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:
____________________________________________________________________________________________________________________________________________
