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Shipper Information
Name:*
Company Name:*
Address:*
City:* Zip Code:*
Country:*: State:*
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Contact Email:*
Contact Name::
Consignee Information
Name:*
Company Name:*
Address:*
City:* Zip Code:*
Country:*: State:*
Contact Phone: Ext. 
Contact Email:
Contact Name:
Carrier: US Transport Network, Inc.   SCAC: USXC   PickUp Reference:

Shipments:

No. Shipping Units:* HM: Kind of Packing, Description of Articles, Special Marks and Exceptions:* Weight:* Class if Known: NMFC-: Sub:
Total Pieces: 0

When transporting hazardous materials include the technical or chemical name fro n.o.s. (not otherwise especified) or generic description of materials UN or NA numbers as defined in US DOT. *Emergency communication standard (HM-126c). Provide emergency response phone numbers in case of incident or accident in box above.

REMIT C.O.D TO: Freight Charges: C.O.D Fee:
Prepaid: Collect: Prepaid: Collect:
  C.O.D Amnt: TOTAL CHARGES:
 
Note: Whe the rate is dependent on value, shippers are required to state specifically in writing the agreed or declared value of the property. The agreed or declared value of the property is hereby specifically stated by teh shipper to be not exceeding: This is to certify that the above named materials are property classified, described, packaged, marked, and labeled, and are in proper condition for transportation according to the applicable regulations of the Department of Transportation: Subject to Section 7 of the conditions, if this shipment is to be delivered to the consignee without recourse on the consignor, the consignor shall sign the following statement. The carrier shall not make delivery of this shipment without payment of freight and all other lawful charges:
$ per Signature: Signature of Consignor:
RECEIVED: subject to classifications and lawfully filed tariffs in effect on the date of issue of this Bill of Landing, the property described above in apparent good order, except as noted (contents and conditions of contents of package unknown), marked, consigned and destined as indicated above which said (the word carrier being understood throughout this contract as meaning any person or corporation in possession of the property under the contract) agrees to carry to its usual place of delivery at said destination if on its route, otherwise to deliver to another carrier on the route to said destination.
It is mutually agreed as to each carrier of all or nay of said property over all or any portion of said route to destination and as to each party at any time interested in all or any said property that every service to be performed hereunder shall be subject to all the Bill of Landing terms and conditions in the governing classification on the date of shipment.
Shippers hereby certifies that he is familiar with all the Bill of Landing terms and conditions in the governing classification and the said terms and conditions are hereby agreed to by the shipper and accepted for himself and his assigns.
NOTICE: Freight moving under this Bill of Landing is subject to the classification and lawfully filed tariffs in effect on the date of this Bill of Landing. This notice supersedes and negates any claimed, alleged, or asserted oral or written contract, promise, representation or understanding between the parties with respect to this freight, except to the extent of any written contract which establishes lawful contract carriage and is signed by authorize representatives of both parties to the contract.
SHIPPER: CARRIER:
PER: PER:
DATE: