Blank Hazard Bill Of Ladden PDF Form

Blank Hazard Bill Of Ladden PDF Form

The Hazard Bill Of Lading form is a crucial document used in the transportation of hazardous materials. It outlines the responsibilities of the shipper and carrier, ensuring that all parties are aware of the nature of the goods being transported. Properly completing this form is essential for compliance with safety regulations and for the protection of all involved in the shipping process.

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The Hazard Bill of Lading is a crucial document in the transportation of hazardous materials. It serves multiple purposes, including providing detailed information about the shipment and ensuring compliance with federal and state regulations. This form includes essential sections such as the shipper's and consignee's information, a description of the hazardous materials being transported, and the associated quantities and weights. Each shipment must specify the type of hazardous material, along with its identification number, to ensure proper handling and safety measures are in place. Additionally, the form outlines payment terms, including options for prepaid or collect freight charges, and it requires the shipper to declare the value of the property being transported. The Hazard Bill of Lading also contains terms and conditions that address liability limitations and procedures for filing claims in case of loss or damage. By accurately completing this form, shippers can help ensure that their hazardous materials are transported safely and legally.

Document Sample

Carrier
TO: FROM:
Consignee Shipper
Street Street
Destination Zip Origin Zip
Route Vehicle Number U.S. DOT Hazmat Reg. No.
Shipper’s No.
Carrier’s No.
SCAC Date
CONTAINS HAZARDOUS MATERIALS
CONTAINS HAZARDOUS MATERIALS
215-BLC-O 3 12466 (Rev. 9/10)
CONTAINS HAZARDOUS MATERIALS
CONTAINS HAZARDOUS MATERIALS
©
Copyright 2010 J. J. KELLER & ASSOCIATES, INC.
®
, Neenah, WI • USA • (800) 327-6868 • jjkeller.com • Printed in the United States
1
STRAIGHT BILL OF LADING – ORIGINAL – NOT NEGOTIABLE
Class or
Rate
Pkg.
Grp.
Weight
(subject to
correction)
Total Quantity
(mass, volume, or
activity)
Hazard
Class
I.D.
Number
Description of Articles
Number and Type
of Packages
HM
BY SHIPPER
BY CARRIER
DRIVER’S
SIGNATURE:
FREIGHT CHARGES:
Prepaid
Collect
COD FEE:
Prepaid
Collect
$
PLACARDS
SUPPLIEDPLACARDS
REQUIRED
NOTE: Liability Limitation for loss or damage in this shipment may be applicable. See 49 U.S.C.
14706(c)(1)(A) and (B).
This is to certify that the above-named materials are properly classified, described, packaged, marked
and labeled, and are in proper condition for transportation according to the applicable regulations of
the Department of Transportation. Per
Subject to Section 7 of conditions, if this
shipment is to be delivered to the consignee
without recourse on the consignor, the
consignor shall sign the following statement:
The carrier shall not make delivery of this
shipment without payment of freight and all
other lawful charges.
(Signature of Consignor)
NOTE: Where the rate is dependent on value, shippers are required to state specifically in writing
the agreed or declared value of the property. The agreed or declared value of the property is
hereby specifically stated by the shipper to be not exceeding $ Per
COD
AMT:
$
Remit COD to:
Address:
City: State: Zip:
TOTAL CHARGES:
$
RECEIVED, subject to individually determined rates or contracts that have been agreed upon in writing between the carrier and shipper, if applicable, otherwise to the rates, classifications and rules that have been established by the
carrier and are available to the shipper, on request; and all applicable state and federal regulations; the Property described above, in apparent good order, except as noted (contents and condition of contents of packages unknown),
marked, consigned, and destined as indicated above, which said company (the word company being understood throughout this contract as meaning any person or corporation in possession of the property under the contract) agrees
to carry to delivery at said destination, if on its route, or otherwise to deliver to another carrier on the route to said destination. It is mutually agreed as to each carrier of all or any of said Property over all or any portion of said route to
destination, and as to each party at any time interested in all or any of said Property that every service to be performed hereunder shall be subject to all the conditions not prohibited by law, whether printed or written, herein contained,
including the conditions on the back hereof, which are hereby agreed to by the shipper and accepted for himself and his assigns.
