|Received, subject to individually
determined rates or contracts that have been agreed upon in writing between
the 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, on request, and to all applicable state and federal regulations.
||The carrier shall not make delivery of this shipment without payment of charges
and other lawful fees
This is to certify that the above named materials are properly classified, packaged,
marked, and labeled, and are in proper condition for transportation according to the applicable regulations of the DOT.
By driver/pallets said to contain
Carrier Signature/Pickup Date
Carrier acknowledges receipt of packages and required placards. Carrier certifies
emergency response information was made available and/or carrier has the DOT emergency response guidebook or equivalent
documentation in the vehicle. Property described above is received in good order, except as noted.