SHIPPER'S DECLARATION FOR DANGEROUS GOODS

Shipper Air Waybill No. 343-700000

Quimicos Alfa
Cll 10 # 20 - 30 Cali - Colombia Page 1 of 1 Pages

Shipper's Reference Number

(optional)

Consignee
Productos Pic
180 paim street, 33153, Miami - USA
AVIANCA

Two completed and signed copies of this Declaration must be handed to the operator. Dos ejemplares WARNING
cumplimentados y firmados de esta Declaracion han de entregarse al exportador.

TRANSPORT DETAILS
Failure to comply in all respects with the applicable Dangerous Goods
Airport of Departure Regulations may be in breach of the applicable law, subject to legal penalties.
This shipment within the limitations
prescribed for: (delte non-applicable) Aeropuerto internacional
Este embarque esta dentro de las
limitacuones prescritas para (tachese
Alfonso Bonilla Aragon AVISO
lo que no procede)
PASSENGER CARGO La falta de cump;imeiento de cualquiera de las normas contenidas en la
reglamentacion sobre Mercacias Peligrosas Aplicables puede constituir una
AND CARGO AIRCRAFT infraccion de la ley correspondiente, sujeta a la responsabilidad legal.
AIRCRAFT ONLY
Shipment Type: (delete non-applicable)
Airport of Destination:
NON-RADIOACTIVE RADIOACTIVE

NATURE AND QUANTITY OF DANGEROUS GOODS

Dangerous Goods Identification

Class Or Packing
Pack- Quantity and Type of packing Authorization
Division Inst.
UN or ID No. PROPER SHIPPING NAME (Subsi- diary
ing
Risk) Group
UN 3071 Mezcla de mercaptanis liquidos toxicos inflamables 6.1(3) ll bilon de acero 5L 661 n/a
mercaptan mixture, liquid, toxic, flammable
Additional Handling Information

cre 6f
24 hr. Emergency Contact Tel. No.

Name/Title of Signatury
I hereby declare that the contents of this consignment are fully and accurately described above by the proper Sofia Numpaque
shipping name and are classified, packaged, marked and labelled/placared, and are in all respects in proper
consition for transport according to applicable inernational and national governmental regulations. I declare that Place and Date
all of the applicable air transport requirements have been met.
Cali- Col November 17, 2021
Por la presente declaro que el (los) contenido(s) de este embarque esta(n) total y acuciosamente descritos(s) mas
arriba por su(s) nombre(s) apropiado(s) de expedicion, y esta(n) clasificado(s), embalado(s) marcado(s) y
Signature
etiquetado(s)/rotulado(s) y que, entodos los aspectos esta(n) en condiciones apropiadas para el transporte de (see warning above)
acuerdo a las regulaciones gubernamentales nacionales e internacionales aplicables. Yo declaro que todos los
requisitos aplicables al transporte aéreo han sido cumplidos. Sofia Numpaque