SHIPPER:
PER: DATE:
CARRIER:
PER: DATE:
EMERGENCY RESPONSE
TELEPHONE NUMBER:
NAME OR CONTRACT NUMBER
OR OTHER UNIQUE IDENTIFIER:
By giving the carrier the property described in this bill of lading (the
“Property”), you agree to all of the terms of this bill of lading.
Section 1 Limitations of Liability
(a) The carrier or party in possession of the Property shall be liable
as at common law for any loss of or damage to such Property,
except as hereinafter provided.
(b) The carrier shall not be liable for loss of, damage to or delay in
delivery of the Property:
(i) caused by an act of God, the public enemy, the authority of
law, or any act or default by you and/or the owner of the
Property, or for natural shrinkage.
(ii) occurring while the Property is stopped and held in transit at
your request or that of any other party entitled to make such
request.
(iii) resulting from a defect or vice in the Property, or from riots or
strikes.
(c) To the extent permitted under the Carmark Amendment, the
liability of the carrier for the Property may be limited to a value
established by written or electronic declaration by you or by
written agreement between the carrier and you. In all cases not
prohibited by law, where a lower value than actual value has
been represented in writing by the shipper or has been agreed
upon in writing as the released value of the Property as
determined by the classification or tariffs upon which the rate is
based, such lower value plus freight charges if paid shall be the
maximum amount to be recovered, whether or not such loss or
damage occurs from negligence.
Section 2 Filing of Claims
(a) Claims against the carrier for loss of or damage to the Property
must be filed in writing with the carrier issuing this bill of lading
within nine months after delivery of the Property (or, in case of
export traffic, within nine months after delivery at port of export)
or, in case of failure to make delivery, then within nine months
after a reasonable time for delivery has elapsed. All causes of
action must be instituted within two years following the date when
written notice is given by the carrier to you that the carrier has
disallowed the claim or any part or parts thereof specified in the
notice. If your claim or action is not filed or instituted properly in
accordance with the foregoing provisions, the carrier shall not be
liable, and such claims may not be paid.
(b) The carrier shall have the full benefit of any insurance that may
have been effected upon or on account of the Property in the
event that the carrier is liable for loss of or damage to the
Property.
Section 3 Method of Transportation
Except as expressly agreed in writing by the parties to this bill of lading, the
carrier is not bound to transport the Property by any particular motor vehicle,
or in time for any particular market or otherwise than with reasonable
dispatch. The carrier shall have the right in case of physical necessity to
forward said Property by any carrier or route between the point of shipment
and the point of destination.
Section 4 Responsibility for Property
(a) If the Property is not removed by the party entitled to receive it
within the free time allowed by tariffs or classifications upon
which the rate is based, (such free time to be computed as
therein provided), the carrier may notify the receiving party of the
arrival of the Property at the destination or at the port of export
(if intended for export). The carrier, in its discretion, may store the
Property in a public or licensed warehouse at the place of
delivery or other available place, at the cost of the owner. The
stored Property will be subject to a lien for all freight and other
lawful charges, including a reasonable charge for storage. The
carrier’s responsibility shall be that of a warehouseman only.
(b) Except as provided in subparagraph 4(c) below, if the Property is
refused by consignee or the party entitled to receive it, or said
consignee or party entitled to receive it fails to receive it within 15
days after notice of arrival shall have been duly sent or given, the
carrier may sell the Property at public auction to the highest
bidder, at such place as may be designated by the carrier. Prior
to any such sale, the carrier shall use commercially reasonable
efforts to notify you that the Property has been refused or
remains unclaimed, as the case may be, and that it will be
subject to sale under the terms of the bill of lading if you do not
arrange for an alternative disposition.
(c) If the Property is perishable and is refused by the consignee or
party entitled to receive it at the destination location, or said
consignee or party entitled to receive it shall fail to receive it
