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 KOPERASI

PERMATA GAYO

Nomor DO: 518/039/DHNI2006

.Jln. Syiah lilama No. M) KanlflUng Simpang {;tallla, Kecamatan Bllndar

K~lhllllalcn Hener Mel"i~lh. Nanggroc Acch Darussalam - 24582

E-mail: pc."matagayo_coop(ii1yahoo.co.id

COMMERCIAL INVOICE
No: 032IInvi PGC/20 10/20 11
Date. 19.1.2011
Messrs. Cooperative Coffees INC
302 Lamar Street Suite E
Americus, GA 31709. USA
Commodity : Sumatra Permata Gayo Highland Arabica Coffee
Shipped by : Reunion V.1109
From : Belawan. Indonesia to New York
Date of Shipment : 28th January 2011
BL NUlllber : BLWNYC010195
DESCRIPTION OF GOODS AMOUNT
320 (Three Hundred Twenty) Bags of 60 kgs nett each
Gross Weight : 19.520 Kgs
Tare . 320 Kgs
Nett Weight : 19.200 Kgs

At USD 3.061 Lbs FOB Belawan

As per contract SUO113 USD 129.524,66
(ContTac price is Incl. usd.10.-/IOOLbs Fairtrade premium)

Say: One Hundred Twenty Nine Thousand Five Hundred Twenty Four point
Sixty Six US Dollars Only
- Insurance to be covered by buyer - Producer & Exporter FLO 10:
- Freight Collect 6589
- Payment C.A.D - Buyer FLO 10 : 1341
Consignee: Cooperative Coffees Inc
302 Lamar Street Suite E
Americus GA 31709, USA
Tel: +l 229 924 3035 Fax: +1 229 924 6250
Connecting Vessel: APL Spinel V.0131W
r . Seal: HJCl UIRlOill HB357243
Marks & No:
roc Koperasi Pennata Gayo
015/1730/34
SUGl13
SUMA1RA PERMATA GA YO HIGHLAND ARABICA COFFEE
SEMI·WASHED SUMATRA
GAYO MOUNTAIN GREEN ARABICA
COFFEE DP GRADE 1
FLO FAIRTRADE AND ORGANIC CERTIFIED
C()QPERATIVE COFFEES FLO ID: 1341
roc FLO ID: 6589
PGC CU ID: 812234
NETT:60KGS
PROD. OF INDONESIA (Armia)
NEW YORK. NY
1-320
 LlSI
SV5N5/5VE5R~SAL SHIPPING, INC.
CTPAT NO. 72545308 OTI LICENSE NO. 17577NF
BILL OF LADING
SHIPPER/EXPORTER: DOCUMENT NO. IBILL OF LADING NO.
BLWNYC010195
KOPERASI PERMATA GAYO
DOMESTIC ROUTING/EXPORT INSTRUCTION
JLN.SYIAH UTAMA No.66 KAMPUNG SIMPANG UTAMl ,

KECAMATAN BANDAR KABUPATEN BENER

MERIAH, NANGGROE ACEH DARUSSALAM -24582

CON~t5bPERATIVE COFFEES INC EXPORT REFER~Et

HJ B Wl00142700
302 W. LAMAR STREET SUITE E.
FOR CARGO DEUVERY PUEASE CONTACT:
AMERICUS, GA 31709. USA

PHONE: +1-229-924-3035 FAX: +1-229-924-6250

UNIVERSAL SHIPPING, INC.
A TIN : BILL HARIS 2855 SOUTH RESERVOIR STREET,
POMONA, CA 91766
NOTI"E~1!LCO TRADING L.P. TEL: (909) 628-2226 FAX: (909) 628-2221
17 BATTERY PLACE, SUITE 1010

NEW YORK, NY 10004

PHONE: +1-212-344-6771 FAX :+1-212-344-8723

FORWARDING AGENT REFERENCES:

ATTN: GEORGE TSIASTSIOS (gtsiatsios@exceltrade.com)

'PRE'ft~fifl()N V.11 09 'P~f:1j'~X~iNDONESIA CY

ON - CARRIAGE BY: OF BILLS OF LADING:
EXPO~1!>t ~~~L 0131 W 'EUW~~ INDONESIA CY
NO.

FINAl DESTINATION: 3(THREE)

PORT ~E:WCffl~ P~~~~r(

PARTICULARS FURNISHED BY SHIPPER

~

MARKS AND NUMBERS
CONTAINER I SEAL
HJCU2200633 I HB35 243
MARK AND NUMBER AS A TACH
NO. OF PKGS. DESCRIPTION OF PACKAGES AND GOODS GROSS WEIGHT MEASUREMENT
SHIPPER'S LOAD, STOW WEIGHT AND COUNT
1 X 20'STD CONTAINER: ~W: 19,520.00 KG~
320 BAGS OF 60 KGS NETT EACH Nw: 19,200.00 KG~
SUMATRA PERMATA GAYO HIGHLAND
ARABICA COFFEE SEMI-WASHED SUMATRA GAYO
MOUNTAIN GREEN ARABICA COFFEE DP GRADE1
FLO FAIRTRADE AND ORGANIC CERTIFIED

FDA NO' 13096723740

"CY/CY"

TOTALNUMBER OF CONTAINERS OR
PACKAGED
ONE UNIT TWENTY CONTAINER ONLY
RECEIVED by the Carrier the Goods as specmed above in apparent good order and condition FR EIGHT CHARGES PREPAID COLLECT
unless otherwise stated. to be transported to such place as agreed. authorized or permitted hereon
and subject to all the terms and conditions appearing on the front and reverse of this Bill of lading
to which the merchant agrees by accepting this Bill of lading. any local privileges and customs
notwrthstanding.

