Professional Documents
Culture Documents
COMMERCIAL INVOICE
dd.10/02/2017
Messrs. Invoice No.
COOPERATIVE COFFEES , INC
302 W, Lamar St Suite E. Americus, GA 31709 USA
032/INV/PGC/2016/2017
I
Tel. +1-229-924-3035, Fax. +1-229-924-6250 FLO ID 6589 Contract No.
Attn: Becky Johnston FLO ID buyer: 1341 SUT171
FDA REG N0.13096723740
Shipped by: B/L Number:
MERATUS MEDAN 5 V.1714 959450011 DD.14/02/2017
From: To:
BELAWAN, INDONESIA NEWARK, NJ - USA
Consignee: Container/Seal No:
TO THE ORDER OF COOPERATIVE COFFEES INC MSKU7289992 / ML-ID222448
302 W, Lamar St. Suite E. Americus, GA31709 USA Connecting Vessel:
Tel.+ 1-229-924-3035, Fax.+ 1-229-924-6250
ANNA MAERSK V.706W
Attn Beck Johnston
Description of Goods
300 (THREE HUNDRED) BAGS+ GRAINPRO BAG
OF 60 KGS NET EACH BAG
SUMATRA PERMATA GAYO HIGHLAND
ARABICA DP GRADE 1 SPECIALTY GREEN COFFEE
FLO FAIRTRADE & ORGANIC CERTIFIED
I. Body issuing the certificate (name and address) 2 a) The National Organic Program standards of the United States Department of
Control Union Certifications B.V. Agriculture/Control Union Certifications standards
Meeuwenlaan 4-6 2 b) Reference number of the ce rt ificate: PRJ 812234/73 1245
8011 BZ ZWOLLE
NETHERLANDS
3. Selle r of the product (name and address) 4. In spection body* (name and address)
Koperasi Pennata Gayo Control Union Ce rtifications B.V.
JI. Syiah Utama. No. 66 Kampung Simpang Utama. Pondok Baru Meeuwenlaan 4-6
24582 Bener Meriah 8011 BZ ZWOLLE
Aceh NETHERLANDS
INDONES IA
5. Producer o r processor of the p roduct* (name and address) 6. Country of dispatch
Certified in compliance with the tenns of the US-Canada Organic Equivalency Arrangement.
~
16. Place and date of issue Jakarta. 20 February 2017 Stamp of the issuing body
~~\~\
Name and signature of authorised person
&,
anagmg Director
- '
~ no Mr. (Winaryo)
Co,,trdllruon~III
~aoalldldD1 hUrwt.d
,~~r.Tlf Sf M N ~ f l f ~
*Explanatory notes
Box 4: The inspection and cen ificati on body for compliance with th e rules on from organic production methods ..
Box 5: The !inn wh ich carri ed o ut the las t operation (processing, packaging, labelling) on the batch.
Box 9: The address of the firm 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 appropri ate, in supplement to the declarations in boxes 11 and 12.