® ® ® ® ® ®

1 ORIGINAL 2 RECEIVER COPY 3 SENDER COPY

ОD-04-02-63/06 е x p r e s s ОD-04-02-63/06 е x p r e s s ОD-04-02-63/06 е x p r e s s
Shipment No. Documents x Parcel: Shipment No. Documents x Parcel: Shipment No. Documents x Parcel:
auto parts auto parts auto parts
description of parcel shipment description of parcel shipment description of parcel shipment

From: CLUJ-NAPOCA (CLUJ) without reviewing

the content From: CLUJ-NAPOCA (CLUJ) without reviewing
the content From: CLUJ-NAPOCA (CLUJ) without reviewing
the content

RO ROMANIA RO ROMANIA RO ROMANIA

Econt’s request No. Econt’s request No. Econt’s request No.

Office: Envelope No: Office: Envelope No: Office: Envelope No:

To: VARNA RC9000 Units: 1 Weight:5.000 kg To: VARNA RC9000 Units: 1 Weight:5.000 kg To: VARNA RC9000 Units: 1 Weight:5.000 kg
5 5 5
real or bulk weight* real or bulk weight* real or bulk weight*
Office: VARNA - DIMITAR DIMITAR X X X cm Office: VARNA - DIMITAR DIMITAR X X X cm Office: VARNA - DIMITAR DIMITAR X X X cm
çîíà * length x width x height in cm çîíà * length x width x height in cm çîíà * length x width x height in cm

Services Price (VAT incl.) Payment cl.No. Sum Services Price (VAT incl.) Payment cl.No. Sum Services Price (VAT incl.) Payment cl.No. Sum
5 18.44 5 18.44 5 18.44
BGN BGN BGN BGN BGN BGN BGN BGN

BGN BGN BGN BGN BGN BGN BGN BGN

BGN BGN BGN BGN BGN BGN BGN BGN

BGN BGN BGN

BGN BGN BGN

BGN BGN BGN

Tariff code: Sender Tariff code: Sender Tariff code: Sender
x 1258.89 7.78 x x 1258.89 7.78 x x 1258.89 7.78 x
BGN

BGN

BGN
ОС: Consignee 26.22 ОС: Consignee 26.22 ОС: Consignee 26.22
sum of declared value sum of declared value sum of declared value
o’clock

o’clock

o’clock
rd rd rd
Р: 3 party Р: 3 party Р: 3 party
after at to after at to after at to

CD: Delivery: CD: Delivery: CD: Delivery:

pay / collect sum of the CD pay / collect sum of the CD pay / collect sum of the CD
DC DC-СР DP DC DC-СР DP DC DC-СР DP
Method of payment of Cash on Delivery Method of payment of Cash on Delivery Method of payment of Cash on Delivery
SK ZK SK ZK SK ZK
storage fee retaining the courier Delivery notice to e-mail address or telephone number storage fee retaining the courier Delivery notice to e-mail address or telephone number storage fee retaining the courier Delivery notice to e-mail address or telephone number

All possible instructions: All possible instructions: All possible instructions:

26.22 26.22 26.22

rate and reason for discount rate and reason for discount rate and reason for discount
total price for courier services: Review - see before you pay total price for courier services: Review - see before you pay total price for courier services: Review - see before you pay

packaging test choice packaging test choice packaging test choice

additional possibilities during a review additional possibilities during a review additional possibilities during a review
BGN BGN BGN BGN

BGN BGN BGN BGN

BGN BGN BGN BGN

Pack: Pallet: receipt of invoice Pack: Pallet: receipt of invoice Pack: Pallet: receipt of invoice
No. of the type of packing pallet No. No. of the type of packing pallet No. No. of the type of packing pallet No.
If the recipient does not accept the If the recipient does not accept the If the recipient does not accept the
REF shipment or part of it after the review: REF shipment or part of it after the review: REF shipment or part of it after the review:
renting a fridge bag renting a fridge bag renting a fridge bag
total price of packaging: total price of packaging: total price of packaging:

