per _____________________________________ Date _______________
Shipper Certification Carrier Certification

This is to certify that the above-named materials are properly classified, Carrier acknowledges receipt of packages and required placards. Carrier certifies emergency response information was made available and/or
described, packaged, marked and labeled, and are in proper condition for carrier has the DOT emergency response guidebook or equivalent document in the vehicle.
transportation according to the applicable regulations of the DOT.
Per ____________________________________________________________________________ Package Nos. __________________________________
Per _________________________________________ Date __________________
Date __________________________________________________________________________________________________________________________

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Uniform Straight Bill of Lading: Rules

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NATIONAL MOTOR FREIGHT CLASSIFICATION 100-Z

UNIFORM STRAIGHT BILL OF LADING

Destination Street ____________________________________________________________________________________________________________

Send freight bill to: _____________________________________________________________________________________________________

Shipper _ Carrier __

Shipper Certification Carrier Certification

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