| according to section 601 (1) Commercial Code |
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| Place |
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Date |
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Zn. |
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| Orderer |
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Reg. No. |
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| Street |
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City/Town |
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| Post code |
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Tel.-No. |
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| E-mail |
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Fax-No. |
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| Bank connect. |
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Acc.-No. |
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| Represented by |
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Position |
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| FORWARDER (represented by the undersigned authorized person): |
| CZECH INTERNATIONAL, a.s. |
| With registered office U pošty 2, 735 64 Havířov, Suchá |
| Reg. No. (IČ): 26870142, DIČ: CZ26870142, č. Raaltrans: Z06 |
| Registered in the Commercial Register with Regional Court in Ostrava, section B, No. 1783 |
| tel.: +420 596 477 111, fax: +420 596 410 292, forwarding@czechint.cz |
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| In your name and on our account, provide please for transportation of the shipment according to following specification: |
Description of goods
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No. of pieces
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Weight
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Dimensions
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Packaging
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Price of the shipment
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Type of vehicle
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Date of loading
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Consignor
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Place of loading
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Contact person
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Tel.-No.
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Customs clearance – loading
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Consignee
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Date of unloading
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Place of unloading
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Contact person
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Tel.-No.Telefon
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Customs clearance - unloading
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Contractual consideration for transport
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Customs charges
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Remarks
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Other stipulations:
- Conditions for the transport are set by relevant provisions in the Commercial Code, CMR – Convention as well as by General forwarding conditions of 01.10.2002, which are published in the part „General forwarding conditions“ on these pages.
- The Orderer undertakes to pay to the Forwarder cost purposefully expended in connection with transportation of the shipment pursuant to the statement of account and consignment note confirmed by the consignee, within 15 days after issuing the invoice, if not agreed otherwise in writing.
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| Thereby we confirm provision of transport according to a. m. instructions. |
Reg. plate of the vehicle |
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Stamp and signature of Orderer’s
authorized person according to
section 20 Civil Code: |
For CZECH INTERNATIONAL, a.s.
Stamp and signature of
Forwarder’s authorized person:
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