1.4 Waybill
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To be completed on the sender's responsibility 1-15 including and 19+21+22. The spaces framed with heavy lines must be filled in by the carrier. |
1. Sender (name, address, country) Dutch Industrial Machines BV Heldringstraat 180-2 Postfus 5411 Amsterdaam 1007 Netherlands
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CMR
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No. 24392 |
In case of dangerous goods mention, besides the possible certification, on the last line of the column the particulars of the class, the number and the letter, if any. | ||||||||||||||||||
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This carriage is subject, notwithstanding any clause to the contrary, to the Convention on the Contract for the International Carriage of goods by road (CMR) | ||||||||||||||||||||||
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2. Consignee (name, address, country) AO Textil Ivanovo Dekabristov 15a Ivanovo Russia |
16. Carrier (name, address, country) AO Rusotra Nekrasova 15/6 Balashikha Russia | |||||||||||||||||||||
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3. Place of delivery of the goods (place, country) Ivanovo Russia
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17. Successive carriers (name, address, country)
No | |||||||||||||||||||||
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4. Place and date of taking over the goods (place, country, date) Heldringstraat 180-2 Amsterdaam 1007 Netherlands 20 March 20__ |
18. Carrier's reservations and observations
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5. Documents attached delivery note invoice No. 245/LD/18 TIR Cornet AC00152748 | ||||||||||||||||||||||
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6. Marks and Nos |
7. Number of packages |
8. Method of packing |
9. Nature of the goods |
10. Statistical number |
11. Gross weight in kg |
12. Volume in m3 | ||||||||||||||||
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polythene and |
Automatic |
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7 x 320 kg |
7 (2m x 1.5 m x 2.8 m) | ||||||||||||||||
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01-17 |
17 |
corrugated |
looms and |
378972 |
10 x 90 kg |
10 (1.2m x 1m x 1.5m) | ||||||||||||||||
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paper |
spares |
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Class |
No |
Letter |
(ADR*) |
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13. Sender's instructions HANDLE WITH CARE
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19. Special agreements
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20. to be paid by: |
Senders |
Currency |
Consignee | |||||||||||||||||||
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Carriage charges |
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Deductions: – |
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Balance |
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14. Instructions as to payment for carriage Carriage paid Carriage forward |
Supplem. charges |
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Other charges: + |
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Total: |
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€ |
9,870. |
00 | ||||||||||||||||
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21. Established in Amsterdam |
on 20 March |
20___ |
15. Cash on delivery |
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22. Dutch Industrial Machines BV
Signature and stamp of the sender
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23. AO Rusotra
Signature and stamp of the carrier |
24. Goods received | ||||||||||||||||||||
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Place Ivanovo |
on 31 March |
20__ | ||||||||||||||||||||
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Signature and stamp of the consignee | ||||||||||||||||||||||
NTERNATIONAL
CONSIGNMENT NOTE