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• <br /> .1011A <br /> KANGAROO EXPRESS OF SOUTHERN COLORADO • <br /> • <br /> Hours: 8am-5pm Mon-Fri 719-543-6900 .• <br /> Date <br /> FROM • TO <br /> NAME NAME , <br /> ADDRESS ADDRESS ` - <br /> CITY/ STATF /ZIP CITY/ STATF/7IP <br /> ATTN: PHONE ATTN: PHONE <br /> • E Bill Shipper 0 Bill Recipient El Bill third party <br /> Pickup waiting time 1 #Pieces j Contents Weight Declared Value Delivery waiting time <br /> I I • <br /> • Shipped'in good order - Signature Date Time X Recipient-Print Name Date Time <br /> Special instructions: <br /> Received in good order by Recipient - Signature <br /> El Same Day 0 Overnight El Hot Shot . <br /> • <br /> • 0 Cash C3 Check# 0 C.O.D.Received$ • <br /> TERMS and CONDITIONS KANGAROO BASE <br /> It is mutually agreed that the good herein described are accepted in apparent good order(except as noted)for transport. .. <br /> Kangaroo Express shall not be held liable for any loss,damage,delay,and/or misdelivery,or non-delivery caused by: <br /> A)Acts of God,authority of law,traffic delays,strikes,riots,or weather conditions. EXCESS WEIGHT <br /> B)Kangaroo Express will not be liable for your acts or omissions.including but not limited to improper packing,securing. . <br /> marking or addressing,or for acts or omissions of the recipient or anyone else with an interest in the package. <br /> The limit of liability for loss or damage to your package is limited to your actual damages or$100.00,whichever is less, WAITING TIME <br /> You pay for and declare a higher authorized value,not to exceed$1,000.00.Shipments of extraordinary value are limited <br /> to a maximum declared value of$100.00 in any event,such as items of sentimental value,artwork,jewelry,furs,money, AFTER HOURS <br /> precious metals,negotiable instruments,and certain other items,such as but not limited to:very fragile items and certain <br /> computer-related losses.If the recipient accepts the package without noting any damage on the delivery record,any and <br /> all claims are waived.We reserve the right to reject a shipment at any time,when such shipment would be likely to cause <br /> damage to other shipments,equipment,or personnel or transportation of which is prohibited by law. • <br /> Sender authorizes Kangaroo Express to deliver this shipment without obtaining a delivery signature and <br /> shall indeminify and hold harmless Kangaroo Express from any claims resulting therefrom. <br /> Release Signature Date TOTAL CHARGES <br />