Uniform Household Goods Bill of Lading
Customer: This bill of lading establishes a contract between you and the household goods carrier. It confirms instructions and authorizes the carrier to move, pack, store, and/or perform services shown. Before you sign this document it is important that you first read the document, including the back, and that you ask for an explanation of anything that is not clear or is different from any previous information received from the carrier or carrier's representatives. This contract is subject to conditions on the back of this form.
Origin and Destination Information
- Origin Address
- Customer
- Phone
- Cell
- Billing Address
- Address of Intermediate Stops
- Destination Address
- Name of Consignee (if different)
- Phone
- Other
Hourly Rated Moves
Personnel name, Start, Stop, and Break times are to be completed for EACH personnel performing the move.
| Date | Vans | Personnel Name | Start | Arrive | Breaks | Depart | End | Total Time | Rate | Charges |
|---|---|---|---|---|---|---|---|---|---|---|
| This is space for a list. | ||||||||||
Storage
If shipment will be placed into storage, the CUSTOMER MUST INITIAL the storage option (Storage in Transit, Permanent Storage, or Storage In-Vehicle) they selected and indicate the storage location.
The storage location will be at: [insert location]
Storage in Transit
I certify that the shipment is to be placed in storage for a period of 90 days or less. I understand that on the 91st day of storage the shipment becomes permanent storage.
- Warehouse Handling In/Out: [insert pounds] lbs x $[insert amount] = [total amount]
- Additional Valuation: $[insert cost] x [number of months] = [total amount]
- Total Storage: [insert pounds] lbs/100 @[rate] x [insert number] months = $[total amount]
- Total Charges: $[insert amount]
Permanent Storage
Shipment is to be placed in storage for more than 90 days.
Storage In-Vehicle
I certify that I have requested Storage-in-Vehicle for a period of [insert number] days at an agreed upon rate of $[insert amount] per day.
[Insert Signature of Customer]
Loss and Damage Protection (Valuation)
The CUSTOMER MUST SELECT AND INITIAL ONLY ONE valuation protection option:
- Basic value protection. I release this shipment to a value of 60 cents per pound per article, at no cost to me. This means I will be paid 60 cents per pound for the net weight of the lost or damaged item, regardless of the actual value of the item.
- Replacement cost coverage with $300 deductible paid by me. This option will cost $[insert amount]. The value I declare must be at least $9.16 times the net weight of the shipment.
- Replacement cost coverage with no deductible. This option will cost $[insert amount]. The value I declare must be at least $9.16 times the net weight of the shipment.
I declare a lump sum total dollar valuation on this entire shipment of $[insert amount].
Total Valuation Charges: $[insert amount]
Estimates
CUSTOMER MUST INITIAL ONE OPTION BELOW:
- I understand this shipment is moving under a binding estimate and that I will be required to pay the amount shown on the estimate.
- I understand this shipment is moving under a non-binding estimate. If the charges shown on the bill of lading exceed the charges on the non-binding estimate given me by the carrier, the carrier must release the shipment to me upon payment of no more than 110% of the estimated charges and will extend credit for at least 30 days in which I must pay the remainder due. In no case will I be required to pay more than 125% of the estimate (plus any supplemental estimate).
Customer Release
I have read and understand this contract, and release my household goods to the carrier subject to the terms and conditions of this contract.
[Insert Customer Signature]
[Insert Date]
[Insert Carrier Representative Signature]
[Insert Date]
Mileage Rated Moves
- Mileage: [insert mileage]
- Mileage Software: [insert software name]
- Gross Weight: [insert pounds] lbs - Tare Weight: [insert pounds] lbs = Net Weight: [insert pounds] lbs.
- Tariff Rate Charged: $[insert amount]
Per Diem
Workers × stays × rate = total charges
- Number of workers: [insert number]
- Number of overnight stays: [insert number]
- Rate per worker: $[insert amount]
- Total Per Diem: $[insert amount]
- Other: [insert description]
- Total Charges: $[insert amount]
Packing Materials and Additional Services (Describe)
| Number of Units | Description | Rate | Per Unit | Charges |
|---|---|---|---|---|
| This is space for a list of packing materials and each associated cost and total per type. | ||||
Total Packing Charges: $[insert amount]
Other Charges
| Description | Rate | Per Unit | Charges |
|---|---|---|---|
| This is space for a list of other charges such as tolls, ferry travel, parking permits, etc. | |||
Total Other Charges: $[insert amount]
Moving, Packing, Materials, Storage Charges
- Transportation Charges: $[insert amount]
- Storage Charges: $[insert amount]
- Valuation Charges: $[insert amount]
- Packing Material Charges: $[insert amount]
- Total Charges: $[insert amount]
- Total Amount Paid: $[insert amount]
- Balance Due: $[insert amount]
Customer Acknowledgement
Customer acknowledges carrier delivered goods.
[Insert Customer Signature]
[Insert Date]
Contract Terms and Conditions of Uniform Household Goods Bill of Lading
Contract terms and conditions of all services performed by the carrier must be included on the back of the bill of lading. The following are the only terms and conditions that can be applied, and these must appear as written below on the back of the bill of lading. This contract is also subject to all rules, rates, and charges in the current tariff published by, or on file with, the Washington Utilities and Transportation Commission.
Section 1
(A) THE CARRIER IS LIABLE for physical loss of, or damage to, any article from external cause while being packed, unpacked, loaded, unloaded, carried, or held in Storage-in-Transit, including breakage, if the articles are packed by the carrier and/or if the breakage results from negligence of the carrier. The carrier is liable directly to the customer for loss and damage, regardless of any cargo insurance policies the carrier may have. The carrier's liability is subject to the limitations of liability described in Section 2.
