STRAIGHT BILL OF LADING - SHORT FORM - ORIGINAL - NON-NEGOTIABLE

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This form contains the only information necessary for the motor carrier to deliver, rate, and invoice the shipment described below. The shipper and/or consignee are client(s) of MercTran, Inc., a third-party logistics service and payer of the freight bill. All agreements between the carrier and MercTran are contained in a signed contract agreement.
Date Pro# B/L# Quote# PO# Carrier#
SHIPPER
Phone
Name
Address
City	State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingDistrict of ColumbiaPuerto Rico Zip
CONSIGNEE
Phone
Name
Address
City	State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingDistrict of ColumbiaPuerto Rico Zip
PPD-3rd PARTY
Name
PAYMENT
PREPAID COLLECT       Amount US$
If COLLECT, is certified or company check acceptable? YES NO
SHIPMENT
#Shipping Units Packaging H/M Description NMFC# Class Weight (lbs.) Rate Charges (carrier use only) Special instructions
HAZARDOUS MATERIALS
Phone

PRINTABLE FORMS & DOCUMENTS

DOT Authorization

MercTran Bond

Transportation Brokerage
Contact (Carrier Contact)

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