1. Goods consigned from (Exporter's business name, address, country) Reference No.

PT. YANMAR DIESEL INDONESIA

JL. RAYA JAKARTA BOGOR KM.34,8
SUKAMAJU, CILODONG, DEPOK
ASEAN TRADE IN GOODS AGREEMENT
JAWA BARAT 1645, INDONESIA ASEAN INDUSTRIAL COOPERATION SCHEME
CERTIFICATE OF ORIGIN
2. Goods consigned to (Consignee's name, address, country) (Combined Declaration and Certificate)
ALL
MADECERTIFIED EQUIPMENT
OUT TO ORDER TRADINGBANK
OF METROPOLITAN CORP.-
AND TRUST CO. FORM D
METROBANK PLAZA SENATOR GIL J. PUYAT AVENUE
NATIONAL HIGHWAY, CAUAYAN
EXT. MAKATY CITY, METRO MANILA, PHILIPPINES
Issued in INDONESIA
(Country)
ISABELA 3305 PHILIPPINES
See Overleaf Notes

3. Means of transport and route (as far as known) 4. For Official Use

Preferential Treatment Given Under ASEAN

Departure Date DECEMBER 26, 2020 Trade in Goods Agreement

Preferential Treatment Given Under ASEAN

Vessel's name/Aircraft etc. SEATTLE C V.0QA7MN Industrial Cooperation Scheme

Preferential Treatment Not Given (Please

State reason's)
Port of Discharge MANILA, PHILIPPINES
.................................................................................................................
Signature of Authorised Signatory of the Importing Country

5. Item 6. Marks and 7. Number and type of packages, description 8. Origin criterion 9. Gross weight or other 10. Number and
number numbers on of goods (including quantity where (see Overleaf Notes) Quantity and Value date of
packages appropriate (FOB) where RVC is Invoices
and HS number of the importing country) applied

1 ACE MODEL TF70L QTY : 450 UNITS RVC GW : 133227/133228

MANILA PORT YANMAR DIESEL ENGINES 60% 42,750.00 KGM DECEMBER 26,
PHILIPPINES AS PER PROFORMA INVOICE NO. S32914 NW : 2020
YANMAR DIESEL DATED 24 NOV 2020 30,600.00 KGM
ENGINE N.W : 30,600.00 KGS USD 286,713.00
C/NO. 01-450 PSCC CODE NO.: 713.82-09
MADE IN INDONESIA L/C NO: 066/LC/001433/20

NOTIFY PARTY :
ALL CERTIFIED EQUIPMENT CORP.
905 PHILAM HOMES, EDSA, QUEZON CITY
1104, PHILIPPINES
HS: 8408.90.99

YANMAR ASIA (S) CORPORATION PTE LTD

SINGAPORE

11. Declaration by the exporter 12. Certification

The undersigned hereby declares that the above details and statement It is hereby certified, on the basis of control carried out, that the declaration
are correct; that all the goods were produced in by the exporter is correct.

INDONESIA
ISSUING OFFICE IN KABUPATEN BOGOR
......................................................................................................................
(Country)
and that they comply with the origin requirements specified for
these goods in the ASEAN Trade in Goods Agreement for the goods
exported to

PHILIPPINES
......................................................................................................................
(Importing Country)

KOTA DEPOK,
......................................................................................................................
Place and date, signature of authorised signatory

13.
v Third Country Invoicing Exhibition

Accumulation De Minimis

Back-to-Back CO v Issued Retroactively

,
.......................................................................................................................................
Partial Cumulation
Place and date, signature and stamp of certifying authority

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