promptly, the carrier, may, in its discretion, to prevent
deterioration or further deterioration, sell the same to the best
advantage at private or public sale. Prior to selling the Property,
the carrier shall use commercially reasonable efforts to notify you
of the refusal of the Property or the failure to receive it, and
request instructions regarding disposition of the Property.
(d) If the procedure described in subsection (b) and (c) is not
commercially reasonable, the carrier may, at its option, sell the
Property under such circumstances and in such manner as may
be authorized by law.
(e) The carrier shall apply the proceeds of any sale made under this
section to the payment of freight, demurrage, storage, and any
other lawful charges and the expense of notice, advertisement,
sale, and other necessary expense and of caring for and
maintaining the Property, if proper care of the same requires
special expense. If following payment of the preceding there is a
balance, such balance shall be paid to the owner of the Property
sold hereunder.
(f) If you direct the carrier to deliver the Property to a location where
there is no regularly appointed freight agent, the carrier shall not
be liable for any loss or damage to Property occurring at such
location after the Property has been unloaded at such location.
Section 5 Valuable Items
(a) The carrier’s liability in connection with the Property is limited to
the lesser of the amount of your actual damages or the declared
value stipulated by the carrier on the face of this bill of lading plus
any freight charges paid by you.
(b) The carrier shall not be liable in any way for any documents,
specie, or for any articles of extraordinary value not specifically
rated in the published classifications or tariffs unless a special
agreement to do so and a stipulated value of the articles are
endorsed on this bill of lading.
Section 6 Joint Liability for Hazardous Goods
You, and if you are an agent, any owner of the Property, shall be joint and
severally liable for and indemnify the carrier against all loss or damage
caused by the shipment of explosives, dangerous or hazardous goods,
without giving prior written notice to the carrier of their nature. At the
discretion of the carrier, any such goods may be warehoused at your and the
owner’s risk and expense or destroyed without compensation.
Section 7 Freight Charges and Payment
(a) You are primarily responsible for the freight and all other lawful
charges, unless you stipulate in writing in the space provided for
that purpose on the face of this bill of lading that the carrier shall
not make delivery without requiring payment of such charges and
the carrier makes delivery without requiring such payment. If you
provide erroneous information that results in the shipment being
reconsigned or diverted to a location other than the location
identified in the original bill of lading, you shall be liable for such
additional charges. The respective liability of you and the
consignee for additional charges provided for herein shall be
pursuant to 49 U.S.C. § 13706.
(b) Nothing in this bill of lading shall limit the right of the carrier to
require the prepayment or guarantee of charges at time of
shipment. If upon inspection the carrier determines that the
articles shipped are not those described in this bill of lading, the
freight charges must be paid upon the articles actually shipped.
Section 8 Effect of Shipper Signature
If this bill of lading is issued on the order of the shipper, or his agent, in
exchange or in substitution for another bill of lading, the shipper’s signature
to the prior bill of lading as to the statement of value or otherwise, or election
of common law or bill of lading liability, in or in connection with such prior bill
of lading, shall be considered a part of this bill of lading as fully as if the same
were written or made in or in connection with this bill of lading.
Section 9 Transport by Water
If all or any part of the Property is carried by water over any part of said route,
and any loss of or damage to the Property occurs while it is in the custody of
the carrier providing the water carriage, the liability of such carrier shall be
determined by that carrier’s bill of lading and by the laws and regulations
applicable to transportation by water. Such water carriage shall be performed
subject to all of the terms and provisions of, and all the exemptions from
liability contained in the Harter Act or the Carriage of Goods By Sea Act, as
applicable.
TERMS AND CONDITIONS
©
Copyright 2009 J. J. KELLER & ASSOCIATES, INC.
®
, Neenah, WI • USA • (800) 327-6868 • jjkeller.com • Printed in the United States

