307735 01/27/17 Q
CITY OF CARMEL, INDIANA VENDOR: 314125
ONE CIVIC SQUARE UPS CHECK AMOUNT: S********96.98*CARMEL, INDIANA 46032 LOCKBOX 577 CHECK NUMBER: 307735
CAROL STREAM IL 60132-0577 CHECK DATE: 01127/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4342100 170AT6027 15.56 POSTAGE
1115 4342100 170AT6037 10.42 POSTAGE
601 5023990 76V77A017 71.00 OTHER EXPENSES
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Delivery Service Invoice
Invoice Date January 14, 2017
' Invoice Number 0000170AT6027
Shipper Number 170AT6
TM
Control ID 115Q
Page 1 of 4
Sign up for electronic billing today!
0749A0000170AT69 77366020050401 Visit ups.com/billing
AB 01 024596 53109 H 63 A For questions about your invoice,call:
(800)811-1648
I�tll'�II'II��I'I"I�IIII'I�I�1'Illlll�ltlll�llllll�llt'1����1��1 Monday-Friday
CARMEL CLAY COMMUNICATION CTR 8:00 am.-9:00 p.m.E.T.
31 1 STAVE NW or write:
CARMEL, IN 46032-1715 UPS
P.U.Box 7247-0244
Philadelphia,PA 19170-0001
Account Status Summary Thank you for using UPS.
Weekly Payment Plan Summary of Charges
Amount Due This Period $15.56 Page Charge
Amount Outstanding(prior invoices) $17.81 Outbound
Total Amount Outstanding $33.37 3 UPS Internet Shipping $14.64
Please include the Return Portion of each outstanding invoice with 3 Adjustments&Other Charges $0.92
your payment.See Account Status for details. Amount due this period $15.56
Questions about your charges? --
To get a better understanding of the charges on your invoice, UPS payment terms rogtrlrs paiyamt of this Invollm by January 25, _
visit our invoice guide and glossary of billing charges at 2017. _
ups.com/invoiceguide -_
Note:This invoice may contain a 1uW awahwgs as described at —
ups.com.For more informatim pias Wait rps com.
Delivery Service In voice
Invoice Date January 14, 2017
' Invoice Number 0000170AT6027
Shipper Number 170AT6
n
Page 3of4
Outbound
UPS Internet Shipping
Pickup ZIP Billed
Date Tracking Number Service Code Zone Weight Charge
01/03 IZ170AT60395050692 Ground Commercial 04357 5 6 11.51
Customer Weight 5
Delivery Area Surcharge-Extended 2.40
Fuel Surcharge 0.73
Customer Entered Dimensions= 14 x 12 x 5 in
Total 14.64
UserlD:CarmellCS
Sender :Brian Smith Receiver:Allen W.Tripp Sr.
Carmel Communications TMDE Calibration Labs,Inc
31 1 st Ave NW 839 River Road
Carmel IN 46032 RICHMOND ME 04357
Message Codes:r
Total for Internet-ID: CarmellCS 14.64
Total UPS Internet Shipping 1 Package(s) 14.64
Total Outbound 1 Package(s) 14.64
Adjustments &Other Charges
Address Corrections
Number of Billed
Tracking Number Service Packages Charge
K2571800314 Ground 1
Recorded:COMM NORTH AMERICA Corrected: —
SEANFIL SCANFIL
2420 t4R PKWY
LAWRENCEVILLE GA 30043 =W
Total Address Corrections 1 0.00
Residential/Commercial Adjustments _
UPS Shipping Document
Shipped Pickup Recorded Billed Adjustment
Date Record Entry Tracking Number Corrected Charge Amount
12/29 K2571800314 Commercial -16.92
Residential 16.92
Residential Surcharge 3.40
Fuel Surcharge 0.18 3.58
Total UPS Shipping Document 1 Package(s) 3.58
Total ResidentiallCommercial Adjustments 1 Package(s) 3.58
Shipping Charge Corrections Learn how to avoid future shipping charge corrections.Visit www.ups.com/avoidcharges.
Pickup Original Service/ ZIP Billed Adjustment
Date Tracking Number Corrected Service Code Zone Weight Charge Amount
12/29 K2571800314 Ground S.D_P_ 30043 4 14 1692
Ground S.D_P. 30043 4 2.0 14.39
Audited Dimensions= 8 x 6 x 4 in
Fuel Surcharge -0.13 -2.66
Sender : Receiver:COMM NORTH AMERICA
CARMEL CLAY COMMUNICATION CTR SEANFIL
CARMEL IN 46032 LAWRENCEVILLE GA 30043
Message Codes :cr
Total Shipping Charge Corrections 1 Package(s) -2.66
Total Adjustments&Other Charges 0.92
024596 2/2
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Delivery Service Invoice
Invoice Date January 21, 2017
OTMM
InvoiceNumber 0000170AT6037
Shipper Number 170AT6
ControlID P120
Page 1 of 3
Sign up for electronic billing today!
