Bill of Lading - Original - Not Negotiable

Issued in accordance with the regulations made under the truck transportation act.

* Indicates required fields.
  Information
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spacer Carrier's Ref No.: Vehicle No.: Cosignor's Ref. No.: spacer
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  Point of Origin
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spacer Date: spacer
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spacer Address: spacer
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spacer City: spacer
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spacer State/Province: Zip/Postal Code: spacer
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  Consignor
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spacer Name: spacer
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spacer Address: spacer
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spacer City: spacer
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spacer State/Province: Zip/Postal Code: spacer
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  Consignee Information
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spacer Name: spacer
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spacer Address: spacer
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spacer City: spacer
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spacer State/Province: Zip/Postal Code: spacer
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  Destination
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spacer Address: spacer
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spacer Route: spacer
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spacer City: spacer
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spacer State/Province: Zip/Postal Code: spacer
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  Shipment Information
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# of Pieces / Quanitity Description of Goods / Special Marks Dangerous Goods Weight
Class Prim. & SubsId PIN/UN Number Packing Group
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Placecard Number Type 24 Hour Emergency Number
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spacer Special Agreement between cosigner and carrier (if any): spacer
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  Frieght Charges
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spacer Prepaid       Collect spacer
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  C.O.D Shipments
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spacer Prepaid    Collect spacer
spacer Amount: $ spacer
spacer Collect Charge: $ spacer
spacer GST: $ spacer
spacer Totals: $ spacer
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spacer Totals: $ spacer
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  Other
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spacer Declared Value:
MAXIMUM LIABILITY SHALL NOT EXCEED $4.41 PER KILOGRAM COMPUTED ON THE TOTAL WEIGHT OF THE SHIPMENT UNLESS DECLARED VALUATION STATES OTHERWISE.
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spacer $ spacer
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spacer At Responisable Transportation Services, we are committed to protecting your privacy. We use the information we collect about you to process your request. Please read our privacy policy for more details. spacer
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