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Bill of Lading - Short Form - Not Negotiable: (Click To Select Date) Page 1 of 1

This bill of lading document summarizes the shipment of a freight delivery from [Shipper Name and Address] to [Receiver Name and Address]. It lists the bill of lading number, trailer and serial numbers, SCAC code, and pro number for the delivery. The document also provides shipping instructions, customer order information, carrier information, freight terms, and signatures acknowledging receipt of the shipment.

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766 views1 page

Bill of Lading - Short Form - Not Negotiable: (Click To Select Date) Page 1 of 1

This bill of lading document summarizes the shipment of a freight delivery from [Shipper Name and Address] to [Receiver Name and Address]. It lists the bill of lading number, trailer and serial numbers, SCAC code, and pro number for the delivery. The document also provides shipping instructions, customer order information, carrier information, freight terms, and signatures acknowledging receipt of the shipment.

Uploaded by

Anonymous hpky5fLnhm
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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[Click to select date] BILL OF LADING – SHORT FORM – NOT NEGOTIABLE Page 1 of 1

SHIP FROM Bill of Lading Number:


[Name]
[Street Address]
[City, ST ZIP Code]
SID No.:
SHIP TO Carrier Name:
[Name] Trailer number:
[Street Address] Serial number(s):
[City, ST ZIP Code]
CID No.:
THIRD PARTY FREIGHT CHARGES BILL TO SCAC:
[Name] Pro Number:
[Street Address]
[City, ST ZIP Code]

Special Instructions: Freight Charge Terms (Freight charges are prepaid unless marked otherwise):
Prepaid  Collect  3rd Party 

 Master bill of lading with attached underlying bills of lading.

CUSTOMER ORDER INFORMATION


Pallet/Slip
Customer Order No. # of Packages Weight Additional Shipper Information
(circle one)
Y N

Y N

Y N

Y N

Grand Total

CARRIER INFORMATION

Handling Unit Package LTL Only


Qty Type Qty Type Weight HM (X) Commodity Description NMFC No. Class
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
Section 2(e) of NMFC item 360

Where the rate is dependent on value, shippers are required to state specifically in writing the agreed or COD Amount: $ __________________________
declared value of the property as follows: “The agreed or declared value of the property is specifically stated
by the shipper to be not exceeding _______________ per _______________. Fee terms: Collect  Prepaid  Customer check acceptable 

Note: Liability limitation for loss or damage in this shipment may be applicable. See 49 USC § 14706(c)(1)(A) and (B).

Received, subject to individually determined rates or contracts that have been agreed The carrier shall not make delivery of this shipment without payment of charges and
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
all other lawful fees.
the shipper, on request, and to all applicable state and federal regulations. Shipper Signature _________________________________________________

Shipper Signature/Date Trailer Loaded: Freight Counted: Carrier Signature/Pickup Date


 By shipper  By shipper
__________________________________  By driver  By driver/pallets said to contain __________________________________
This is to certify that the above named materials are properly Carrier acknowledges receipt of packages and required
classified, packaged, marked, and labeled, and are in proper  By driver/pieces placards. Carrier certifies emergency response information
condition for transportation according to the applicable was made available and/or carrier has the DOT emergency
regulations of the DOT. response guidebook or equivalent documentation in the
vehicle. Property described above is received in good order,
except as noted.

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