Customers may include the following items in a shipment; however, the carrier is not responsible for the condition or safe delivery of:
- Coins, currency, deeds, notes, postage stamps, letters, drafts, or valuable papers of any kind.
- Jewelry, precious stones, or precious metals.
- Items of extraordinary value.
- Items requiring temperature control.
- Household pets.
- Live plants.
- Perishable items.
- Furniture or other items made of pressboard, particle board, or similar pressed material.
(B) THE CARRIER IS NOT LIABLE for the loss of or damage to any article from external cause while being carried or held in Storage-in-Transit, due to the following circumstances:
- Breakage, when items are packed by the customer or the customer’s representative unless it can be proved that the breakage resulted from negligence by the mover in handling the articles.
- Internal damage to electronics (radios, stereos, VHS players, CD/DVD players, televisions, computers, printers, scanners, etc.) when no visible damage to the external packaging or contents exists or if the item was packed by the customer or the customer’s representative.
- Loss or damage from insects, moths, vermin, mold, fungus, or bacteria within the customer’s belongings or that develop therein due to conditions present before the carrier picks up the customer’s belongings.
- Loss or damage because the item was in an obvious state of disrepair at the time of shipment, provided that the carrier noted the disrepair on the inventory.
- An act, omission, or order of the customer, or loss or damage resulting from the customer’s inclusion in the shipment of such articles as explosives, dangerous articles, or dangerous goods.
- Defective design of an article, including susceptibility to damage because of atmospheric conditions such as temperature or humidity changes.
- Force majeure.
- Seizure, confiscation, or destruction under quarantine by order of any government or public authority.
- Strikes, lockouts, labor disturbances, riots, civil commotions, or the acts of any person or persons taking part in any such occurrence or disorder.
Carriers will not accept the following items for shipment:
- Explosives.
- Dangerous goods.
- Property liable to damage carrier equipment or other property.
The customer assumes all liability for goods he/she leaves unattended before pickup by the carrier. The customer also assumes all liability for goods when the customer directs the carrier, in writing, to unload or deliver property at a location that will be unattended.
Section 2
The carrier's maximum liability shall be determined based on the valuation option selected by the customer on the face of this contract.
(A) If the customer selected Basic Value Protection, the carrier's maximum liability shall be the actual loss or damage not exceeding $0.60 per pound of weight of any lost or damaged article(s).
(B) If the customer selected Replacement Cost Coverage with Deductible, the carrier's maximum liability shall be the amount of the actual loss or damage less a $300 deductible not exceeding $9.16 times the net weight of the shipment, or the lump sum declared value, whichever is greater. This option is the option that will apply if the customer fails to indicate a choice on the face of this contract and the customer will be liable for charges applying to this option.
(C) If the customer selected Replacement Cost Coverage, the carrier's maximum liability shall be the amount of the actual loss or damage not exceeding $9.16 times the net weight of the shipment, or the lump sum declared value, whichever is greater.
The customer is responsible for any additional insurance the customer wishes to purchase.
Section 3
Unless specific arrangements have been authorized by this contract, the carrier is not required to transport the customer's goods by any particular schedule, means, or vehicle and is not liable for delays resulting from causes other than negligence of the carrier. Further, in case of unforeseen circumstances which prevent the carrier from completing delivery, the carrier has the right to forward the customer's property by another carrier.
Section 4
(A) The customer must pay all legal charges.
(B) If the carrier is required to refer this contract for collection of charges due to an attorney, shipper agrees to pay reasonable attorney fees and collection costs.
(C) If this contract is referred to a court for resolution, the losing party shall be responsible for payment of the other party’s reasonable attorney fees and court costs.
(D) The customer shall be responsible to indemnify the carrier against loss or damage caused by inclusion in the shipment of explosives, dangerous articles, or dangerous goods.
Section 5
(A) A carrier may place a shipment into storage at the public warehouse nearest the point of destination if the carrier is unable to make a delivery because:
- The carrier was unable to locate a customer at the address given on the bill of lading, estimate, or the correct address if known by the carrier.
- The customer refused or was unable to accept delivery.
- If, during the move, it becomes apparent the customer is unable or refuses to pay up to 100 percent of a binding estimate or 110 percent of a non-binding estimate, plus any supplemental estimate.
(B) The carrier's liability as a common carrier ends with delivery to the public warehouse or carrier’s permanent storage facility. The shipment becomes subject to the warehouse's liability, terms, and conditions.
(C) The carrier must notify the customer by every means of contact the carrier has for the customer, including telephone and e-mail. In addition, the carrier must mail or deliver a written notice to the destination address advising that it was unable to make delivery and advising the customer of the name, address, e-mail address, if applicable, and telephone number of the warehouse where the shipment is stored.
(D) If the customer does not receive or claim the shipment within 30 days after the carrier mailed or delivered the written notice required in Item 40(3), the shipment becomes subject to disposition by the carrier in accordance with the Washington State Uniform Commercial Code, Chapter 62A.7 RCW.
Section 6
To receive compensation for a claim for loss, damage, overcharge, injury, or delay, the customer must file a written claim with the carrier within nine months after date of delivery. In the case of failure to make delivery, the claim must be filed within nine months after a reasonable time for delivery has elapsed. Claims must contain sufficient information to identify the property involved. A copy of the original paid transportation bill, bill of lading contract, or shipping receipt must accompany the written claim.