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‘ “Delivery note and statement
we osittre012 ena
. 80525654
conte SAINT-MARC Ourraterence 90282499
™ 02 32 23 58 59
Sold pay 300466 Shinto pany 401730
‘AVIO DIEPEN BV
eden BOERHAAVEWEG 5-7
ed 2408 AD ALPHEN A/D RIJN
401
0120522 eta
Shipment vie ross weight 62506
UPS FRANCE “STANDARD || wumoer of packages
: 3 weight 50006
Part number
hem 7 |Already shipped| Shipped aly
I (Balance) | vom
90 NSAGS7910EA2000 ° 25 000
020-0008:20 o Pc
: - = CONTR.
code cova Custom code 85960088 |
. Ongine /Ongn: FR
N* dappel 40120522
Commentary: PLEASE CAN YOU SEND US AN AMENDMENT FOR THE
PRICE
(Customs code’: 85369085
[Code date : 12-23 |
DECLARATION DE CONFORMITE AUX STIPULATIONS DUNE COMMANDE ETABLIE PAR LINDUSTRIEL FOURN|SSEUR CONFORMEMENT AUX:
NORIES NF EN4SOT4/NF L_00.015C / Statament of conformity wth the stipulations of an order established byt
standaré NF ENSSOT4INF L.00-015C
Nous we
species,
We nereay,
industial supplier conforming to
Doint aux exgences
de conforms
‘SUPPLIER'S INSPECTION
Name and function: DESNOYERS CORINNE.
| AGENT EXPEDITION
Date oar012
‘Sgnsture
Eventuellement, visa et date du Service de Surveitance ou de
TORGANISME DE SURVEILLANCE; du cient ou organisme mandatt
‘require, signature and date by the Government Inspection or by the
INSPECTION BODY, customer. or appointed body,
THIS IS A
TRUE COPY
Pating date = 06/11/2012
F 72 008
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