VAT-ID-No.

: DE 129 481 986 date : 2006/09

Court of jurisdiction is MUNICH, Germany

Telephone: +49 (0)89 - 896073 0

INSIDE BOOKING FORM
Please fax to:
FERRIES ASSISTANTS TO MUNICH Telefax:+49 (0)89 83485 85 NORTHERN EUROPE
Telefax:+49 (0)89 82113 04 SOUTHERN EUROPE
E-mail: ferry@transcamion.com
TRANSCAMION SCHIFFAHRTSAGENTUR GMBH
Bodenseestr. 5 * D 81241 Mnchen
Name of Ferry Assistant : COSMINA
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Last time and hour for confirmation: Contact person to confirm the booking:
Bobe Cristian
Client Number / Name and location :
Telephone: 0724 533 980
Numele societatii SC ALEXNEL SRL
Cod fiscal RO9144964 Telefax: 0242535009
Adresa DN 3A KM 111, COMUNA DRAGALINA, JUDETUL
CALARASI, Romania
Cod postal 917080

E-mail for confirmation: bobe.cristian@gmail.com

VAT-ID-No:

Quotation Number.
RATE AGREED FOR THESE CROSSINGS
PORTAL RATE INTRANET SPECIAL OTHER SPECIAL:
Please book for this company following shipment for a vehicle with normal measures and weight:
OUTWARD: ruta tur loaded empty HOMEWARD: ruta retur loaded empty

Port of dep.: CALAIS Port of dep.: DOVER

Port of arr. Port of arr.:

Date of dep.: time Date of dep.: time:

Ferry service/line: Ferry service/line:

1. TRUCK ( max. 16,5/18,5 x 2,5 x 4 metres )

Plate-Number tractor / trailer Kind of cargo: Weight of cargo: to

CL20ABA/CL37ABA Dimensions: LxWxH / L: _______m x W: _____,_____ x H: ____,____

1 STAN CONSTANTIN CO-DRIVER:

2. TRUCK ( max. 16,5/18,5 x 2,5 x 4 metres )

Plate-Number tractor / trailer Kind of cargo: Weight of cargo: to

Dimensions: LxWxH / L: _____,____m x W: _____,_____ x H: ____,____

DRIVER: 1 CO-DRIVER

Maritime
Insurance oneway Value of vehicle 55.000,- 100.000,- 150.000,-

Yes No Up to 2 days of crossing 26,00,- 47,00,- 71,00,-

2-4 days of crossing 39,00,- 70,00,- 105,00,-
From 4 days of crossing 52,00,- 95,00,- 141,00,-

Reefer-truck: Dangerous cargo (IMCO & UN. No Pls list separately)

yes no electric conn. yes no

Payment Credit Account by pre-payment by creditcard

Euroshell AmEx Mastercard Visa MSCard

Client is disposing of a credit account at TRANSCAMION : by remittance by direct debit OR

7 0 7 7 2 5 1 5 0 0 2 2 2 4 7 0 2 4 3 0 9 1 8
Euroshell cardnumber American Express / Visa / Eurocard valid until

Card verification number CVV AMEX (4 numbers)

Visa / Eurocard (last 3 numbers on the back of card)