Fill and Sign the Indemnity 497331633 Form

Indemnity Agreement regarding Lost or Missing Bill of Lading Indemnity agreement made ______________ (date) between _______________________ (Name of Claimant) , of ___________________________ _____________________________________________ (street address, city, state, zip code) , hereinafter called Claimant , in favor of _____________________ (Name of Carrier) , of ____________________________________________________________ ____________ (street address, city, state, zip code) , hereinafter called Carrier. For and in consideration of delivery to it of the shipment described below, without surrender of the original bill of lading covering the same, _____________________ (Name of Claimant) agrees to indemnify ____________________ (Name of Carrier) and any other interested carriers, if any, from any and all lawful claims that may be made against ______________________ (Name of Carrier) or such other carriers arising out of the shipment, and will pay to ____________________ (Name of Carrier) or such other carriers all losses, damages, costs, counsel fees, or other expenses that __________________ (Name of Carrier) or such other carriers may suffer or pay by reason of the delivery. The above-described bill of lading cannot be produced for the following reason: (state reason for inability to produce bill of lading) __________________________ ______________________________________________________________________ ______________________________________________________________________ _____________________________________________________________________. Description of Shipment  Articles or Items: (Description of articles or items) ______________________ ________________________________________________________________ ________________________________________________________________.  Consignor: ____________________ (Name of Consignor) .  From: ___________________________________________________________ ______________________________________________ (Place of shipment) .  Consignee: _____________________ (Name of Consignee) .  At: ______________________________________________________________ (Destination) .  Route: __________________________________________________________ ___________________________________________ (Description of route) .  Freight Bill No. _____________ (number) . Dated: __________________ (date) .  Issuing carrier: __________________________ (Name of Issuing Carrier) .  Bill of Lading No. _______________ (number) . Dated: _______________ (date)  Issuing carrier: ________________________ (Name of Issuing Carrier) . Witness my signature this ____________________ (date) . __________________________ (Printed Name of Claimant) __________________________ (Signature of Claimant)