Document x53Zvy4rbbVbzJanKB4KOR130

(Uniform Domestic Straight Bill of lading -- Short fomjfs adopted by Rail and Motor Carriers JUn# 10, 1949) -' , this ME7 JrKANDUM is an acknowledgment that a "bili of lading has been-issued and is not the Original Bill of Lading, rjra copy or duplicate, covering the property named herein, and is intended solely for filing or record. RECEIVED,,subject !he classifications and tariffs in effect on the date of the receipt by the comer of tbc property described in the Original Bill of Uding y, FROM S6RVSC IN&aSTSSAjL S A i i $ _ . the property described below, jn apparent gotid order, except as noted (contents and condition of contents of packages unknown), marked, consigned, and destined as indicated below, winch said earner (ththee wwoordrd coa; rrier being undcr- sio^^tiiroughout this contract as meaning any person or corporation in possession of the property undet the contract) agrees to carry to its usual piaee of delivery at said designation, if on its route, otherwise to deliver to^aenther earner on the route to said destination It is mutually agreed, as to each carrier of all or any of said property over all or any portion of said route to destination, and as to each party at any time interested in all*ir any of said property, that every service to be performed hereunder shall be subject to all the terms and conditions of the Uniform Domestic Straight BiH of Lading set forth (1) m Official, Southern, Western and Illinois Freight Classifications in effect on the date hereof, if this ts a rail or a rail-water shipment, or (21 in the applicable motor earner classification or tariff if this ib a motor carrier shipment Shipper hereby certifies that he is familiar nith all the terms and conditions of the said bill of lading, including those on the back thereof, set forth in the classification or tanff which governs the transportation of this shipment,and the said terms and conditions ate hereby agreed to by the shipper and accepted for himself and hs assigns. At imxiMwm* mmtmmn April 3, 1962 Shipper's No._ Consigned to Destination V<fsyminge-x3 Co,_________ e/o Lakeland Hospital tflecorisfiate of Route Delivering Carrier 77? tWs*tri Car Initial NO packages DESCRIPTION OF ARTICLES, SPECIAL MARKS, AND EXCEPTIONS Sacks asph&lfcwss natural crude Company Agent's No------------------------------------------ (Mail or street address of consignee--For purposes of notification only.) County of Car No. * WEIGHT {Sub. to Correction) Subject to Section 7 of Conditions of applicable bill of lading, if this shipment is to he delivered to the consignee without recourse on the consignor, the consignor shall sign the following statement. The carrier shall not make delivery of this shipment without payment of freight and all other law.nl charges CLASS or RATE (Signature of consignor) CK. COL It charges are to be prepaid, write r 6tamp here, "To Ik* Prepaid." - Received $ ................................................. to apply m prepayment of the charges on the property described hereon. Thi3 is to certify that the above articles are properly described by name and are packed and marked and are in proper condition for transportation according to the appli cable regulations prescribed by the Interstate Commerce Commission and the Secretary of Commerce. Agent or Cashier. S Per (The signature here acknowledges only the amount prepaid.) i/ ^A >' ft Charges advanced: -. -- / "Shipper's imprint in lieu of stamp; not a part of bill of lading approved by Die Interstate Commerce Commission." / The fibre boxes used for this shipment* conform to the specifications set forth \ in the box maker's certificate tjiereon, and all other requirements of 'Rule f] of the Consolidated Freight Classificatidrr .................. . If the shipment moves between two ports by a carrier by water, the law requires that the bill of lading shall state,, whether'11 ts "carrier's or shipper's weight." ` Note.--Where the rate is dependent on value, shippers are required to state specifically m writing the agreed or dechpred vsftye of the property. The agreed or declared value of the property t* hereby specifically stated by the shipper to be not exceeding ^ per _ s,, . C.. --------------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------JJ" ; *<> iOjf. Permanent post-office address of shippen Shipper Per &1. r$i Per. -V- _ Agent BSIS-Robers onO18 7 8