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4 <br />~ ~ <br />I <br />1 1 <br />f <br />I <br />P, <br />t. <br />+I <br />~; <br />~~~ <br />I <br />,; <br />,~ <br /> <br />o°` ~"1e ~ ~~`"e~ B & L Delivery Inc. <br /> P.O. Box 20724 <br /> Portland, OR 97294-0724 . <br />L6 <br />LC <br />~ <br />(503)256-3400 <br />r <br />trs Re(rie„~ your ~'+`~~ fax (503) 256-4715 <br />Order # Ref #- ~.~--_~-~ • - .; ~ <br />f <br />'~ <br />11 <br />'t <br />L Date ~ ~~~ , -~~/ <br />~ <br /> 4 <br />. <br />Y . .~J <br />. J ~..I <br />Charge to: Sender ~ Receiver Other <br />Acct# Pieces Weight Driver y <br />Sender `' ` ~,-~ ~ i~ ~~-~ Telephone 503.771.19$6 <br />Company <br />Re es En irteexin Iac. <br /> <br />Address <br />., <br />City State Zip <br />nd (}$ 972Q6 <br />Receiver """~ ; ,,,~-. Telephone <br />Company ` ,. i ~~ ~..._./ <br />Address t c,-l <br />t ~a <br />f7 ~ ~ ~_~' 1 <br />X_~ <br />~#f <br />f <br />fi <br />.~s <br />t: .. <br />, <br />: <br />_ <br />L <br /> <br />~` Services <br />Car Bike <br />Non-Stop Rush Route IS min 30 min. 60 min. 3 hr. <br />Additional Instructions <br />Round Trip ^ <br />. _ ~- <br />i ~ <br /> <br />7C / ,$` <br />/OcS <br /> TOTAL ~_ <br />C <br />IARGE ~ 3a <br /> r <br />Sender Signature : -~ PU Time <br /> <br />Receiver Signature Print t ' ~ Del Time <br />~.: <br />SHIPPER <br />