FORWARDING NOTE FOR GENERAL AND DANGEROUS MERTANDISE

(FOR ALLCARGO USE ONLY)

SEGMENT: EXIM DOMESTIC COASTAL

FROM TO
TERMINAL PVT. SIDING CRT/PFT PORT TERMINAL PVT. SIDING CRT/PFT PORT
MODINAGAR ICD / ACMTPL Mundra

EXIM DOMESTIC/COSTAL
CUSTOMER TYPE: EXPORTER IMPORTER ASSOCIATE CORPORATE CUSTOMER TYPE: CORPORATE CUSTOMER BUSINESS ASSOCIATE GENERAL/FF*/OTHERS
CHA NAME & EMU LINES PVT LTD CORPORATE CUSTOMER NAME & CODE (CARGO OWNER):
FORWARDER'S NAME & CODE: SERVICE MODE*: DD TD TT DT
TRANSPORTED BY: SELF TPT. ALLCARGO TRANSPORTED BY: SELF TPT. ALLCARGO
In case of ALLCARGO service, Kindly provide In case of ALLCARGO service, Kindly provide
PICK UP POINT MODINAGAR ICD / UTTAR PRADESH PICK UP POINT /KM -
DELIVERY POINT New York DELIVERY POINT /KM -
SHIPPING BILL NO./TP CONSIGNMENT ID/INDENT :
PAYMENT MODE (CASH/CHEQUE/DD/PDA/CCA) & NO. Line PDA BOOKING TYPE (PAID/TO PAY) :

CONSIGNOR NAME & ADDRESS: CMA CGM AGENCIES INDIA PVT LTD
GSTIN:

CONSIGNEE NAME & ADDRESS: CMA CGM AGENCIES INDIA PVT LTD
GSTIN:

HAZRDOUS(YES/NO), IF
TARE YES
NUMBER OF COMMODITY HSN CARGO WEIGHT VERFIED GROSS MASS VALUE OF CARGO/FOB
CONTAINER NO. TYPE SIZE WEIGHT COMMODITY NAME IMDG/RLY,RED TARIFF EWAY BILL NO. SEAL NO.
ARTICLES CODE (in MT) (VGM) OF CONTAINER VALUE (in Rs.)
(in MT) CODE
CMAU0388884 1X20 2.190 64 20.340 22.530 0.00 A/S:C5882065,
C/S:BOLT02528202

TEMU3234179 1X20 2.180 64 20.360 22.540 0.00 A/S:C5882067,

C/S:BOLT02528203

(Accepted on said to contain basis)

CMAU0388884 : 6249340 TEMU3234179 : 6249340

1. I declared that each consignment of the value Rs.______________________ and engage **/do not enagage** to pay percentage charge on access value for the increased risk as required by ALLCARGO (Description and contents in
each packages and its value should be specially mentioned). Alternative ALLCARGO risk and Owner's risk rate being available, I elect to pay ___________________ rates.
2. Please declared wheather above container/s contains high value cargo - YES/NO
3. I do hereby certify that I have satisfied myself that the description, mark and weight or quantuty of goods consigned by me have been correctly entered in the Forwarding Note. I further declares that I have read and accept the
Terms & Conditions mentioned herein and overleaf.

Tick the appropriate options shown above.

*DD - Door to Door, TD - Terminal to Door, TT - Terminal to Terminal, DT - Door to Terminal, FF - Freight Forwarder.
** Strike out any clause inapplicable before signing this form.

Signautre & Seal of the customer

Date : Address:
 TERMS & CONDITIONS

1. Unless the consignor declares in clause (1) overleaf the value of any consignment & pays percentage charge on exess value as required by ALLCARGO, the maximum limit of amount of monetary liability of ALLCARGOfor loss,
destruction, damage, Deterioration or non-delivery consignment shall not exceed Rs.50 per kg.

2. When alternative 'ALLCARGO Risk' and 'Owner Risk' rate are quote, the latter will apply, unless the sender in Clause(1) overleaf enter the words 'ALLCARGO Risk' when he will pay or engage to pay the higher and wiil reserve a
certificate with this effect.

3. I futher declare that I accept responsibility for any consequences to the property of the ALLCARGO, or to the property of other persons, entrusted to the ALLCARGO for conveyance, or otherwise which may be caused by the said
consignment, and that all risk and responsibility whether to the ALLCARGO, to their servants or to others remains solely and entirly with me.

NOTE:- The attention of the sender or his agent is invited to the principal terms and conditions applying to the carriage of dangerous goods byALLCARGO which are set forth in I.R.C.A Red Tariff and International Maritime of
Dangerous goods (IMDG).

Here enter additional declaration which may be required by the Rules laid down in the I.R.C.A.Red Tariff and International Maritime of Dangerous goods (IMDG).