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SHIPPER:
The agreed or declared value of the property is herby specifically stated by the shipper to be $50.00 USD per carton, unless otherwise indicate, Declared value (Not to exceed $5,000 per shipment): _______________ per ______________________________________
(Shipper Name/Authorized Personnel)
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DESTINATION (To):
Paul Rao
39 Pinesbridge Rd
Yorktown Heights
NY
10598
9142435457
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ORIGIN (From):
Forward Air - JFK
184-54 149th Ave
Springfield Gardens
NY
11413
7185537166
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DRIVERS LICENSE:
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CARRIER:
Cougar Express
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APPOINTMENT INFORMATION |
READY DATE/TIME |
DELIV DATE/TIME |
| SERVICE LEVEL:
Standard |
DATE
01/25/06
TIME 14:05 EST
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DATE
01/30/20
TIME 16:00 EST
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* * ALL INFORMATION BELOW IS REQUIRED * * |
SHIPMENT INFORMATION:
| No. of Pieces |
Actual Weight |
Dimensions |
Dimm Weight |
Description of Goods |
1 |
68 |
47X
15X
29 |
105.39 |
TV |
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Cash Amount __________
Driver's Initials __________
Check Amount _________
Driver's Initials __________
Receiving
Agent Initials __________
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FAA Security Endorsement: I certify that this cargo does not contain any unauthorized explosives, incendiaries or hazardous materials.
I consent to a search of this cargo.
I am aware that this endorsement and any original signature, along with other shipping documents, will be retained on file for at least (30) days.
DRIVER AT ORIGIN SIGNATURE_________________________________DATE__________TIME________
PRINT NAME_______________________________________________DATE__________TIME________
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DESTINATION SIGNATURE_____________________________________ DATE__________TIME________
PRINT NAME___________________________________________TOTAL NUMBER OF PIECES__________
TOTAL PIECES |
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QUANTITY DAMAGED |
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QUANTITY OVER |
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QUANTITY SHORT |
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RECEIVED ABOVE DESCRIBED GOODS IN GOOD CONDITION EXCEPT AS NOTED (OVERAGE, SHORTAGE, AND DAMAGED)
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| Carrier shall be liable for actual amount of loss or damage to products or goods incurred by any carrier as a result of damage, loss, or delay resulting from the acts or omissions of any carrier which liability shall not exceed the shipments declared value.
If no value is declared, then the maximum amount shall be limited to US$050/lb., not to exceed $50 per carton.
Carrier does not assume liability higher than US$5,000.00 per shipment.
In no circumstances shall any carrier be responsible for concealed loss or damage.
In no event shall carrier be liable for any indirect, special, consequential or incidental damages.
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