ALL SERVICES SUBJECT TO THE TERMS AND CONDITIONS OF THE FXF 100 SERIES RULES TARIFF. SEE FEDEX.COM FOR DETAILS. --- QUESTIONS? CALL 1.866.393.4585
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|   |   |   |   |   |   |   | Date |   |   |   |   |   |   |   |   | Purchase Order # |   |   |   | 
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|   |   |   |   |   |   |   | Shipper # |   |   |   |   |   |   |   | Shipper # |   |   |   | 
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|   |   |   |   |   |   |   |   | REQUIRED: Please select a service type | OPTIONAL: You may select a money-back guarantee | 
|   |   |   |   |   |   |   |   | q | FedEx Freight | ® | Priority | delivery (charges and tariff limitations may apply). | 
|   |   |   |   |   |   |   |   | q A.M. Delivery q Close of Business Delivery | 
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|   |   |   |   |   |   |   |   | q FedEx Freight® Economy | 
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| SHIPPER (from) | Please provide ZIP codes and phone numbers. |   |   |   |   |   |   | CONSIGNEE (to) |   |   |   |   |   |   |   |   | 
| Shipper |   |   |   |   | FXF Acct. # |   |   | Consignee |   |   |   |   |   |   |   |   |   | FXF Acct. # | 
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| Attn. to |   |   |   |   | Area Code |   | Phone Number | Attn. to |   |   |   |   |   |   |   |   | Area Code | Phone Number | 
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| Address |   |   |   |   |   |   |   |   |   |   |   |   | Address |   |   |   |   |   |   |   |   |   |   |   | 
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| Address (Store, Dept., Ste., Flr., Apt., Div.) |   |   |   |   |   |   |   |   |   |   |   | Address (Store, Dept., Ste., Flr., Apt., Div.) |   |   |   |   |   |   |   | 
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| Address |   |   |   |   |   |   |   |   |   |   |   |   | Address |   |   |   |   |   |   |   |   |   |   |   | 
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| City |   |   |   |   |   |   |   |   |   |   |   |   | City |   |   |   |   |   |   |   |   |   |   |   | 
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| State/Province |   |   | ZIP/Postal Code |   | Country |   | State/Province |   |   | ZIP/Postal Code |   |   | Country | 
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| Optional or Additional Service Fees and Charges rLiftgate rInside Pickup rLimited Access |   | Optional or Additional Service Fees and Charges rLiftgate rInside Delivery rLimited Access | 
| Shipper Bill of Lading # |   |   |   |   |   |   |   |   |   |   |   |   | rCustom Delivery Window: |   |   |   |   |   |   |   | 
| Special Instructions |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   | 
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| BILL FREIGHT CHARGES TO (if different than above): |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   | 
| Name |   |   |   |   |   | FXF Acct. # |   |   |   | Mailing Address |   |   |   |   |   |   |   | 
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| City |   |   |   |   |   |   |   |   |   | State |   | ZIP/Postal Code | Country |   |   | Area Code |   | Phone Number | 
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| Freight charges are PREPAID unless | USD | C.O.D. |   |   | 1. | The letters | “C.O.D.” must appear | in box before consignee’s name above. |   |   |   | 
| marked collect. |   |   |   |   | 2. | C.O.D. funds to be collected as: |  Certified Funds  Company Check | Personal Check | 
|   | CAD |   |   |   | 
| CHECK BOX IF COLLECT  |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   | 
| AMOUNT | 3. | C.O.D. fee to be paid by:  Shipper  Consignee |   |   |   | 
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REMIT C.O.D. TO (if different than shipper above):
|  |   | TOTAL H/U: |   | H MARK “X” OR “RQ” IN THE HM COLUMN TO DESIGNATE HAZARDOUS MATERIALS OR REPORTABLE QUANTITY AS DEFINED IN DOT REGULATIONS. |   | 
|  |   |   |   |   | FOR INTERNATIONAL SHIPMENTS INDICATE BROKER NAME, FAX AND PHONE NUMBERS. |   | 
