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Name:
Date:

. pab;it
Closed at $2.45 on 8 February 2013
OM)
KOPERASI
PERMATA GAYO
Nomor DB ; 518/039/ DB f V /2006
Jlo. Syiab Utama No.66 Kampung Simpang Utruna, Kecamatan Bandar
Kabupateu Beuer Meriab, Nauggroe Aeeb Darussalam - 24582 - Indonesia
302 W, Lamar St. Suite E. Americus, GA 31709 USA
Tel. +1-229-924-3035, Fax. +1-229-924-6250
Attn: Chelsea Carter
Shippedby:
Arisara V.1313
FromJ
Belawan, Indonesia
ConsigneeJ
Email :
FLO ID 6589
flO 10 buyer: 1341
. FDA REG NO.13096723740
B/LNumber:
602519461 00.1
To:
Mewark, f(]
Container/Sea/liD:
Contract No.
SUG134
To The Order of Cooperative Coffees Inc MRKU6822066/ Ml-ID1245880
302 W. Lamar St. Suite E. Americus, GA 31709 USA
Tel. +1-229-924-3035, Fax. +1-229-924-6250
Connecting Vessel:
Attn: Chelsea Carter
CMA CGM MEUSANOE V.785S
Description of Goods
300 (three hundred) Bags of 60 Kgs Net Each Bag
SUMATRA PERMATA GAYO HIGHLAND
ARABICA DP GRADE 1 GREEN COFFEE
FLO F AIRTRADE & ORGANIC CERTIFIED
Marks & Nos. Notify Party:
PGC EXCELCO TRADING L.P.
015/1730/45 17 BATTERY PLACE, SUITE 1010
SUO 134 NEW YORK,NY 10004
FLO ill: 1341 TEL. + 1-212-344-6771,FAX. + 1-212-344-8723
SUMATRA GAYO MOUNTAIN ATTN: GEORGE TSIASTSIOS
GREEN ARABICA COFFEE DP GRADE 1 (GTSIATSIOS@EXCELTRADE
FLO FAIRTRADE + ORGANIC CERTIFIED
ill CU: 812234
FLOID: 6589
PROD OF INDONESIA
NETf60KGS
NEWARK,NJ
1-300
Gross Weight
Ta re
Nett Weight
: 18,300 Kgs
300 Kgs
: 18,000 Kgs
Price
Organic Premium
fairtrade Premiun
: US$.
: US$.
: US$.
4,297.701Mtons
661.38/Mtons
440.921Mtons
Price total : US$. S,400.00/Mtons
FOB Belawan NSW as per contract no.SUG134
Say: NinetySeven Thousandand Two Hundred DollafS only.
- Insurance to be covered by buyer
- Freight Collect
- Payment c.A. 0
- ''This cargo/coffee has not been refused entry by any country"
US$. 77,358.60
US$. 11,904.84
USS. 7,936.56
US$. 97,200.00
BILL OF LADING FOR a<;;t:AN TRANSPORT I SCN: M. AEU
OR MULTIMODAL TRANSPORT
MAERSK LINE
8fLNo602519461
. .. ..----1
Shipper
KOPERASI PERMATA GAYO 602519461
JL.SYIAH UTAMA NO.66 KAMPUNG
, &port; references Svc Contract
SIMPANG
532992
UTAMA KEC,BANDAR,KAB.BENER MERIAH,
I Onward inlandttlUling (NOt part of carriage as defined in.tlause I" For "<0<111\ .nIl risk Of
ACEH-24582 INDONESIA
narrN>l .. L. P. ...
COFFEES INC 17 BAnERY PLACE,SUITE 1010 NEW
302 W.LAMAR ST. SUITE E AMERICUS, YORK,NY 10004
GA 31709 USA.TEL.+1-229-924-3035
FAX.+1-229-924-6250 AnN.CHELSEA 8723 ATIN:GEORGE TSIASTSIOS
CARTER FLO 10: 1341 ! (GTSIATSIOS@EXCEL.TRADE.COM)
ARISARA
Porto! l.oiIding
BELAWAN, INDONESIAN NJ,United States
PARTICULARS FURNISHED BY SHIPPER
1 Container Said to Contain 300 Bag
Weight
18300 KGS
Measurement
25 C8M
0901110000 (HS)
300 BAGS OF 60 KGS NET EACH BAG
SUMATRA PERMATA GAYO HIGLAND ARABICA DP GRADE 1
GREEN COFFEE FLO FAIRTRADE & ORGANIC CERTIFIED
PGC
015/1730/45
SUG134
FLO 10 : 1341
SUMATRA GAYO MOUNTAIN
GREEN ARABICA COFFEE
DP GRADE 1
FAIR TRADE FLO + ORGANIC CERTIFIED
ID CU:812234
FLO 10:6589
PROD OF INDONESIA
NETI 60 KGS
NEWARK,NJ
1 300
oove partkvlars as declared by Shipper, but wnnout
Collect llate
Q;;ners Ii<:':eipt (see"clause land Total numbe,
of containers or receiVed by Carner.
