CONTAINER VERIFIED GROSS MASS DECLARATION NO.

20190033-20190036-0000040844

CONTAINER NO : TCLU 266510 6

CUSTOMER NAME : FM GLOBAL LOGISTICS PT.
CUSTOMER ADDRESS : RUKAN ARTHA GADING NIAGA BLOK H NO 11 KELAPA
GADING BARAT, KELAPA GADING, JAKARTA UTARA
JOB ORDER NO : 202008E09339
BOOKING NO : 411IN2008246
ARRIVAL TS : 19/08/2020 21:24

The undersigned, PT TERMINAL PETIKEMAS SURABAYA, herewith declared, for and on behalf of the
customer, that the Verified Gross Mass of the subject container is:

22,460 KGS
M. G. W. : 30,480 KGS
VGM ASCERTAINED TS : 19/08/2020 21:56

DEPARTURE VESSEL : CAPE MOSS ( HC033A / HC033R )

DEPARTURE TS :
LOAD PORT : IDSUB - SURABAYA, INDONESIA
DISCHARGE PORT : MYTPP - TANJUNG PELEPAS, MALAYSIA

Disclaimer: ISSUED BY:

1. TPS is not responsible for the cargo inside above container.
Therefore, TPS shall be free from all risks and responsibilities
PT TERMINAL PETIKEMAS SURABAYA
including but not limited, the status/legality, condition and quality JL. TANJUNG MUTIARA 1
SURABAYA 60177
of the cargo inside the container.
EAST JAVA, INDONESIA
2. The "VGM " declared on this document is the "verified gross PHONE +62313283265
mass" as obtained by using method 1 (amendment SOLAS VI/2 EMAIL HUMAS@TPS.CO.ID
and paragraph 5)

The Verified Gross Mass has been ascertained by PT TERMINAL PETIKEMAS SURABAYA on a calibrated weighing device, this device
has been approved and certified by the competent local authorities.
The calibration certificate and the approval will be produced upon first request.