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Combined Uniform Household Goods Bill of Lading and Freight Bill-New York Commercial Zone

COVERED WAGON, INC.
MOVING-STORAGE-TRUCKING
506 HUDSON STREET
NEW YORK 14, N.Y.
ALgonquin 5-1788
NAME Richard Stankiewicz
FROM Storage 712 GReenwich St APT.
TO Stable GalloRy APT.
OTHER STOPS
Moving Date 3/23/24 DAY Mon TIME A.M. P.M.
TIME RECORD
Start        A.M./P.M. Customer Initials
Finish       A.M./P.M  Customer Initials
JOB HOURS
TRAVEL Hours
MOVING RATE: 1 SW 2 MEN @$11 00 Per Job Hr., Plus Hrs Travel Time
ESTIMATE OR REMARKS
Approx estimate-packing date-Instructions on job-or other info.
VALUATION
Customer (Shipper) is required to declare in writing the released value of the property. The agreed or declared value of the property is hereby specifically stated by the customer (shipper) and confirmed by their signature heron to be NOT exceeding 30 ( ) cents per pound per article unless specifically excepted. The Customer (Shipper) hereby declares valuations in excess of the above limits on the following articles: 
Article | Value
READ BY
IMPORTANT
(SIGN BEFORE START OF ANY SERVICE)
The Shipper, subject to and based on the rates, rules, regulations, and conditions in the carriers lawfully published tariff hereby orders the carrier to furnish transportations facilities and service described herein subject to all conditions herein contained, including valuation agreed or declared and the conditions on the back hereof which are hereby agreed to by the Shipper and accepted for himself and his assigns. Unless credit arrangements are made in writing the Shipper agrees to pay charges in cash, money order, or certified check prior to complete delivery. 
CUSTOMER:
By:
MOVER:
By:
DELIVERY RECEIPT
Except as specifically endorsed heron All services and All articles recieved in Good Condition. 
CUSTOMER:
By:
RATES and DESCRIPTION      Charges
Moving hours @ $ per hr. 
OVERTIME hours @ $ per hr. 
PIANO CHGS:
OTHER:
 Barrels, packed @ $ each
 Barrels, loaned @ $ each
 Wardrobes @ $ each
 Cartons or boxes @ $ each
 Matt, Cartons @ $ each
Other
Whse. Labor chgs.
Storage chgs.
Other
INSURANCE
Shipper declares the full value of the shipments for the purpose of insurance to be:
Amt. $ @ $ per $100.00
TOTAL CHARGES
Advance Deposit
BALANCE DUE
RECEIVED PAYMENT
MOVER
By
TERMS. Charges Payable in Cash, Money Order, or Certified Check on Delivery, BILL OF LADING |GIVE TO CUSTOMER BEFORE START OF JOB|