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Fill in a Valid Hazard Bill Of Ladden Form

The Hazard Bill of Lading is a crucial document used in the transportation of hazardous materials, serving as a contract between the shipper and the carrier. This form outlines the specifics of the shipment, including the nature of the hazardous materials, and establishes the responsibilities and liabilities of both parties. By ensuring compliance with safety regulations, the Hazard Bill of Lading plays a vital role in protecting public safety and the environment during the transport of potentially dangerous goods.

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Fill in a Valid Hazard Bill Of Ladden Form

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®, Neenah, WI • USA • (800) 327-6868 • jjkeller.com • Printed in the United States	HAZARDOUS MATERIALS
ASSOCIATES, INC.	CONTAINS
© Copyright 2010 J. J. KELLER &

CONTAINS HAZARDOUS MATERIALS

STRAIGHT BILL OF LADING – ORIGINAL – NOT NEGOTIABLE

					Shipper’s No.
Carrier					Carrier’s No.
Carrier				SCAC				Date
TO:				FROM:
Consignee				Shipper
Street				Street
Destination			Zip	Origin					Zip
Route					Vehicle Number			U.S. DOT Hazmat Reg. No.

Number and Type	HM	I.D.	Description of Articles		Hazard	Pkg.	Total Quantity		Weight	Class or
of Packages	HM	Number	Description of Articles		Class	Grp.	(mass, volume, or		(subject to	Rate
of Packages		Number			Class	Grp.		activity)	correction)	Rate
								activity)	correction)

CONTAINS HAZARDOUS MATERIALS

Remit COD to:			Subject to Section 7 of conditions, if this	COD AMT:		COD FEE:
			shipment is to be delivered to the consignee
Address:			without recourse on the consignor, the				□
			consignor shall sign the following statement:			Prepaid
City:	State:	Zip:	The carrier shall not make delivery of this	$
			shipment without payment of freight and all			Collect	□ $
			other lawful charges.
NOTE: Where the rate is dependent on value, shippers are required to state specifically in writing					TOTAL CHARGES:
						FREIGHT CHARGES:
the agreed or declared value of the property. The agreed or declared value of the property is				$
hereby specifically stated by the shipper to be not exceeding $		Per	(Signature of Consignor)			□ Prepaid		□ Collect

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 all applicable state and federal regulations; the Property described above, in apparent good order, except as noted (contents and condition of contents of packages unknown), marked, consigned, and destined as indicated above, which said company (the word company being understood throughout this contract as meaning any person or corporation in possession of the property under the contract) agrees to carry to delivery at said destination, if on its route, or otherwise to deliver to another carrier on the route to said destination. It is mutually agreed as to each carrier of all or any 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 of said Property that every service to be performed hereunder shall be subject to all the conditions not prohibited by law, whether printed or written, herein contained, including the conditions on the back hereof, which are hereby agreed to by the shipper and accepted for himself and his assigns.

NOTE: Liability Limitation for loss or damage in this shipment may be applicable. See 49 U.S.C.				PLACARDS	□ BY SHIPPER	□ BY CARRIER
14706(c)(1)(A) and (B).		PLACARDS		SUPPLIED	□ BY SHIPPER	□ BY CARRIER
This is to certify that the above-named materials are properly classified, described, packaged, marked		PLACARDS		SUPPLIED
		REQUIRED		DRIVER’S
and labeled, and are in proper condition for transportation according to the applicable regulations of		REQUIRED		DRIVER’S
the Department of Transportation. Per				SIGNATURE:

SHIPPER:			CARRIER:
PER:	DATE:		PER:		DATE:

EMERGENCY RESPONSE		NAME OR CONTRACT NUMBER
TELEPHONE NUMBER:		OR OTHER UNIQUE IDENTIFIER:

215-BLC-O 3 12466 (Rev. 9/10)

CONTAINS HAZARDOUS MATERIALS 1

TERMS AND CONDITIONS

By giving the carrier the property described in this bill of lading (the “Property”), you agree to all of the terms of this bill of lading.

Section 1 Limitations of Liability

(a)The carrier or party in possession of the Property shall be liable as at common law for any loss of or damage to such Property, except as hereinafter provided.

(b)The carrier shall not be liable for loss of, damage to or delay in delivery of the Property:

(i)caused by an act of God, the public enemy, the authority of law, or any act or default by you and/or the owner of the Property, or for natural shrinkage.

(ii)occurring while the Property is stopped and held in transit at your request or that of any other party entitled to make such request.

(iii)resulting from a defect or vice in the Property, or from riots or strikes.

(c)To the extent permitted under the Carmark Amendment, the liability of the carrier for the Property may be limited to a value established by written or electronic declaration by you or by written agreement between the carrier and you. In all cases not prohibited by law, where a lower value than actual value has been represented in writing by the shipper or has been agreed upon in writing as the released value of the Property as determined by the classification or tariffs upon which the rate is based, such lower value plus freight charges if paid shall be the maximum amount to be recovered, whether or not such loss or damage occurs from negligence.