Visit ups.com/billing
0749A0000170AT69 77366030049819
AB 01 050394 59155 H 133 A For questions about your invoice,call:
(800)811-1648
���II�II�II" 'I�'I�III�I�II�lll�ll�lllll�l�ll����l���l��lll�l��l Monday-Friday
8:00 am.-9:00 p.m.E.T.
CARMEL CLAY COMMUNICATION CTR
31 1 STAVE NW or write:
CARMEL, IN 46032-1715 UPS
P.O.Box 7247-0244
Philadelphia,PA 19170-0001
Account Status Summary Thank you for using UPS.
Weekly Payment Plan Summary of Charges
Amount Due This Period $10.42 Page Charge
Amount Outstanding(prior invoices) $33.37 Outbound
Total Amount Outstanding $43.78 3 UPS Internet Shipping $10.42
Please include the Return Portion of each outstanding invoice with Amount due this period $10.42
your payment.See Account Status for details.
Questions about your charges? UPS payment terms require payment of this invoice by February 1,
To get a better understanding of the charges on your invoice, 2017'
visit our invoice guide and glossary of billing charges at Note:This invoice may contain a fuel surcharge as described at
ups.com/invoiceguide ups.com.For more information,please visit ups.com.
I
Delivery Service Invoice
Invoice Date January 21, 2017
' Invoice Number 0000170AT6037
Shipper Number 170AT6
Page 3 of 3
Outbound
UPS Internet Shipping
Pickup ZIP Billed
Date Tracking Number Service Code Zone Weight Charge
01117 1 Z170AT60393103085 Ground Commercial 07866 4 3 9.90
Fuel Surcharge 0.52
Total 10.42
1st ref:RMA#4394-F132 UserlD:CarmellCS
Sender :Brian Smith Receiver:Service Center
Brian Smith L-3 Mobile Vision
31 1 st Ave NW 400 Commons Way
Carmel IN 46032 ROCKAWAY NJ 07866
Total for Internet-ID: Carmelics 10.42
Total UPS Internet Shipping 1 Package(s) 10.42
Total Outbound 1 Package(s) 10.42
L 050394 2/2
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Delivery Service Invoice
Invoice Date January 7, 2017
Shipped from: Invoice Number 000076V77A017
CARMEL UTILITIES DISTRIBUTION Shipper Number 76V77A
3450 W 1031ST ST Control ID N703
WESTFIELD,IN 46074
Page 1 of 5
Sign up for electronic billing today!
0749A000076V77A4 77366010049267 Visit ups.com/billing
AB 01 047226 47404 H 149 A For questions about your invoice,call:
(800)811-1648
Monday-Friday
CARMEL UTILITIES 8:00 am.-9:00 p.m.E.T.
3450 W 131 ST ST or write:
CARMEL, IN 46074-8267 UPS
P.O.Box 7247-0244
Philadelphia,PA 19170-0001
Incentive Savings Thank you for using UPS.
Total incentive savings this period $98.80 Summary of Charges
Your amount due this period includes these savings.
See incentive summary section for details. Page Charge
Account Status Summary Outbound
Weekly Payment Plan 3 UPS Internet Shipping $71.00
Amount Due This Period $71.00 Amount due this period $71.00
Amount Outstanding(prior invoices) $14.57 UPS payment terms require payment of this invoice by February
Total Amount Outstanding $85.57 11,2017.
Please include the Return Portion of each outstanding invoice with =
your payment.See Account Status for details. Payments received late are subject to a late payment fee of 6%of
the Amount Due This Period.(see Tariffrrerms and Conditions of
Questions about Your charges? Service at ups.com for details)
To get a better understanding of the charges on your invoice,
visit our invoice guide and glossary of billing charges at Note:This invoice may contain a fuel surcharge as described at
ups.com/invoiceguide ups.com. The published fuel surcharge is 5.251Y.for UPS Ground
Services and UPS Standard Services,4.25%for UPS Domestic Air
�.� Services and UPS 3 Day Select,and 4.25 for US Export Worldwide
n_ Services.Ground Fuel Surcharge does not apply to UPS Ground
r packages originating in the 48 contiguous states when subject to
Iv(i/ Retail rates.For more information,visit ups.com.
