ZF
Central Arizona Freight Inc.
PO BOX 1656
CHANDLER AZ85244
THE SOUTHWEST
cc
Phone: (602) 278-3803
I PHONE
SHIPPER NO.
Page: 1
NO.
CONSIGNEE NAME
ADDRESS
ADDRESS
STATE
I ZIP
(REQUIRED)
STATE
MARK "X" IN "HM" COLUMN FOR
HAZARDOUS MATERIALS
HM
I ZIP
EMERGENCY RESPONSE TELEPHONE NUMBER
FOR ALL HAZARDOUS MATERIALS
KIND OF PACKAGING, DESCRIPTION OF ARTICLES, SPECIAL MARKS AND EXCEPTIONS
I TRAILER II
Weight CLBS)
<Subj@ct To
Corr@ction}
TECHNICAL NAMES ARE REQUIRED
FOR "N.O.S." AND OTHER GENERIC
DESCRIPTIONS FOR ALL HAZARDOUS
MATERIALS ITEMS
FOR CARRIER USE ONLY
CLASS NMFC NO.
RATE
EXTENSION
TOTAL
§
C.O.D. FEE TO BE PAID BY:
X
SHIPPER
CONSIGNEE
3RD PARTY
C.O.D. PAYMENT METHOD:
Company Check Ok
Cash or Certified funds
NOTE<l} Liability Limitation for loss or damag@ on this shipHnt may b@ applicabh.
NOTEC2} Commoditi@s r@quiring sp@cial or additional car@ or addition in handling or stowing must b@ so
mark@d and packag@d as to@nsur@ saf@ transportation with ordinary car@. SH S@c 2C@} or NMFC Ihm 360.
NDTEC3} Wh@r@ th@ rat@ is d@p@nd@nt on valu@, shipp@rs ar@ r@quir@d to stat@ spRCifically in writing th@
agrHd or dMlar@d valu@ of prop@rty as follows:
Th@ agrHd or dMalr@d valu@ of th@ prop@rty is sp@cifically stat@ by th@ shipp@r to b@ not @xcHding
$
0 COLLECT
II
(REQUIRED)
TOTAL
$
(REQUIRED)
SPECIAL INSTRUCTIONS
CITY
COD
I RATE QUOTE
ROUTE
ADDRESS
I ZIP
STATE
CHARGES ARE PREPAID
UNLESS MARKED COLLECT
BILL TO
NO.
ON COD SHIPMENTS THE LETTERS "COD" MUST APPEAR BEFORE THE CONSINEE'S NAME
DESTINATION CITY
THIRD PARTY BILLING
NUMBER
SHIPPING
UNITS
I PHONE
PURCHASE ORDER NO.
SHIPPER NAME
CITY
AFFIX
PRO-LABEL
HERE
E-<0
HE-i
:.::0
TOTAL
NAME
ADDRESS
r,:io CITY
r:>::u
STATE
ZIP
NOTEC4} Subj@ct to S@ction 7 of Conditions of applicabh bill of lading. If this shipHnt is
to b@ d@liv@r@d to th@ consignH without r@cours@ on th@ consignor, th@ consignor shall
sign th@ following stat@Hnt: Th@ carri@r may d@clin@ to mak@ d@liv@ry of this
shipHnt without payHnt of fr@ight and all oth@r lawful charg@s.
PER
(Signature of Consignor-if Section 7 applies)
Received, subject to individually determined rates or contracts that have been agreed upon in writing between 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
upon request. The property described above, in apparent good order, except noted (contents and conditions of contents of packages unknown)
marked, consigned, and destined as shown below, which said carrier agrees to carry to destination, if on its routes, or otherwise to deliver
to another carrier on the route to destination. Every service to be performed hereunder shall be subject to the terms and conditions of the
Uniform Bill of Lading set forth in the National Motor Freight Classification in effect on date of shipment, as well as, the conditions on
the face hereof, which are hereby agreed to by the shipper and accepted for himself and his assigns.
THIS IS TO CERTIFY THAT THE ABOVE
NAMED MATERIALS ARE PROPERLY
CLASSIFIED, DESCRIBED, PACKAGED
MARKED AND LABELED, AND ARE
IN PROPER CONDITION FOR
TRANSPORTATION, ACCORDINGTO THE
APPLICABLE REGULATIONS OF THE
DEPARTMENT OF TRANSPORTATION
AUTHORIZED SIGNATURE
AUTHORIZED SIGNATURE
SHIPPER
CARRIER
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