Section 2 Filing of Claims

(a)Claims against the carrier for loss of or damage to the Property must be filed in writing with the carrier issuing this bill of lading within nine months after delivery of the Property (or, in case of export traffic, within nine months after delivery at port of export) or, in case of failure to make delivery, then within nine months after a reasonable time for delivery has elapsed. All causes of action must be instituted within two years following the date when written notice is given by the carrier to you that the carrier has disallowed the claim or any part or parts thereof specified in the notice. If your claim or action is not filed or instituted properly in accordance with the foregoing provisions, the carrier shall not be liable, and such claims may not be paid.

(b)The carrier shall have the full benefit of any insurance that may have been effected upon or on account of the Property in the event that the carrier is liable for loss of or damage to the Property.

Section 3 Method of Transportation

Except as expressly agreed in writing by the parties to this bill of lading, the carrier is not bound to transport the Property by any particular motor vehicle, or in time for any particular market or otherwise than with reasonable dispatch. The carrier shall have the right in case of physical necessity to forward said Property by any carrier or route between the point of shipment and the point of destination.

Section 4 Responsibility for Property

(a)If the Property is not removed by the party entitled to receive it within the free time allowed by tariffs or classifications upon which the rate is based, (such free time to be computed as therein provided), the carrier may notify the receiving party of the arrival of the Property at the destination or at the port of export (if intended for export). The carrier, in its discretion, may store the Property in a public or licensed warehouse at the place of delivery or other available place, at the cost of the owner. The stored Property will be subject to a lien for all freight and other lawful charges, including a reasonable charge for storage. The carrier’s responsibility shall be that of a warehouseman only.

(b)Except as provided in subparagraph 4(c) below, if the Property is refused by consignee or the party entitled to receive it, or said consignee or party entitled to receive it fails to receive it within 15 days after notice of arrival shall have been duly sent or given, the carrier may sell the Property at public auction to the highest bidder, at such place as may be designated by the carrier. Prior to any such sale, the carrier shall use commercially reasonable efforts to notify you that the Property has been refused or remains unclaimed, as the case may be, and that it will be subject to sale under the terms of the bill of lading if you do not arrange for an alternative disposition.

(c)If the Property is perishable and is refused by the consignee or party entitled to receive it at the destination location, or said consignee or party entitled to receive it shall fail to receive it promptly, the carrier, may, in its discretion, to prevent deterioration or further deterioration, sell the same to the best advantage at private or public sale. Prior to selling the Property, the carrier shall use commercially reasonable efforts to notify you of the refusal of the Property or the failure to receive it, and request instructions regarding disposition of the Property.

(d)If the procedure described in subsection (b) and (c) is not commercially reasonable, the carrier may, at its option, sell the Property under such circumstances and in such manner as may be authorized by law.

(e)The carrier shall apply the proceeds of any sale made under this section to the payment of freight, demurrage, storage, and any other lawful charges and the expense of notice, advertisement, sale, and other necessary expense and of caring for and maintaining the Property, if proper care of the same requires special expense. If following payment of the preceding there is a balance, such balance shall be paid to the owner of the Property sold hereunder.

(f)If you direct the carrier to deliver the Property to a location where there is no regularly appointed freight agent, the carrier shall not be liable for any loss or damage to Property occurring at such location after the Property has been unloaded at such location.

Section 5 Valuable Items

(a)The carrier’s liability in connection with the Property is limited to the lesser of the amount of your actual damages or the declared value stipulated by the carrier on the face of this bill of lading plus any freight charges paid by you.

(b)The carrier shall not be liable in any way for any documents, specie, or for any articles of extraordinary value not specifically rated in the published classifications or tariffs unless a special agreement to do so and a stipulated value of the articles are endorsed on this bill of lading.

Section 6 Joint Liability for Hazardous Goods

You, and if you are an agent, any owner of the Property, shall be joint and severally liable for and indemnify the carrier against all loss or damage caused by the shipment of explosives, dangerous or hazardous goods, without giving prior written notice to the carrier of their nature. At the discretion of the carrier, any such goods may be warehoused at your and the owner’s risk and expense or destroyed without compensation.

Section 7 Freight Charges and Payment

(a)You are primarily responsible for the freight and all other lawful charges, unless you stipulate in writing in the space provided for that purpose on the face of this bill of lading that the carrier shall not make delivery without requiring payment of such charges and the carrier makes delivery without requiring such payment. If you provide erroneous information that results in the shipment being reconsigned or diverted to a location other than the location identified in the original bill of lading, you shall be liable for such additional charges. The respective liability of you and the consignee for additional charges provided for herein shall be pursuant to 49 U.S.C. § 13706.

(b)Nothing in this bill of lading shall limit the right of the carrier to require the prepayment or guarantee of charges at time of shipment. If upon inspection the carrier determines that the articles shipped are not those described in this bill of lading, the freight charges must be paid upon the articles actually shipped.

Section 8 Effect of Shipper Signature

If this bill of lading is issued on the order of the shipper, or his agent, in exchange or in substitution for another bill of lading, the shipper’s signature to the prior bill of lading as to the statement of value or otherwise, or election of common law or bill of lading liability, in or in connection with such prior bill of lading, shall be considered a part of this bill of lading as fully as if the same were written or made in or in connection with this bill of lading.

