STRAIGHT BILL OF LADING - SHORT FORM - ORIGINAL - NOT NEGOTIABLERECEIVED, subject to the classifications and tariffs in effect on the date of issue of this Original Bill of Lading             Ship by:
          
The property described below. in apparent good order, except as noted (contents and condition of contents of packages unknown), marked, consigned, and destined as indicated below, which said carrier (the word carrier being understood throughout this contract as meaning any person or corporation in possession of the property under the contract agrees to carry to its usual place of delivery at said destination if on its route otherwise to deliver to another carrier on the route to said destination It is mutually agreed, as to each carrier of all or any said property over all or any portion of said route to destination and as to each party at any time interested in all or 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 Bill of Lading set forth (1) in Official Southern Western and Illinois Freight Classifications in effect on the date hereof If this is a rail or rail-water shipment or (2) in the applicable motor carrier classification or tariff if this is a motor carrier shipment.
From 
         
At       ,
   Date (mm/dd/yy) 
 
  Shipper's #: 
  Carrier's #:  

ON COLLECT ON DELIVERY SHIPMENTS, THE LETTERS "COD" MUST APPEAR BEFORE CONSIGNEE'S NAME - OR AS OTHERWISE PROVIDER IN ITEM 430, SEC. 1.
             BY GENCOM TRANSPORTATION, INC.                                          800-501-1281 
  CONSIGNEE  
       and   
 DESTINATION ,
            Route    
 
                Delivering Carrier  
  
      CAR OR VEHICLE INITIALS & NO
  
No
Units






 *
HM





 KIND OF PACKAGE, DESCRIPTION OF MATERIAL,
SPECIAL MARKS, AND EXCEPTIONS






*WEIGHT
(Sub to Cor)






 Class or
Rate





 Ck
Col






 Subject to Section 7 of Conditions of applicable bill of lading if this shipment is to be delivered to the consignee without recourse on the consignor, the consignor stall sign the following statement. The carrier shall not make delivery of this shipment without payment of freight and all other lawful charges.
_____________________________
(Signature of Consignor)

   If charges are to be prepaid write or stamp here
"To be Prepaid"

           
When transporting hazardous materials include the technical or chemical name for n.o.s. (not otherwise specified) or generic description of material with appropriate UN or NA number as defined in US DOT Emergency Response Communication Standard (HM 126C). Provide emergency response phone number in case of incident or accident (in box at right).
 Remit  
 C.O.D. To
 Address ,
  EMERGENCY
RESPONSE PHONE NO.

 

         COD AMT $
      
      Received $___________________
To apply in prepayment of the charges on the property described hereon ____________________________
(Agent or Cashier) Per__________________________
(The signature here acknowledges only the amount prepaid)
  
    
*If the shipment moves between two ports by a carrier by water, the law requires that the bill of lading shall state whether it is carrier's or shipper's weight.
†The fiber boxes used for this shipment conform to the specifications set forth in the box maker's certificate thereon, and all other requirements of Consolidated Freight Classification
†Shipper's imprint in lieu of stamp not part of bill of lading approved by the Interstate Commerce Commission
        
  
     Charges Advanced $___________________ 
Note-Where the rate is dependant on value, shippers are required to state specifically in writing the agreed or declared value of the property
The agreed or declared value of the property is hereby stated by the shipper to be not

Exceeding       Per   
This is to certify that the above named materials are properly classified, described, packaged, marked and labeled and are in proper condition for transportation according to the applicable regulations of the Department of Transportation _______________________________________Signature   COD Charge To Be Paid By:
 
  
  
   ,
       Per   Agent   Per
   
 Permanent post office address of shipper
 Mark with "X" to designate Hazardous Material as defined in Title 49 of Federal Regulations