Land-Transport Shipping order to

NAVIS Schiffahrts- und Speditionsges. mbH

P.O. Box 10 29 27 ∙ 28029 Bremen / GERMANY

Phone: +49 (421) 335 48 – 0 ∙ Fax.: +49 (421) 32 31 09 ∙ E-Mail:

We hereby authorise NAVIS Schiffahrts- und Speditionsges. mbH, Bremen to handle the following consignment in accordance with the latest version of the Allgemeinen Deutschen Spediteurbedingungen - ADSp - (German Forwarders' Standard Terms and Conditions of Trading) according to the following instructions:

Shipper / Consignee / Place of loading / destination
Company / Company / Company
Postcode / City / Postcode / City / Postcode / City
/ / / / /
Contact person / Phone No. / Contact person / Phone No. / Contact person / Phone No.
/ / / / /
Reference No. / Reference No. / Reference No.
VAT No. / EORI-No. / VAT No. / EORI-No.
/ / /
You will receive from:
Please take delivery of the following consignment on at:
Estimated Time of Delivery:
Markings / Quantity / Type of packaging / Contents (detailed description of goods) / Gross weight (kg) / L / Dims. (cm)
W / H
Total: / Total:
Notes: /

Dangerous goods

/

These goods are subject to are not subject to the Dangerous Goods Regulations.

ADR class

/ /

Package group

/

Classification code

/ /

UN-Number

/

Transport insurance

/ to be covered by ------NAVIS GmbH, Brementhe client (shipper)the consignee / Transport insurance sum: EUR

Enclosures

/ Export Declaration / Packing list / Commerical invoice / Certicicate of origin
/ Customs Power of Attorney / Dangerous Goods Declaration as per ASR / others:
03.01.2017
Date / Place / Name / Signature / Stamp

Page 1 of 1

Place of business and jurisdiction in Bremen · Trade Register Bremen B 98 90 · VAT No.: DE 811 117 072 · Taxnumber: 71/582/01709 · Managing Director: Remo Stork

We operate exclusively in accordance with the Allgemeine Deutsche Spediteurbedingungen 2017 – ADSp 2017 – (German Freight Forwarders' General Terms and Conditions 2017). The ADSp 2017 can be downloaded under www.navis-ag.com/en/terms-and-conditions. Note: In clause 23 the ADSp 2017 deviates from the statutory liability limitation in section 431 German Commercial Code (HGB) by limiting the liability for multimodal transportation with the involvement of sea carriage and an unknown damage location to 2 SDR/kg and, for the rest, the customary liability limitation of 8,33 SDR/kg additionally to Euro 1,25 million per damage claim and EUR 2,5 million per damage event, but not less than 2 SDR/kg.