File Specifics

Fact Name Details
Form Title Hazardous Materials Straight Bill of Lading – Original – Not Negotiable
Governing Law This form is governed by federal regulations, specifically 49 U.S.C. and applicable state laws regarding hazardous materials transportation.
Contact Information J. J. Keller & Associates, Inc., Neenah, WI, USA, (800) 327-6868
Liability Limitations The carrier's liability for loss or damage may be limited, based on the value declared by the shipper.
Claim Filing Period Claims for loss or damage must be filed within nine months after delivery or a reasonable time for delivery has elapsed.
Emergency Response The form requires an emergency response name or contract number, ensuring readiness in case of hazardous material incidents.
Payment Responsibility The shipper is primarily responsible for freight and other lawful charges unless otherwise specified.
Joint Liability Shippers and agents are jointly liable for any loss or damage caused by the shipment of hazardous goods without prior notice to the carrier.

How to Use Hazard Bill Of Ladden

Completing the Hazard Bill of Lading form requires careful attention to detail. Each section must be filled out accurately to ensure the safe and compliant transportation of hazardous materials. Follow these steps to fill out the form correctly.

  1. Shipper’s No.: Enter the shipper's identification number.
  2. Carrier: Write the name of the carrier responsible for transport.
  3. Carrier’s No.: Input the carrier's identification number.
  4. SCAC: Provide the Standard Carrier Alpha Code.
  5. Date: Fill in the date of shipment.
  6. From: Include the shipper's name and address.
  7. To: Enter the consignee's name and address.
  8. Destination Zip: Specify the zip code of the destination.
  9. Origin Zip: Specify the zip code of the origin.
  10. Route: Indicate the route for transportation.
  11. Vehicle Number: Write the vehicle number used for transport.
  12. U.S. DOT Hazmat Reg. No.: Enter the Department of Transportation hazardous materials registration number.
  13. HM I.D.: Specify the hazardous material identification number.
  14. Description of Articles: Clearly describe the hazardous materials being shipped.
  15. Hazard Class: Indicate the hazard class of the materials.
  16. Total Quantity: State the total quantity of packages.
  17. Weight: Provide the weight of the shipment.
  18. Collect or Prepaid: Check the appropriate box for payment method.
  19. Total Charges: Fill in the total charges for the shipment.
  20. Signature of Consignor: The shipper must sign to confirm the information is accurate.
  21. Emergency Response Name or Contract Number: Include the emergency response contact information.
  22. Telephone Number: Provide a contact number for emergencies.

After completing the form, review it for accuracy. Ensure all required fields are filled out correctly. Once verified, submit the form to the carrier for processing. Proper documentation is essential for compliance and safety during transportation.

Your Questions, Answered

What is the Hazard Bill of Lading form?

The Hazard Bill of Lading form is a shipping document that serves as a receipt for goods being transported, specifically hazardous materials. It outlines the details of the shipment, including the shipper, consignee, type of materials, and any special handling requirements. This form is essential for ensuring compliance with safety regulations and proper handling of hazardous materials during transportation.

Who is responsible for filling out the form?

The shipper is primarily responsible for accurately completing the Hazard Bill of Lading form. This includes providing detailed information about the hazardous materials being shipped, such as their classification, quantity, and any special handling instructions. Ensuring this information is correct is crucial, as inaccuracies can lead to legal liabilities and safety hazards.

What should I include in the description of articles section?

In the description of articles section, you should provide a clear and detailed account of the hazardous materials being shipped. This includes:

  • The specific name of the material.
  • Any relevant identification numbers (e.g., UN number).
  • The quantity and type of packaging used.
  • Any special handling or emergency response information.

Providing comprehensive details helps ensure safe transport and compliance with regulations.

What happens if the consignee does not pick up the shipment?

If the consignee fails to pick up the shipment within the designated time frame, the carrier may store the property at the owner's expense. The carrier has the right to sell the property at public auction if it remains unclaimed for a specified period. Prior to any sale, the carrier will make reasonable efforts to notify the shipper about the unclaimed property.

How do I file a claim for loss or damage?

To file a claim for loss or damage, you must submit a written claim to the carrier that issued the Hazard Bill of Lading within nine months of the delivery date. If the property was not delivered, the claim must be filed within nine months after a reasonable delivery time has passed. Failing to follow these guidelines may result in the claim being denied.

What are the potential liabilities associated with shipping hazardous materials?

Liabilities can arise from various factors, including:

  • Loss or damage to the property during transport.
  • Inaccurate information provided on the bill of lading.
  • Failure to comply with safety regulations.

Shippers are jointly liable for any damages caused by the shipment of hazardous materials, especially if prior written notice of their nature was not given to the carrier.

Can I change the declared value of the shipment after the bill is issued?

Once the Hazard Bill of Lading is issued, the declared value of the shipment is generally considered final. If you wish to change the declared value, it must be done in writing and agreed upon by the carrier before the shipment is transported. Keep in mind that any discrepancies could affect liability in case of loss or damage.

Common mistakes

  1. Incomplete Information: Failing to fill out all required fields can lead to delays. Ensure that every section is completed, including shipper and consignee details.

  2. Incorrect Hazard Class: Selecting the wrong hazard class for the materials can result in regulatory violations. Always verify the classification of hazardous materials.