Delivery Service Invoice
Invoice Date January 7, 2017
' Invoice Number 000076V77A017
Shipper Number 76V77A
n
Page 3 of 5
Outbound
UPS Internet Shipping
Pickup ZIP Published Incentive Billed
Date Tracking Number Service Code Zone Weight Charge Credit Charge
01/05 1Z76V77A0390678751 Ground Commercial 46202 2 2 8.07 -4.58 3.49
Fuel Surcharge 0.42 -0.36 0.06
Total 8.49 -4.94 3.55
1st ref:Weekly Fluoride UswID:CarmelWater
Sender :Michelle Breedlove Receiver:
Carmel Utilities Distributin Indiana State Dept.of Health
3450 w 131 st 550 W. 16th Street
CARMEL IN 46074 INDIANAPOLIS IN 46202
1Z76V77A0391385913 Ground Commercial 46202 2 2 8.07 -4.58 3.49
Fuel Surcharge 0.42 -0.36 0.06
Total 8.49 -4.94 3.55
1st ref:Weekly Fluoride UserlD:CarmelWater
Sender :Michelle Breedlove Receiver:
Carmel Utilities Distributin Indiana State Dept.of Health
3450 w 131 st 550 W. 16th Street
CARMEL IN 46074 INDIANAPOLIS IN 46202
r 1Z76V77A0391419681 Ground Commercial 46202 2 2 8.07 -4.58 3.49
Fuel Surcharge 0.42 -0.36 0.06
Total 8.49 -4.94 3.55
1st ref:Weekly Fluoride UserID:CarmelWater
Sender :Michelle Breedlove Receiver:
Carmel Utilities Distributin Indiana State Dept.of Health
3450 w 131 st 550 W.16th Street -
CARMEL IN 46074 INDIANAPOLIS IN 46202
`iZ76V77A0391812291 Ground Commercial 46202 2 2 8.07 -4.58 3.49
Fuel Surcharge 0.42 -0.36 0.06
Total 8.49 -4.94 3.55
1st ref:Weekly Fluoride USerID:CarmelWater
Sender :Michelle Breedlove Receiver: -
Carmel Utilities Distributin Indiana State Dept.of Health
3450 w 131 st 550 W.16th Street
CARMEL IN 46074 INDIANAPOLIS IN 46202
.1 Z76V77A0392057874 Ground Commercial 46202 2 2 8.07 -4.58 3.49
Fuel Surcharge 0.42 -0.36 0.06
Total 8.49 -4.94 3.55
1st ref:Weekly Fluoride USerID:CarmelWater
Sender :Michelle Breedlove Receiver:
Carmel Utilities Distributin Indiana State Dept.of Health
3450 w 131 st 550 W. 16th Street
CARMEL IN 46074 INDIANAPOLIS IN 46202
' IZ76V77A0392102869 Ground Commercial 46202 2 2 8.07 -4.58 3.49
Fuel Surcharge 0.42 -0.36 0.06
Total 8.49 -,4.94 3.55
1st ref:Weekly Fluoride UserlD:CarmelWater
Sender :Michelle Breedlove Receiver:
Cannel Utilities Distributin Indiana State Dept.of Health
3450 w 131 st 550 W.16th Street
CARMEL IN 46074 INDIANAPOLIS IN 46202
1Z76V77A0392147802 Ground Commercial 46202 2 2 8.07 -4.58 3.49
Fuel Surcharge 0.42 -0.36 0.06
Total 8.49 -4.94 3.55
1st ref:Weekly Fluoride UserlD:CarmelWater
Sender :Michelle Breedlove Receiver:
Carmel Utilities Distributin Indiana State Dept.of Health
3450 w 131 st 550 W.16th Street
CARMEL IN 46074 INDIANAPOLIS IN 46202
047226 2/3
Delivery Service Invoice
Invoice Date January 7, 2017
' Invoice Number 000076V77A017
Shipper Number 76V77A
n
Page 5 of 5
Outbound
UPS Internet Shipping(continued)
Pickup ZIP Published Incentive Billed
Date Tracking Number Service Code Zone Weight Charge Credit Charge
01/05 iZ76V77A0393717444 Ground Commercial 46202 2 2 8.07 -4.58 3.49
Fuel Surcharge 0.42 -0.36 0.06
Total 8.49 -4.94 3.55
1st ref:Weekly Fluoride USerID:CarmelWater
Sender :Michelle Breedlove Receiver:
Carmel Utilities Distributin Indiana State Dept.of Health
3450 w 131 st 550 W. 16th Street
CARMEL IN 46074 INDIANAPOLIS IN 46202
1 Z76V77A0393814928 Ground Commercial 46202 2 2 8.07 -4.58 3.49
Fuel Surcharge 0.42 -0.36 0.06
Total 8.49 -4.94 3.55
