700026945

Not Negotiable House Air Bill (Air Consignment note) Issued By

Shipper'sName and Address A/C No

PT. CHANG SHIN INDONESIA,

JL DUSUN GINTUNG KOLOT RT16 RW04 PT. EXPO FREIGHT INDONESIA
GINTUNG KERTA KLARI ID-41371 Wisma Udaya, 3rd Floor, JL. Danau Sunter Selatan, Block O-IV, No. 35
KARAWANG,INDONESIA. Jakarta Utara 14350, Indonesia
Tel +62 21 6531 3976 Fax +62 21 6530 7279
Website : www.expolankafreight.com

Consignee's Name and Address A/C No

COPIES MARKED ORIGINAL ARE ORIGINALS AND HAVE SAME VALIDITY

NIKE EUROPEAN OPERATIONS
NETHERLANDS BV THE SHIPPER (" THE CUSTOMER ") CERTIFIES THAT THE PARTICUlARS ON THE
FACE HERE OF ARE CORECT AND AGREES TO THE CONDITIONS SET OUT ON THE
COLOSSEUM 1 REVERSE SlDE HEREOF WHICH SHALL BE DEEMED TO BE INCORPORATED HEREIN
HILVERSUM, 1213 NL
PT. CHANG SHIN INDONESIA,
................................................................................................................
Signature of Shipper
Notify Party
Special Instructions:
NIKE EUROPEAN OPERATIONS
NETHERLANDS B.V.
on behalf of NIKE EUROPE HOLDING B.V.
NIKELAAN 1
CHGS WT/VAL Other
Laakdal, B-2430 Currency
Code
Declared Value for Carriage Declared Value for Customs

Belgium PP CC PP N.V.D. NCV

USD CC CC X X
Airport of Departure and Requested Routing INSURANCE. If shipper request insurance in accordance with
Amount of Insurance conditions on reverse hereof. inlicate amount to be insured in figures
JAKARTA, INDONESIA in box marked "Amount of Insurance"

Destination MASTER AIRWAYBILL NO. FREIGHT CARRIER AND FLIGHT NO JKT-DOH QR957/03
BRUSSELS 157-0699 6076 COLLECT DOH-BRU QR195/06
No of Packages & Actual Gross Chargeable
Kg/ Rate/Charge Description and Marks
Method of Packing Weight lb.
Weight

24 199.00 K 412.50 $1.01 Invoice No.: JJI17040342

24 Ctns =288 Pairs of Footwear Division Good
Invoice Date: 2-JUN-2017
PO. No.: 4504583691
Material Code: 847569-002
Item: 00010
Ship to/ Plant Code: 1065
Buy/ Purchase Group: First Quality
Retailers PO# (if available): 5801654349

OR DATE: 02 JUN 2017

32X59X43 cm 4 DESTINATION CHARGES

416.63 35X64X48 cm 20
Freight

FSC 181.50 FSC : 0.44/KG Entry

ISS : 0.10/KG
+ VAT 1% Extra Lines

DOC to Accompany Airbill Duty

ISS 41.25
Delivery

H/C

Total

This Computer Generated Document requires No Signatures.

VAT 1% 6.39
03-06-2017 JAKARTA PT. EXPO FREIGHT INDONESIA
............................................................................................................................
645.77 Executed on (Date) at (Place) Signature of Issuing Agent

700026945