Document kDdaEoV4dO9zv1vBb1BGNDwBV
R i= A
& X R R Es S S
COLLECT
UNIFORM EXPRESS RECEIPT
NON-NEGOTIABLE
Origin
752-F.TROY, N.Y.
Cod* No.
? 1412
Deitinollon City, and Slalo
NATICK, MASS.
.--Code No.
Rocolpl No.
C 55-61-11
Conilgnee'* Name, Addrei* and Credll Account Nor,
Date Shipped
Advance*
FORD MOTOR COMPANY ` BOSTON DEPOT . WORC TPK AT. SPEEN ROAB.
Shipper'* Name ond Addret*
THE BEND IX CORPORATION ' FR I CTl. ON .MATER I AL ' DTV j S I ON
12/21 1967
Paid In'Part
Storage
XX' | X X
Priced, By, V I.
Other- ".
XX I XX
Declared Value
Value Ctrnrde*
x x Txx
No. Pc*. Commodity Oeicftpllon Vr
2 Cl NS ASBESTOS BRAKE 'f , :;W0N-FLE)<)
Commodity Code
BLOC KS " * '
Weight
Rate Expreti Charge*'
.. 3i Bail* XX | XX
\ . Total !4 ? ' r. XX |x-x
1
'"I, C.O.D. . .
.
---- *1
l, , i ,
,*
C.O.D. Service Chg, * ' 1 i XX |: X X
SHIPPER'S COPY
NOTE--The Company will not pay over $50, In care of loti, or 50 cent* per pound, actual weight, for on/ihlpmonl tn excou of 100 pound*, unluit o greater vatuo li declurod an</chorgoi for inch creator vatuo paid.
Coir -Claw Collect Service Gig,Prom Conitgnoe? YES1' DNO
.......... rorm-3001 (N65)
Dato
Number Piece*
Hour
2--
A. M. P. M.
for Railway f:xproit Aunncy, Inc.
Recelvod ihlpmonl duterfbod truon, tubjoct to Iho Claiitncntloni and Tnrlfft in affect on the data hereof, which carrier agrnai to carry upon the tor/ntKttid ccndWom cl iha Uniform fxprott Receipt ol fortli In part on Iho rovorio tldo horoof and In full tn Iho oflodlvn Official Exploit Climlflcallon on lllu with Iho Inlentalo Commorce Commtulon and Iho reg. ulalory hodlet of llio ttaloi lo which tho thlppor agrvoi and at ovldnnco thuroof accopH title receipt. Value herein
declared by Shipper to bo I hat ontored In tpaco Itoroon, loading "Declared Voluo".
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