|  |   |   |   | area code |   |   |   |   |   |   | 
|  |   | HM EMERGENCY CONTACT PHONE NUMBER (_______) ______________________ |   |   |   |   |   |   | 
|  | EEI/SED Number or Exception______________________________________ | AREA CODE | 
|  |   | CUSTOMER REGISTERED W/EMERGENCY RESPONSE INFO. PROVIDER or CONTRACT # | Phone # (_______) ___________________ | 
|  | ___________________________________________________________________ | Broker Name______________________________________________________ | AREA CODE | 
|  | Fax # (_______) _____________________ | 
|  |   | NOTE (1) Where the rate and carrier’s liability for loss or damage may be dependent on value, shippers |   |   |   |   |   |   | 
|  | FOR FREIGHT COLLECT SHIPMENTS |   |   |   |   | 
|  |   | must state specifically in writing the agreed or declared value of the property as follows: “The agreed |   |   |   |   | 
|  | Subject to Section 7 of conditions of applicable Bill of Lading. If this shipment is to be delivered to the consignee, | 
|  |   | or declared value of the property is specifically stated by the shipper to be not exceeding________ | 
|  |   | per_________.” |   |   | without recourse on the consignor, the consignor shall sign the following statement. The carrier may decline to | 
|  |   | Note(2)liabilitylimitationforlossordamageonthisshipmentshallbeapplicableasprovidedbycontract | make delivery of this shipment without payment of freight and all other lawful charges. | 
|  |   | or in the current NMFC or this carrier’s governing tariffs. See FXF 100 Series Rules Tariff for complete | Consignor Signature____________________________________________________________________________________________ | 
|  |   | limited liability provisions. Carrier’s maximum standard liability is limited to $25 per pound per package | 
|  |   | for NEW articles and $.50 per pound per package (or its equivalent in Mexican Pesos (MXN) or Canadian | SHIPPER CERTIFICATION |   |   |   |   |   | 
|  |   | Dollars(CAD),attherateofexchangewhichisineffectattheplaceandonthedateofshipment)for USED | Iherebydeclarethatthecontentsofthisconsignmentarefullyandaccuratelydescribedabovebythepropershipping | 
|  |   | orRECONDITIONEDarticles. Innocaseshallcarrierliabilityexceed$100,000peroccurrence(oritsequivalent | name, and are classified, packaged, marked and labeled/placarded, and are in all respects in proper condition for | 
|  |   | inMXNorCADattherateofexchangewhichisineffectattheplaceandonthedateofshipment) for NEW | 
|  |   | articlesor$10,000peroccurrence(oritsequivalentinMXNorCADattherateofexchangewhichisineffect | transport according to applicable international and national governmental regulations. | 
|  |   | at the place and on the date of shipment) for USED or RECONDITIONED articles. For availability and limits | Shipper Signature___________________________________________________________________ Date_____________________ | 
|  |   | of excess liability coverage and applicable rates and charges, please refer to FXF 100 Series Rules Tariff. Not | 
|  |   | selecting an additional coverage option is considered to be a waiver of same and standard liability coverage | CARRIER CERTIFICATION |   |   |   |   |   | 
|  |   | willapply. |   |   | Carrier acknowledges receipt of packages and required placards. Carrier certifies emergency response information | 
|  |   |  ArticlesareNEW,andrequireExcessLiabilityCoverageintheamountof_______________ | wasmadeavailableand/orcarrierhastheDOTemergencyresponseguidebookorequivalentdocumentinthevehicle. | 
|  |   | oUSD oCAD oMXNper olb. orokg.Additionalchargeswillapply. | 
|  |   |  ArticlesareUSEDorRECONDITIONEDandrequire ExcessLiabilityCoverage.Additionalchargeswillapply. | DATE | DRIVER/EMPLOYEE NUMBER |   | PIECE COUNT | TRAILER # | 
|  |   | NOTE (3) Commodities requiring special or additional care or attention in handling or stowing must be so |   |   |   |   |   |   | 
|  |   | markedandpackagedastoensuresafetransportationwithordinarycare.SeeSec.2(e)ofNMFCItem360. |   |   |   |   |   |   | 
|  | Create your next Bill of Lading online at fedex.com/us/freight/main/ |   | FedEx Freight |   | CO202/518-FXF 0023776PM |