You are on page 1of 1

MASTER BILL OF LADING

Date: 09/11/15
SHIP FROM:

Mc Spadded Fast Lube

Name:
Address:

459 N. Wilson St.

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)

COUNCIL BLUFFS, IA 51501

City/State/Zip:

Scac:

THIRD PARTY FREIGHT CHARGES - Bill TO:


Name:
Address:

Pro number:

Load number:

WARREN DISTRIBUTION C/O INTELLIGENT


AUDIT SWIFT LOGISTICS

4080 McGinnis Ferry RD, Ste 102


Alpharetta, GA 30005

Freight Charge Terms: (freight charges are prepaid unless marked otherwise)

City/State/Zip:
SPECIAL INSTRUCTIONS:

Prepaid

Collect

3rd Party

XXXXX

Please reference RGA #290589 on all paperwork


Master bill of lading, with attached underlying Bills of lading
(check box)

CUSTOMER ORDER
NUMBER

# WEIGHT
PKGS

CUSTOMER ORDER INFORMATION


Must
5-Digit
4-Digit
Deliver
Destination Destination
By
Number
Number
Date

PALLET/
SLIP
(CIRCLE ONE)

RGA #290589

1867
Y
Y
Y
Y
Y
Y
Y

Grand Total

Y
|
|
|
|
|
|
|

5-Digit
Department
Number

Additional Shipper Info

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

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

4 drums

1867

drums

1867

Polar -20 Wash 55gl


CONSUMER COMMODITY, ORM-D

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

COD Amount: $__________________


Fee Terms: Collect

Prepaid

Customer check acceptable:

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:

This is to certify the above named materials are


properly described, packaged, marked and labeled, are
in proper condition for transportation according to the
applicable regulations of the DOT.

Troy Zeising

Freight Counted:

By Shipper

By Shipper

By Driver

By Driver/Pallets said to
contain
By Driver/Pieces

Carrier Signature/Pickup Date


Carrier acknowledges receipt of packages and required placards.
Carrier certifies emergency response information was made available
and/or carrier has the DOT emergency response guidebook or
equivalent documentation in the vehicle. Property described above is
received in good order, except as noted.

55

You might also like