ADDENDUM TO UNIFORM HOUSEHOLD GOODS BILL OF LADING

SHIPPER DECLARATION OF VALUE

IMPORTANT: There are two (2) potions available to cover loss and/or damages:

OPTION 1:              Actual cash value. This option provides for reimbursement for loss or damage NOT
                                 EXCEEDING Three hundred ($300.00) dollars PER MOVE, based on the
                                 Deprecation value at the time of the loss or damage. This option is included in the
                                 Transportation and there is no addition CHARGE. Should your goods be involved
                                 in a catastrophe such as a fire, accident or any other nature, the Carrier will assume
                                 liability not to exceed Twenty five hundred ($2500.00) dollars. The Carrier shall have
                                 the option of repairing and or restoring the original condition.

OPTION 2:             Full Value Protection. This option provides coverage based on current replacement
                                 value at the time of loss or damage, up to the dollar amount of valuation declared
                                 by you (SEE NOTE). The cost is based on the actual value of the goods, and the
                                 Deductible, if any, declared by you. Carrier shall have the option of repairing and
                                  or restoring to the original condition.

**DECLARATION**

Prior to the move the shipper must select one of the options listed below. If shipper
refuses to select on of these options, the carrier will not be required to perform the move.

Shipper herby releases the entire shipment to a value not exceeding:

___________________________ Option 1- (Depreciated Value) -$300.00 per move
SIGNATURE OF SHIPPER AND DATE based on depreciation value at no additional charge.

___________________________   Option 2(a)- (REPLACEMENT VALUE)-(See Note)
SIGNATURE OF SHIPPER AND DATE                  $                     with no deduction at a charge $10.95 per
                                                          thousand ($1,000) of declared value. This would result in an
                                                          additional charge of $________________.

____________________________ Option 2(b)- (REPLACEMENT VALUE)-(See Note)
SIGNATURE OF SHIPPER AND DATE                                  $______________ with a $300.00 deduction at a charge
                                                        $3.65 per thousand ($1,000) of declared value. This would
                                                          result in an additional charge of $___________________.

NOTE: Must be an amount equal to or exceeding $3,500 per room excluding halls, attics,
garage, closets, bath. A self-storage unit of 10X10 will constitute a room.

This document shall be completed and signed PRIOR TO MOVE and made a permanent part
of the Bill of Lading.

If carrier Fails to require shipper to choose one of the above Liability Option, the shipper will considered
have chosen 2(a) (Replacement Value, no deductible) at no charge to shipper.

BILL OF LADING/ORDER NO:_________________________ DATE:______________________ HUTCHINSON MOVING & STORAGE

NAME OF SHIPPER _____________________________________________________________ 716 EAST 2^nd STREET

( ) HOURLY RATED MOVE ( ) WEIGHT & DISTANCE MOVE TIFTON, GA 31749

CARRIER REPRESENTATIVE:______________________________________________________ 229-382-6023