Bill of Lading
 = Required Field
Date: 12/12/2018 10:52:24 AM
Consignee Information  Shipper Information 
 Consignee Name  Shipper Name
 Consignee Address  Shipper Address
 Consignee City, State, Zip
 
 ,    Shipper City, State, Zip  ,  
 Consignee Phone, Ext.    Shipper Phone, Ext.  
 Consignee Email  Shipper Email
   Haz-Mat Emergency Phone
COD Information Other Information
 Total Amount $  Shipper's Number
 Check Type
Certified Company
 Purchase Order Number
 COD FEE TO BE
Prepaid Collect
 Quote Number
Remit COD Information Same as shipper Bill To Information 
 Remit COD Name  Bill To Name
 Remit COD Address  Bill To Address
 Remit COD City, State Zip  ,    Bill To City, State Zip  ,  
 Remit COD Phone, Ext.    Bill To Phone, Ext.  
 Remit COD Email  Bill To Email
Pieces Pkg. Type HM NMFC Item NO. Description of Articles, Special Marks, and Exceptions Class Weight(lbs.)
Pieces Pkg. Type HM NMFC Item NO. Description of Articles, Special Marks, and Exceptions Class Weight(lbs.)
Pieces Pkg. Type HM NMFC Item NO. Description of Articles, Special Marks, and Exceptions Class Weight(lbs.)
Pieces Pkg. Type HM NMFC Item NO. Description of Articles, Special Marks, and Exceptions Class Weight(lbs.)
Pieces Pkg. Type HM NMFC Item NO. Description of Articles, Special Marks, and Exceptions Class Weight(lbs.)
Declared Value Special Instructions
$ per