  3. Missing Signatures: Omitting signatures from the shipper or carrier can invalidate the form. Ensure all necessary parties sign the document.

  4. Improper Weight or Quantity: Entering inaccurate weight or quantity can lead to additional charges or issues during transport. Double-check these figures before submission.

  5. Failure to Declare Value: Not stating the agreed or declared value of the property can limit recovery in case of loss or damage. Make sure to include this information clearly.

  6. Ignoring Special Requirements: Not adhering to specific regulations for hazardous materials can lead to legal repercussions. Familiarize yourself with all applicable regulations.

  7. Incorrect COD Instructions: Providing incorrect cash on delivery (COD) instructions can complicate the payment process. Clearly specify the COD amount and ensure it matches the agreement.

Documents used along the form

The Hazard Bill of Lading form is a crucial document in the transportation of hazardous materials. It serves as a receipt for the goods and outlines the terms of the shipment. Alongside this form, several other documents are commonly used to ensure compliance with regulations and facilitate smooth logistics. Below is a list of these documents, each with a brief description.

  • Material Safety Data Sheet (MSDS): This document provides detailed information about the properties of a hazardous material, including its handling, storage, and emergency measures in case of an incident. It is essential for ensuring safety during transportation and use.
  • Shipping Papers: These documents accompany hazardous materials during transport and include details about the contents, emergency contact information, and handling instructions. They must be readily accessible to drivers and emergency responders.
  • Emergency Response Guidebook (ERG): This guide is a vital resource for first responders in the event of a hazardous materials incident. It provides instructions on how to handle various types of materials and outlines safety measures.
  • Certificate of Compliance: This document certifies that the hazardous materials being shipped comply with all applicable regulations and standards. It is often required by regulatory agencies and can help facilitate the shipping process.
  • Container Labels: Labels on hazardous material containers indicate the type of hazard and necessary precautions. Proper labeling is critical for safety and compliance during transportation.
  • Driver Training Certificates: These certificates confirm that drivers have received the necessary training to handle and transport hazardous materials safely. They are important for regulatory compliance and safety assurance.
  • Transport Security Plan: This plan outlines the measures taken to secure hazardous materials during transport. It addresses potential security threats and ensures that proper protocols are in place.
  • Consignment Note: This document serves as proof of the contract between the shipper and the carrier. It includes details about the shipment, such as the type of goods and delivery instructions.

Each of these documents plays a significant role in the safe and compliant transportation of hazardous materials. Understanding their purpose and ensuring they are correctly completed can prevent legal issues and enhance safety during transit.

Similar forms

The Hazard Bill of Lading form is similar to the Standard Bill of Lading, which serves as a receipt for goods and a contract between the shipper and carrier. Both documents outline the details of the shipment, including the description of the goods, the shipper's and consignee's information, and the terms of transportation. However, the Hazard Bill of Lading specifically addresses the transportation of hazardous materials, ensuring compliance with safety regulations, while the Standard Bill of Lading does not include such specifications.

Another document that shares similarities is the Freight Bill. Like the Hazard Bill of Lading, the Freight Bill details the charges associated with transporting goods. It includes information about the shipper, consignee, and the items being shipped. However, the Freight Bill does not serve as a contract for transportation but rather as a request for payment, which is a key distinction from the Hazard Bill of Lading.

The Air Waybill (AWB) is also comparable. It acts as a receipt for goods and a contract between the shipper and the airline carrier. The AWB contains details about the shipment and includes terms of carriage. While the Hazard Bill of Lading is specific to hazardous materials, the AWB is used for air transport and may not necessarily address hazardous materials unless specifically noted.

The Ocean Bill of Lading is another relevant document. It serves a similar purpose as the Hazard Bill of Lading but is specific to goods transported by sea. This document also acts as a contract and receipt, detailing the shipment's particulars. The Ocean Bill of Lading may include clauses related to hazardous materials, but its primary focus is on maritime transport.

Additionally, the Consignment Note is akin to the Hazard Bill of Lading in that it serves as proof of the contract between the shipper and carrier. It includes essential details about the shipment, such as the nature of the goods and delivery instructions. However, it typically lacks the extensive legal language and liability clauses found in the Hazard Bill of Lading.

