Professional Documents
Culture Documents
Date: 09/11/15
SHIP FROM:
Name:
Address:
City/State/Zip:
Vinita OK 74301
RGA #290589
Shipper Order#(s):
SHIP TO:
WARREN DISTRIBUTION
2849 RIVER ROAD
Name:
Address:
SWIFT
CARRIER NAME:
Trailer number:
Seal numbers)
City/State/Zip:
Scac:
Pro number:
Load number:
Freight Charge Terms: (freight charges are prepaid unless marked otherwise)
City/State/Zip:
SPECIAL INSTRUCTIONS:
Prepaid
Collect
3rd Party
XXXXX
CUSTOMER ORDER
NUMBER
# WEIGHT
PKGS
PALLET/
SLIP
(CIRCLE ONE)
RGA #290589
1867
Y
Y
Y
Y
Y
Y
Y
Grand Total
Y
|
|
|
|
|
|
|
5-Digit
Department
Number
N
N
N
N
N
N
N
1867
CARRIER INFORMATION
Handling Unit
Qty
Type
Package
Qty Type
COMMODITY DESCRIPTION
Weight Hazmat
X
LTL ONLY
NMFC
CLASS
4 drums
1867
drums
1867
Grand Total
Where their rate is dependent 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 the property is specifically stated by the shipper to be not exceeding
_________________
CONTRACT
Prepaid
Per _________________________
Note: Liability Limitation for loss or damage in this shipment may be applicable. See 49 U.S. C. 14706(1)(A) and (B).
RECEIVED, subject to individually determined rates or contracts that have been agreed uponThe
in writing
carrier shall not make delivery of this shipment without payment of freight and
between the carrier and shipper, if applicable, otherwise to the rates, classifications and rulesall
that
havelawful charges.
other
been established by the carrier and are available to the shipper, on request, and to all applicable state
and federal regulations.
_______________________________Shipper Signature
SHIPPER SIGNATURE/DATE
Trailer Loaded:
Troy Zeising
Freight Counted:
By Shipper
By Shipper
By Driver
By Driver/Pallets said to
contain
By Driver/Pieces
55