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7 777" 77 <br />Delivery Services, LLC <br />Service: <br />35# or less - <br />Over 35# - <br />Pickup /Delivery Receipt No. R S - <br />Date —7/i <br />541 - 461 -2992 Time Called <br />PO Box 40283 <br />Eugene. OR 97404 Time PU 1 �_ <br />ma' Time Delivered <br />RUSH [] 2 Hour or less E2 y Same Day [:1 Next Day ❑ Driver_( -Y ,/ <br />ick up From: -,^ <br />me Phone No. <br />usiness Na <br />ddro 3 <br />ity s zip <br />Release by: <br />b authorize Bolt Delive rvices to Pick -u Items listed below. <br />Picked -up: <br /># of <br />5 1 I ��s <br />r 41 D s_ �5_ S73 Y <br />-2- ter/ ;:;-75 a- <br /># of pieces <br />S hip To: <br />G i � <br />a <br />loco Name <br />Phone No. <br />Ad dress <br />city <br />state Zi <br />/ u <br />Recdved by: <br />Race' All ms Lisfed Below in Condition <br />Bill Shipper ❑ Bill Receiver ❑ Bill 3rd Party <br />Collect - Amount $ ❑ Company Check OK ❑ Cash or Certified Funds <br />