Forwarding order

(* - required fields)

Order reference:*




We hereby place an order to CARTRAG spolka z o. o, 81-963 Gdynia, Żeromskiego 32 registered in the District Court in Gdańsk, XVI Commercial Department of National Court Registry, KRS No. 0000014213 to forward the cargo
from:*
to:*

1. Client
Name of the company or first name and surname:*
Legal form:*
Address of the registered office or home address:*
Personal Identification Number:*
Taxpayer Identification Number:  
Statistical Identification Number:  

2. Client's bank account number
Bank name and address:
Account number:

3. Client's person in charge
First name and surname:*
Phone No.:*
Fax No.:  
e-mail:*

4. Cargo description*

5. Strategic goods
Strategic goods:
From military list, category:
From dual-use list, category:

6. Value of the goods

7. Exprter/Vendor
Name of the company:
Contact person first name and surname:
Phone No.:
Fax No.:
e-mail:

8. Importer/Purchaser
Name of the company:
Contact person first name and surname:
Phone No.:
Fax No.:
e-mail:

9. Shipper and place of shipment
Name of the company or first name and surname:
Contact person first name and surname:
Shipment address:
Phone No.:
Fax No.:
e-mail:

10. Consignee and place of delivery
Name of the company or first name and surname:
Contact person first name and surname:
Delivery address:
Phone No.:
Fax No.:
e-mail:

11. Terms of delivery according to Incoterms 2000

12. Specific conditions pertaining to the organization of transport, pursuant to the letter of credit or any other arrangements

13. Customs clearance
Mode of customs clearance:
Place of customs clearance:
No. of Customs Office:
Who is to place a guarantee:

14. Port of shipment/discharge
Shipment port:
Discharge port:

15. Date when goods are ready for shipment

16. Cargo insurance
(Terms and conditions of cargo insurance available under www.cartrag.com.pl)

17. Additional instructions

18. Attached documents

This Agreement shall be governed by the Polish Law and the General Polish Forwarding Conditions 2010, pursuant to the offer No.:
General Polish Forwarding Conditions are enclosed to this Agreement and are available on the web site.

In case the Client is a foreigner, any disputes arising out of this Agreement shall be resolved by the Court of Arbitration by the National Chamber of Forwarding and Logistics (PIFFA) in Gdynia.

The Client’s statement:

We hereby declare that we are fully aware of the contents of the General Polish Forwarding Conditions 2010 and we give our consent to include them to the text of this Agreement.



PLEASE PRINT THE FILLED FORM, SIGN IT AND STAMP, AND SEND TO US BY FAX OR SCANNED. THANK YOU.