1st ref:Weekly Fluoride UserlD:CarmelWater
Sender :Michelle Breedlove Receiver:
Carmel Utilities Distributin Indiana State Dept.of Health
3450 w 131 st 550 W.16th Street
CARMEL IN 46074 INDIANAPOLIS IN 46202
-1Z76V77A0394179702 Ground Commercial 46202 2 2 8.07 -4.58 3.49
Fuel Surcharge 0.42 -0.36 0.06
Total 8.49 ,4.94 3.55
1st ref:Weekly Fluoride UserlD:CarmelWater
Sender :Michelle Breedlove Receiver:
Carmel Utilities Distributin Indiana State Dept.of Health
3450 w 131 st 550 W. 16th Street
CARMEL IN 46074 INDIANAPOLIS IN 46202
1 Z76V77A0394291787 Ground Commercial 46202 2 2 8.07 -4.58 3.49 -_
Fuel Surcharge 0.42 -0.36 0.06 _
Total 8.49 -4.94 3.55
1st ref:Weekly Fluoride UserlD:CarmelWater =
Sender :Michelle Breedlove Receiver:
Carmel Utilities Distributin Indiana State Dept.of Health -_
3450 w 131 st 550 W. 16th Street
CARMEL IN 46074 INDIANAPOLIS IN 46202
1 Z76V77A0394650657 Ground Commercial 46202 2 2 8.07 -4.58 3.49
Fuel Surcharge 0.42 -0.36 0.06
Total 8.49 -4.94 3.55
1st ref:Weekly Fluoride UserID:CarmelWater
Sender :Michelle Breedlove Receiver:
Carmel Utilities Distributin Indiana State Dept.of Health -
3450 w 131 st 550 W. 16th Street
CARMEL IN 46074 INDIANAPOLIS IN 46202
1 iZ76V77A0394741979 Ground Commercial 46202 2 2 8.07 -4.58 3.49
Fuel Surcharge 0.42 -0.36 0.06
Total 8.49 -4.94 3.55
1st ref:Weekly Fluoride UserlD:CarmelWater
Sender :Michelle Breedlove Receiver:
Carmel Utilities Distributin Indiana State Dept.of Health
3450 w 131 st 550 W. 16th Street
CARMEL IN 46074 INDIANAPOLIS IN 46202
Total for Internet-ID: CarmelWater 169.80 -98.80 71.00
Total UPS Internet Shipping 20 Package(s) 169.80 -98.80 71.00
Total Outbound 20 Package(s) 169.80 -98.80 71.00
047226 3/3
UPS Internet Shipping: Shipment Receipt Page 1 of 4
Shipment Receipt
Transaction Date: 05 Jan 2017 Tracking Number: 1Z76V77A0394650657 `
1Z76V77A0392102869.
1Z76V77A0392057874.
1Z76V77A0391419681x
1Z76V77A0391812291 '
1Z76V77A0394179702 '
Receive 1 Z76V77A0391385913 1 Z76V77A0393814928
! 1Z76V77A0392970734f
Date : 1Z76V77A0393077341
PO # : 1Z76V77A0390678751 '
• 1Z76V77A0392238964 -
ACCT # : 1Z76V77A0394741979-
1Z76V77A0394291787
,Use : 1Z76V77A0392712398'
�P24-611
���� 1 Z76V77A0392147802 �
1Z76V77A0392662013`
1Z76V77A0392839029
1Z76V77A0393382832
1Z76V77A0393717444
In
Address Information
Ship To: Ship From: Return Address:
Indiana State Dept.of Health Carmel Utilities Distributin Carmel Drinking Water Plant
550 W.16th Street Michelle Breedlove Jaimie Foreman
Suite B 3450 w 131 st 4915 E 106th Street
INDIANAPOLIS IN 462022218 CARMEL IN 46074 INDIANAPOLIS IN 46280
Telephone:317-733-2859 Telephone:317-379-3115
email:mbreedlove@carmel.in.gov email:#oreman@cannel.in.gov
Package Information
Weight Dimensions/Packaging Declared Value Reference Numbers
1. 2.0 lbs 12 x 6 x 3 in. Reference#1 -Weekly Fluoride
(2.0 lbs billable) Other Packaging
2. 2.0 lbs 12 x 6 x 3 in. Reference#1 -Weekly Fluoride
(2.0 lbs billable) Other Packaging
3. 2.0 lbs 12 x 6 x 3 in. Reference#1 -Weekly Fluoride
(2.0 lbs billable) Other Packaging
4. 2.0 lbs 12 x 6 x 3 in. Reference#1 -Weekly Fluoride
(2.0 lbs billable) Other Packaging
5. 2.0 lbs 12 x 6 x 3 in. Reference#1 -Weekly Fluoride
(2.0 lbs billable) Other Packaging
6. 2.0 lbs 12 x 6 x 3 in. Reference#1 -Weekly Fluoride
(2.0 lbs billable) Other Packaging
