| 1. From | Phone | |
| Date Nov 30, 1999 | ||
| Shipper's Name |
Mobile |
|
| Company |
Email Address |
|
| Department | ||
| TIN | Business Style | |
| Address: | ||
| City / Province |
Postal Code | |
| 2. To | Phone | |
| Date | ||
| Recipient's Name |
Mobile |
|
| Company |
Email Address | |
| Department | ||
| Address | ||
| City / Province |
Postal Code | |
| 3. Contents (Complete Description) | Total Declared Value | |
| |
||
| Total Packages | Dimension | Actual Weight |
| |
|
|
| 4. Packaging | ||
| Documents | Parcel | Crating |
| Small | Own Packaging | Skeletal Crating |
| Large | Others | Close Crating |
| 5. Mode of Shipping | ||
| Airfreight | Seafreight | Land Trip |
| 6. Services | ||
| Door to Door | Port to Door | Door to Port |
| 7. Delivery Instruction | ||
| Hold at Location | With Documents for Return |
Other ___________ |
| 8. Commodity Class | ||
| Regular | Fragile | Other |
| High Value | Perishable | |
| DG | Heavyweight | ____________ |
| 9. Document Attached | ||
| Invoice/Billing Statement | DG (MSDS) | |
| Packing List | Other | |
| Bill of Lading | ____________ | |
| 10. Sender's Name (Printed Name & Signature) | ||
| By signing on this document, I agree to the terms and conditions at the back of this non-negotiable Bill of Lading |
||
| 11. Receiving Employee (Printed Name & Signature) | ||
| All shipments sent via CBL Freight Forwarder and Courier Express Int'. Inc. are being picked up and delivered fastly, efficiently, and reliably. Pickup date/time:_____________________ |
||
| 12. Mode of Payment | |
| Bill Shipper | Cash/Check |
| Bill Consignee/Freight Collect | |
| 13. Charges | |
| Freight Charge | |
| Freight Charge | |
| Total Based Amount | |
| IATA | |
| Total Billing | |
| Declared Value | |
| ODA | |
| Crating | |
| Others | |
| Total |
|
| 14. Recipient Printed Name & Signature | |
| Received accompanying shipment in good order and condition. |
|
| Date Received |
Time |
| Type of ID |
ID No. |
| Relationship to the consignee |
|