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
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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:
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