7. 2.0 lbs 12 x 6 x 3 in. Reference#1 -Weekly Fluoride
(2.0 lbs billable) Other Packaging
8. 2.0 lbs 12 x 6 x 3 in. Reference#1 -Weekly Fluoride
(2.0 lbs billable) Other Packaging
9. 2.0 lbs 12 x 6 x 3 in. Reference#1 -Weekly Fluoride
(2.0 lbs billable) Other Packaging
10. 2.0 lbs 12 x 6 x 3 in. Reference#1 -Weekly Fluoride
(2.0 lbs billable) Other Packaging
https://www.ups.com/uis/create?ActionOriginPair=default PrintWindowPage&key=recei... 1/5/2017
UPS Internet Shipping: Shipment Receipt Page 2 of 4
11. 2.0 lbs 12 x 6 x 3 in. Reference#1 -Weekly Fluoride
(2.0 lbs billable) Other Packaging
12. 2.0 lbs 12 x 6 x 3 in. Reference#1 -Weekly Fluoride
(2.0 lbs billable) Other Packaging
13. 2.0 lbs 12 x 6 x 3 in. Reference#1 -Weekly Fluoride
(2.0 lbs billable) Other Packaging
14. 2.0 lbs 12 x 6 x 3 in. Reference#1 -Weekly Fluoride
(2.0 lbs billable) Other Packaging
15. 2.0 lbs 12 x 6 x 3 in. Reference#1 -Weekly Fluoride
(2.0 lbs billable) Other Packaging
16. 2.0 lbs 12 x 6 x 3 in. Reference#1 -Weekly Fluoride
(2.0 lbs billable) Other Packaging
17. 2.0 lbs 12 x 6 x 3 in. Reference#1 -Weekly Fluoride
(2.0 lbs billable) Other Packaging
18. 2.0 lbs 12 x 6 x 3 in. Reference#1 -Weekly Fluoride
(2.0 lbs billable) Other Packaging
19. 2.0 lbs 12 x 6 x 3 in. Reference#1 -Weekly Fluoride
(2.0 lbs billable) Other Packaging
20. 2.0 lbs 12 x 6 x 3 in. Reference#1 -Weekly Fluoride
(2.0 lbs billable) Other Packaging
0 UPS Shipping Service and Shipping Options
Service: UPS Ground Service
Guaranteed By: End of Day Friday,Jan 6,2017
Shipping Fees Subtotal: 169.80 USD
Transportation 161.40 USD
Fuel Surcharge 8.40 USD
Additional Shipping Options
Quantum View Notify E-mail Notifications: No Charge
1 jcloud@carmel.in.gov: Delivery
2 mbickel@carmel.in.gov: Ship,Delivery
3 jforeman@carmel.in.gov: Ship,Exception,Delivery
Payment Information
Bill Shipping Charges to: Shipper's Account 76V77A
Shipping Charges: 169.80 USD
A discount has been applied to the Daily rates for this shipment
Negotiated Charges: 71.00 USD
Subtotal Shipping Charges: 71.00 USD
Total Charges: 71.00 USD
Note:This document is not an invoice.Your final invoice may vary from the displayed reference rates.
For delivery and guarantee information,see the UPS Service Guide.To speak to a customer service representative,call 1-800-PICK-UPS for domestic services
and 1-800-782-7892 for international services.
Responsibility for Loss or Damage
UPS's liability for loss or damage to each domestic package or international shipment is limited to$100 without a declaration of value.Unless a greater value is
recorded in the declared value field of the UPS shipping system used,the shipper agrees that the released value of each package covered by this receipt is no
greater than$100,which is a reasonable value under the circumstances surrounding the transportation.To increase UPS's limit of liability for loss or damage,a
shipper may declare a higher value and pay an additional charge.See the UPS Tariff[Terms and Conditions of Service("UPS Terms")at www.ups.com for UPS's
liability limits,maximum declared values,and other terms of service.UPS does not accept for transportation and shippers are prohibited from shipping,packages
https://www.ups.com/uis/create?ActionOriginPair=default PrintWindowPage&key=recei... 1/5/2017