Date

Bill of Lading – Short Form – Not Negotiable
Ship From: Bill of Lading Number:
SID No.:  
Ship To: Carrier Name: Metro Express America, Inc (MC: 547518)
CID No.: Trailer number:

Serial number(s):
Third Party Freight Charges Bill to: SPAC:
Pro Number:

BAR CODE SPACE

 
Special Instructions: Freight Charge Terms
(Freight charges are prepaid unless marked otherwise):
Prepaid □   Collect □   3rd Party □
□Master bill of lading with attached underlying bills of lading.
Customer Order Information
Customer Order No. # of Packages Weight Pallet/Slip
(circle one)		 Additional Shipper Information
      Y N  
      Y N  
      Y N  
      Y N  
Grand Total      
Carrier Information
Handling Unit Package   LTL Only
Qty Type Qty Type Weight HM (X) Commodity Description
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		 NMFC No. Class
                 
                 
                 
                 
                 
                 
                 
Where the 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 _______________ per _______________." COD Amount: $ ______________________________________________ .
Fee terms:
Collect □     Prepaid □    Customer check acceptable □
Note: Liability limitation for loss or damage in this shipment may be applicable. See 49 USC § 14706(c)(1)(A) and (B).
Received, subject to individually determined rates or contracts that have been agreed upon in writing between the carrier and shipper, if applicable, otherwise to the rates, classifications, and rules that have been established by the carrier and are available to the shipper, on request, and to all applicable state and federal regulations. The carrier shall not make delivery of this shipment without payment of charges and all other lawful fees. ________________________________________________________
Shipper Signature/Date ____________________________________ .
This is to certify that the above named materials are properly classified, packaged, marked, and labeled, and are in proper condition for transportation according to the applicable regulations of the DOT.		 Trailer Loaded:
□ By shipper
□ By driver		 Freight Counted:
□ By shipper
□ By driver
said to contain
___ pallets / ___ 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.