1 container
orori9inalli(sllL
3/THREE
Oed.reilV.I"" (see<iause 7.3)
--... ....
PT. PELAYARAN BINTANG PUTIH
This transport document has one or more numbered pages
As for the carrier
B/L: 602519461 Page; 2
D
MAERSKLINE
MRKU6822066 ML-ID1245880 20 DRY 8'6 300 6ag 18300 KGS 25 CBM
SHIPPER'S LOAD, STOW, WEIGHT AND COUNT
FREIGHT COLLECT
CY/Cy
Collect Unit Currenq P r ~ R;>t. /' Fre!\lht &. Cllal1les
!
TRANSACTION CERTIFICATE
USA FOR PRODUCTS FROM NOP ORGANIC PRODUCTION
11. Body issuing the certificate (name and address)
Control Union certifications B.V.
Meeuwenlaan 46
8011 BZ ZWOLLE
NETHERLANDS
i
2.ThQ National Organic Program Standards of the United States Department of
Agriculture/Control Union Certifications standard,
Reference number of the certificate: PRJ 8122341281496
3. of the product (name and address) 4. Inspection body (name and address)
Koperasi Pennata Gayo Control Union certifications B, V.
JI. Syl.h Utama. No. 66 Kalllpung Simpang Utama, Pondok Baru, Kab. 6enor Mccuwcnlaan 46
MedahAceh Tengah 8011 BZ ZWOLLE
Nanggroe Acch Darussalam NETHERLANDS
INDONESIA
5. Producer or processor of the product' (name and address)
Koperasl Permata Gayo (Export)
11. Kongs; No. 27[1 Mariendal. Medan
Sumatera Utara
INDONESIA
6. Country of dispatch
INDONESIA
7. Consignee (name and address)
Cooperative Coffees Inc.
302 Lamar Street Suite E
GA31709 Americus
UNITED STATES
8. Coumry of destination
UNITED STATES
9. Address and place of destination
10. Marks and numbers, container nO(5), number and kind. Ttade name of the product.
NOPcertified
Production Lot/batch Gross mass Net mass
Year numbers (kgs) (kgs)
100% organic Pennata Gayo Arabic. Coffee (Semi Washed ArabiC. Coffee Dp
grade I Organic/NOP and FLO Fairtradc Certified Prod of Indonesia) packed in 2013 18300.00 18000.00
Units 60 Kgs in 300 bags
from organic production methods.
InvOiceno: 045/INV/PGCi2012l2013 d.d.080213
Transport document no.: 602519461 d.d. 110213
Comainer no.; MRKU6822065
Identification codes: Permata Gayo Cooperative Identification Numbcr:015/1730/,15. sue 134 Seal Number: MLID1245S80
f:>hlppil1g Company: MAERSK,LlNE
II. Gross mass
18300.00 kg"
12. Net mass
18000.00 kgs
13. Alternative units ..
14. Declaration of the body issuing the certificate
15. Addltlonal<JCclal;r.,n (if ji',oprlllte)
j . .
"',
". ,"co I "
- .>
Name.'1I,11s1 tlii\ person
'""'"'ry '""
of the is.',uing body
On beha of ar ire tor
l\ \'/'

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'Explanatory notes, .
Box 4: The inspecUbtt and certification body for compliance with the on from organic production mQthods ..
Box 5: The fjrm wbidt carried out the last operation (processing. packaging, lab<lllng) on the balch.
60x 9: The address ofllle firm where the hatch will be delivered. if different from the address in box 7.
!lox 13: e.g. volume in meters. to be given. where appropriate. in supplement to the declllrations in boxes II and 12.