NONNEGOTIABLE STRAIGHT BILL OF LADING HOUSEHOLD MOVERS ______________________________________________ (Name of issuing carrier)
Received, pursuant to shipper's order for services (if any) and subject to the classifications and tariffs, rules, and regulations in effect on the date of the issue of this bill of lading, at _____________ (place of issue) on __________ (month & day), ____ (year), from __________ (shipper) of_____________________ (address), the property described below (contents and conditions of contents of packages unknown) consigned and destined as shown below. Each person or corporation in possession of the property under the contract, referred to in this document as carrier, agrees to carry to destination indicated below, if within the scope of its lawful operations, otherwise to deliver to another carrier to deliver to such destination. It is mutually agreed, as to each carrier of all or any of the property over all or any portion of route to destination, and as to each party at any time interested in all or any of the property, that every service to be performed under this document shall be subject to all conditions not prohibited by law, whether printed or written, contained in this bill of lading, including the terms and conditions on the reverse of this bill of lading, which are hereby agreed to by shipper and accepted for himself or herself and his or her assigns. Consigned to: __________________________________________ Address: _____________________________________________ City: _____________________________ State: ______________ Delivering carrier: __________ (designate) I. C. C. No.:__________
Subject to paragraph 7 of the terms and conditions, if this shipment is to be delivered to consignee without recourse on consignor, consignor shall sign the following statement:
Carrier shall not make delivery of this shipment without payment of transportation and all other lawful charges.
________________________________________________________ (Signature of shipper, if desired)
Weight
Rate
Charge _______________ _______________
Description _______________ _______________
_____________ ____________ _____________ ____________
Class ____________________ Table ______________________ rates apply
Received __________ Dollars ($__________) to apply in prepayment of the charges on the property described in this bill of lading.
_________________________________________________ (Signature, if appropriate) Agent or Driver (The signature here acknowledges only the amount prepaid.)
All advances and lawful charges must be paid in cash, money order, or certified check before carrier delivers or relinquishes possession of the property, unless otherwise indicated below by carrier.
SHIPPERS ARE REQUIRED TO DECLARE IN WRITING THE RELEASED VALUE OF THE PROPERTY
Except for the articles listed immediately below, the agreed or declared value of the property is hereby specifically stated by shipper, for purposes of the rates to be charged under this bill of lading, to not exceed _________ cents (__________¢) per pound, per article.
_____________________________________________, (Shipper)
_____________________________________________ (Signature)
Shipper declares valuations in excess of the limit set forth above on the following specific articles: Article __________ __________ __________ __________ Excess Value $__________ $__________ $__________ $__________
Space Below Is for Convenience of Carrier, and Is Not a Part
of the Bill of Lading Contract.
WEIGHT CERTIFICATE
Weight of vehicle before and after loading above described: ________________ Shipment is shown below. See Summary for net weight of shipment.
Tare Weight: ________________________________________ lb. Gross Weight: _______________________________________ lb. Van Number: _________________
Signature as to tare: _________________________________________ Signature as to gross: ________________________________________
Gross weight: ___________________________________________ lb..
Weighed by: ______________________________________________ _____________________________________________ (Signature)
Weigh master: Tare weight: _________________________________ lb.
Location of scale: Net weight: __________________________________ lb. Address: _______________________________________ ___________________________________________ City ___________________________________________ State
CONTRACT TERMS AND CONDITIONS
Set forth general terms and conditions:
____________________________________________________________________________________ ________________________________________________________