The Dangerous Goods Declaration is another document that parallels the Hazard Bill of Lading. It is specifically designed for the transport of hazardous materials and certifies that the goods have been properly classified and packaged. While both documents address hazardous materials, the Dangerous Goods Declaration is focused solely on compliance with safety regulations, whereas the Hazard Bill of Lading encompasses broader shipping terms.

The Packing List is similar in that it provides a detailed breakdown of the items included in a shipment. It lists the contents and quantities, serving as a reference for both the shipper and consignee. However, the Packing List does not serve as a contract for transportation, nor does it address the specific regulations applicable to hazardous materials.

The Delivery Order also shares some similarities with the Hazard Bill of Lading. It is issued by the shipper to instruct the carrier to deliver the goods to a specified party. While it outlines the delivery instructions, it does not provide the same level of detail regarding liability and terms of transportation as the Hazard Bill of Lading.

The Certificate of Origin is another document that relates to shipping but focuses on the origin of the goods rather than the transportation terms. It certifies where the goods were produced and may be required for customs clearance. While it is essential for international shipping, it does not address the specifics of hazardous materials or the terms of carriage.

Lastly, the Receipt for Goods is comparable as it acknowledges the receipt of items being shipped. It provides basic information about the shipment but does not contain the comprehensive terms and conditions found in the Hazard Bill of Lading. This document is primarily used to confirm that the goods have been received by the carrier.

Dos and Don'ts

When filling out the Hazard Bill of Lading form, consider the following guidelines:

  • Ensure all information is accurate and complete to avoid delays or issues.
  • Clearly describe the hazardous materials being shipped, including their classification and quantity.
  • Sign the form where indicated to acknowledge responsibility and acceptance of terms.
  • Keep a copy of the completed form for your records and future reference.

Avoid these common mistakes:

  • Do not leave any sections blank; incomplete forms may be rejected.
  • Avoid using vague descriptions for the materials; specificity is crucial.
  • Do not forget to include the declared value of the shipment, as it is required.
  • Never sign the form without reviewing all terms and conditions, as this indicates acceptance.

Misconceptions

Here are 10 misconceptions about the Hazard Bill of Lading form:

  1. It is only for hazardous materials. Many believe this form is exclusively for hazardous materials. However, it can also be used for non-hazardous shipments.
  2. All shipments require this form. Not every shipment needs a Hazard Bill of Lading. It is specifically required for shipments containing hazardous materials.
  3. The shipper is not responsible for the contents. Some think that once the shipment is handed over, the shipper has no responsibility. In fact, the shipper remains responsible for ensuring the accuracy of the information provided.
  4. It guarantees delivery of the shipment. Many assume that this form guarantees delivery. However, delivery is subject to various conditions and regulations.
  5. Only professional shippers can use it. Individuals can also use the Hazard Bill of Lading. It is not limited to professional shipping companies.
  6. There are no penalties for incorrect information. Providing incorrect information can lead to penalties. The shipper is liable for any discrepancies that arise from false declarations.
  7. It covers all types of loss or damage. This form does not cover all types of loss or damage. There are limitations on the carrier's liability as specified in the document.
  8. Once signed, it cannot be changed. While changes are not common, the Hazard Bill of Lading can be amended if both parties agree and document the changes properly.
  9. It is a simple form with no legal implications. This form has significant legal implications. It serves as a binding contract between the shipper and carrier.
  10. It is the same as a regular bill of lading. The Hazard Bill of Lading has specific requirements and regulations that differ from a standard bill of lading.

Key takeaways

When filling out and using the Hazard Bill of Lading form, it is crucial to follow specific guidelines to ensure compliance and protect your interests. Here are five key takeaways:

  • Accurate Information is Essential: Ensure all details, including shipper and consignee information, are complete and accurate. This helps prevent delays and potential legal issues.
  • Declare Hazardous Materials: Clearly identify and classify any hazardous materials being shipped. This is not just a legal requirement but also critical for the safety of all parties involved.
  • Understand Liability Limitations: Familiarize yourself with the limitations of liability for loss or damage. Knowing these terms can help you make informed decisions regarding insurance and claims.
  • File Claims Promptly: If there is a loss or damage, claims must be filed in writing within nine months. Timely action is essential to ensure your claim is considered valid.
  • Review Payment Responsibilities: Be clear about who is responsible for freight and other charges. Misunderstandings in this area can lead to additional costs and disputes.

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