26.22 26.22 26.22

The shipment will paid by The return will paid by The shipment will paid by The return will paid by The shipment will paid by The return will paid by
total price of the shipment: total price of the shipment: total price of the shipment:

TANTAU DANIEL TANTAU DANIEL TANTAU DANIEL

Return waybill Return waybill Return waybill
Sender: Sender: Sender:

Strada Albiei 4 STR ALBIEI NR 4,CLUJ-N Strada Albiei 4 STR ALBIEI NR 4,CLUJ-N Strada Albiei 4 STR ALBIEI NR 4,CLUJ-N
individual / legal entity individual / legal entity individual / legal entity
Address: Address: Address:
APOCA, ROMANI Tel: 0742513346 APOCA, ROMANI Tel: 0742513346 APOCA, ROMANI Tel: 0742513346
residential quarter, street, number, block of flats, entrance, floor residential quarter, street, number, block of flats, entrance, floor residential quarter, street, number, block of flats, entrance, floor

Name: ANA TANTAU Name: ANA TANTAU Name: ANA TANTAU

MID AVTO MID AVTO MID AVTO
name, surname / commercial outlet name, surname / commercial outlet name, surname / commercial outlet
Consignee: Consignee: Consignee:
ul. Usta kolao Ficheto 3 STR USTA KOLY ul. Usta kolao Ficheto 3 STR USTA KOLY ul. Usta kolao Ficheto 3 STR USTA KOLY
individual / legal entity individual / legal entity individual / legal entity
Address: Address: Address:
O FICHETO NR Tel: 359895518640 O FICHETO NR Tel: 359895518640 O FICHETO NR Tel: 359895518640
residential quarter, street, number, block of flats, entrance, floor residential quarter, street, number, block of flats, entrance, floor residential quarter, street, number, block of flats, entrance, floor

Name: ZELEANOVIC GEORGE Name: ZELEANOVIC GEORGE Name: ZELEANOVIC GEORGE

name, surname / commercial outlet name, surname / commercial outlet name, surname / commercial outlet
Acceptance and delivery of shipment Acceptance and delivery of shipment Acceptance and delivery of shipment
Accepted by: date: hour: Accepted by: date: hour: Accepted by: date: hour:
Courier’s name and signature dd, mm, yy hh:min Courier’s name and signature dd, mm, yy hh:min Courier’s name and signature dd, mm, yy hh:min
Sender: Sender: Sender:
name and surname Signature name and surname Signature name and surname Signature
Attempt for delivery: Courier: date: hour: Attempt for delivery: Courier: date: hour: Attempt for delivery: Courier: date: hour:
1. Returned after review 2. Non-existent (wrong) address 3. The person does not live on the address / There is not such a company on this 1. Returned after review 2. Non-existent (wrong) address 3. The person does not live on the address / There is not such a company on this 1. Returned after review 2. Non-existent (wrong) address 3. The person does not live on the address / There is not such a company on this
address 4. Refused 5. Absence 6. CD cannot be paid 7. Company does not work address 4. Refused 5. Absence 6. CD cannot be paid 7. Company does not work address 4. Refused 5. Absence 6. CD cannot be paid 7. Company does not work
Delivered by: date: hour: Delivered by: date: hour: Delivered by: date: hour:
Courier’s name and signature dd, mm, yy hh:min Courier’s name and signature dd, mm, yy hh:min Courier’s name and signature dd, mm, yy hh:min

Consignee: Consignee: Consignee:

name and surname Signature name and surname Signature name and surname Signature
Delivery is made according to the General Terms of Econt Express Ltd., published at Delivery is made according to the General Terms of Econt Express Ltd., published at Delivery is made according to the General Terms of Econt Express Ltd., published at
www.econt.com www.econt.com www.econt.com