The particulars, given above as stated by the shipper and the weight, measure, quantity condition.
FREIGHT COLLECT
contents and value of the Goods are unknown to the Carrier.

In WITNESS whereof one (1) original Bill of lading has been signed if not otherwise stated above
the same being accomplished the other if any to be void if required by the Carrier one (1) Original
Bill of lading must be surrendered duly endorsed in exchange for the goods of delivery order,
SECO~ DO'''i~~I~
•e
"'('; . '.I
..
'7.:: ..:~;
",""--,.c;"':'.'5fIo.~ .••'~"';. ~:-: ••
Al
,,,,,,".. .J

Place and date of issue

signed on behalf of the Carrier:

EXCESS VALUE CHARGE

TOTAL CHARGES
ATTACHMENT FOR B/l NO.BlWNYC010195
MARKS AND NUMBER

PGC
015/1730/34
SUG113
SUMATRA PERMATA GAYO

HIGHLAND ARABICA COFFEE

SEMI-WASHED SUMATRA

GAYO MOUNTAIN GREEN ARABICA

COFFEE DP GRADE 1
FLO FAIRTRADE AND ORGANIC CERTIFIED
COOPERATIVE COFEES FLO 10: 1341
PGC FLO 10:6589

PGC CU 10:812234

NETT: 60 KGS

PROD. OF INDONESIA

NEW YORK. NY

1 - 320

SECOND ORrGINAL

 TRANSACTION CERTU'ICATE

LSA FOR PRODUCTS FROM I'OOP ORGANIC PRODUCnON

: I Body l$Sumg the certlftcate (name and address) 2.The National Organic Program st.ndards of the United States Department of
Contrul UnIOn certIfications 8.V. AgnculturelControl l;nion Certifications. standards
Meeuwenlaan 4·6 Reference number of Ihe cel11ficate: PRJ 812234/164293
8011 BZ ZWOLLE
NETHERLANDS
3. SeHer of (he pn:x1uct (name and address) 4. Inspection body· (name and address)
Kopera~lPennata Gayo Control Union certifications B,V,
JI SYlah Clam" No, 66 Kampung 511npang L:tama, Pondok Barn, Kab, Bener Meeuwenlaan 4-6
,
MeriahAceh T.ngah 8011 BZ ZWOLLE
:"\ an ggrOt! A ceh Darussa lam NETHERLANDS
I~DONESIA

5. Producer or processor of the product* lname and address) 6, Country of dispatch

Koperas; Permata Gayo (Export) INDONESIA
JI. Kongsl No. 278 Marjendal, Medan
Sumalera Utara
INDONESIA
7, Consignee (name and address) 8_ Country of destnHdl0n
U;lTED STATES
Cooperative Coffees Inc,
302 W.Lamar St. Suite E,
GA 31709 Americus
9. Address and place of destinalion*
UNITED STATES
10. Marks and numbers, container oo(s), number and kind. Trade name of the product. II. Gross mass
Production LOlJbatch Gross mass Net mass
t>:OP certified 1100% organic,' organic)
Year numbers (kgs) (kgs) 19520,00 kgs

100% organic Sumatra Perrnata Gayo HIghland Arabica Coffee (SEMI· WASHED
SlJMA TRA GAYO MOUNTAIN GREEN ARABICA COFFEE DP GRADE I) 201() . 19520,00 1920(},0(} 12 Net mass
packed in units of 60 kg' in 320 bags 19200.0(} kg.
from organic production methods,
Invoice no,: 032!1nviPGCl20 10120 I 1 d,d.19·01·11 13, Alternative units •
Transpol1 document no,: BLWNYCOIOl95 d,d.28·(1I·11
Container no ' HJCli220063·)
fdent1f1cation codes o15!l7JO!34 C SUG 113, Transport C amp'flY UOlversal ShIpping inc, Seal)\o, HB35724)

14. Declaration of the body "surng the certificate

15. Additional declaration (ifappropriale)

Norify Party: Excelso Trading L.P.

---', .f ' ---.....

~~ ~
16, Place and date of issue Jakarta, 01 February 2011
Name and signature of authorised person

,.Jil'"
On behalf of Managing Dire.

J,. .
~=~
"
Wi oSuyo

'Explanatory notes

?z c[ Cerfi fi co.t1.

Box 4: The inspection and certification body for compliance with the ruies on from organic producuon melhods..

0
--,,-­
~UIt!In~ •
. . . . _ _ _ .., ... t.JniIIiIIf

Box S: The firm which carried out the ,.. t operation !,processing, packaging, labelling) on the batch,

Box 9: The .ddr.,,,

oflbe linn where the batch will be delivered, if different from the address in box 7.

Box 13: e.g. volume in meters. to be given. where appropriate. in supplement to the declarations In boxes II and 12.

I of!