Section 9 Transport by Water

If all or any part of the Property is carried by water over any part of said route, and any loss of or damage to the Property occurs while it is in the custody of the carrier providing the water carriage, the liability of such carrier shall be determined by that carrier’s bill of lading and by the laws and regulations applicable to transportation by water. Such water carriage shall be performed subject to all of the terms and provisions of, and all the exemptions from liability contained in the Harter Act or the Carriage of Goods By Sea Act, as applicable.

Document Information

Fact Name	Description
Form Type	This is a Hazardous Materials Straight Bill of Lading, which is not negotiable.
Governing Law	The bill is subject to federal regulations, specifically 49 U.S.C. § 14706(c)(1)(A) and (B).
Liability Limitations	The carrier's liability for loss or damage may be limited based on the shipper's declared value.
Claims Filing	Claims for loss or damage must be filed within nine months after delivery or reasonable time for delivery.
Emergency Response	Emergency response information must be included, such as a name, contract number, and telephone number.

Hazard Bill Of Ladden - Usage Guidelines

Filling out the Hazard Bill of Lading form is a critical step in ensuring the safe and compliant transport of hazardous materials. By accurately completing this form, you help facilitate the movement of goods while adhering to necessary regulations. Follow these steps to ensure that all required information is provided clearly and correctly.

Begin by entering the Shipper’s Number in the designated field.
Fill in the Carrier and Carrier’s Number as applicable.
Provide the SCAC code, which is a unique identifier for the carrier.
Enter the Date of shipment.
In the FROM section, fill out the Shipper information, including Street, City, State, and Zip.
Complete the TO section with the Consignee details, including Street, City, State, and Zip.
Indicate the Destination and Origin Zip codes.
Fill in the Route and Vehicle Number as necessary.
Provide the U.S. DOT Hazmat Reg. No. along with the HM I.D. and Description of Articles.
Specify the Hazard Class and Packaging Type for the materials being shipped.
Enter the Total Quantity and Weight of the shipment.
Indicate whether the shipment is Prepaid or Collect and fill in the COD Amount and COD Fee if applicable.
Complete the Total Charges and Freight Charges sections.
Have the Consignor sign the form, confirming the information provided.
Ensure the Driver’s Signature is included, along with the Date.
Finally, provide an Emergency Response Name or Contract Number and the corresponding Telephone Number.

Once the form is completed, it is essential to keep a copy for your records. This document will serve as proof of the shipment and can be crucial in case of any issues during transport. Ensure that all parties involved have access to the necessary information to facilitate smooth handling and delivery of the hazardous materials.

Common PDF Forms

Uscis I864 - It is advisable to keep a copy of the submitted I-864 for records.

For those navigating end-of-life care choices, it is crucial to have access to resources that clarify important documents like the DNR Order form. Proper guidance on how to complete and implement this form can be found at Colorado PDF Templates, which aims to ensure that individuals are well-informed and their preferences are honored.

Da - Loss of accountability can lead to legal consequences, highlighting its importance.

Dos and Don'ts

When filling out the Hazard Bill of Lading form, it is crucial to follow certain guidelines to ensure accuracy and compliance. Below is a list of things you should and shouldn't do:

Do ensure all information is accurate and complete, including the description of hazardous materials.
Do clearly indicate the total quantity and weight of the packages being shipped.
Do sign the form where required, confirming that you understand the terms and conditions.
Do check for any specific requirements related to the transportation of hazardous materials.
Do keep a copy of the completed form for your records.

Don't omit any necessary details about the hazardous materials, as this could lead to legal issues.
Don't use vague language when describing the contents of the shipment.
Don't forget to include any special handling instructions if required.
Don't leave the form unsigned, as this could invalidate the shipment.
Don't ignore any regulations that pertain to the specific type of hazardous materials being shipped.

Common mistakes

Incomplete Information: Failing to fill out all required fields can lead to delays. Ensure every section is completed, including the shipper and consignee details.
Incorrect Hazard Class: Misclassifying the type of hazardous material can result in serious consequences. Double-check the classification against the material's safety data sheet (SDS).
Missing Signatures: Not signing the form can void the agreement. Ensure that the shipper's signature is present before submission.
Wrong Weight or Quantity: Providing inaccurate weight or quantity can lead to additional charges or shipment delays. Always verify these details before submitting the form.
Improper Packaging Information: Failing to specify how the hazardous materials are packaged can lead to mishandling. Clearly describe the packaging used.
Ignoring COD Instructions: If the shipment is cash on delivery (COD), make sure to fill out the COD amount and fee correctly. Missing this information can complicate the delivery process.
Omitting Emergency Contact Details: Not providing an emergency response name or contact number can hinder quick action in case of an incident. Always include this crucial information.
Not Reviewing for Errors: Skipping a final review of the completed form can lead to simple mistakes that may have significant repercussions. Take the time to check for accuracy.

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