Date: 02-10-2023

Certificate of Fact
of Loss/Leakage/Shortage/Damage
without Prejudice

1. Booked From: Ahmedabad-India to Doha-Qatar

2. Invoice Number & Date: HCCO/04-2301/AHD & 18 April 2023.
3. Consignment Said To Contain: 11kV Compact Substation (Containing ABB Make RMU, Voltamp
Make 1600kVA 11/0.433kV-Distribution Transformer & ABB Make LT & APFC Panel)
4. VESSEL: CAP SAN JUAN 317W
5. Consignor: Hamzavi Consultancy Company
6. Consignee: Providence Maintenance Services
7. Date of Arrival: 19 May 2023.
8. Date of Delivery: 21 May 2023.
9. Freight and other dues Received: Consignor Scope
10. Outer Condition and Marking of package at the time of survey: Some parts of the wrapping
were torn or completely removed on certain sides. The door of the panel was slightly opened and
there are some scratches on it as well. It seemed like there might have been some mishandling
during transit.
11. Internal Packing Condition and contents found: After further examination, it was discovered
that the base channel of the substation was severely bent and damaged. Unfortunately, this caused
badly damage to some of the internal components as well. Additionally, the main cable was broken
during transit.
12. Nature and Extent of Loss/shortage/Leakage/Damage: It had happen in transit as one side of
the Load bearing might be low due to which Compact Substation load may be at LV Compartment
side.
13. Number and Weight of Articles: 01 & 9000 Kgs.
14. Assessed Valued of Loss/Shortage/Leakage/Damage: QAR 60,500.00 (Based on Estimation from
HASTE CONTRACTING & TRADING W.L.L)
15. Consignor's Invoice No. & Date: HCCO/04-2301/AHD & 18 April 2023
16. Value and other details of the goods given in the invoice: USD 65,590.00
17. Whether insured and, if so with whom: Consignor Scope
18. Any other Remarks:-

We Agree to the above "Without Prejudice". The Consignment was transported at Owner's Risk. This
Certificate is issued at the request of the consignee preliminary for the purpose of lodging a claim
with their underwriters with whom the subject consignment is insured and without admission of any
liability of negligence or default on our part in regard to the above loss/ destruction / shortage /
damage / breakage/ leakage in transit.