DECLARATION VGM (VERIFIED GROSS MASS) - …

1 Website : CONTAINER TRUCK OUT DATESEAL NUMBERSIZE (20'/40')CONTAINER TARE WEIGHT IN KGSCARGO GROSS WEIGHT IN KGSVGM WEIGHT IN KGS(container tare weight + cargo GROSS weight) OF PACKAGESVGM WEIGHT IN KGS(Total cargo GROSS weight for all packages in the shipment)12345 WEIGHT METHOD OF VGM METHOD 1 (BY WEIGHING) (PLEASE PUT "X")CONTAINER SEALED HAS BEEN WEIGHED AFTER THAT ALL GOODS HAVEBEEN PACKGED, STUFFED AND FIXED IN THE CONTAINERMETHOD 2 (BY CALCULATION) ALL SINGLE PACKAGES , INCLUDE PACKING , HAVEN BEEN WEIGHED INDIVIDUALLYWe understand & confirm missing, incorrect and/or belated VGM statements may result in non-acceptance of the shipment byvessel operating carriers & a delay in the originally planned schedule. Any additional cost by delay due to non-acceptance ofthe shipment by the carrier to be covered by the undersignedadministrative) will be borne by the shipper that incorrectly declared the DECLARING AGENT UNDERSIGNED BELOWDECLARATION VGM ( verified GROSS mass ) SHIPPERS' COMPANY NAMEADDRESSAUTHORIZED CONTACT VGM TELEPHONE NUMBERFAX NOE-MAILBOOKING REFERENCENAME OF BOOKED VESSELETD/ETAVOYAGE NOPLACE OF RECEIPTMARKS & NUMBERSDESCRIPTION OF GOODSPORT OF LOADINGPORT OF DISCHARGEFINAL DESTINATIONFull Container Load (FCL)CONTAINER NUMBERLess than Container Load (LCL)"All business transacted as agents for and on behalf of PCL Co.

2 Ltd and in accordance with SLA Standard Trading Conditions (a copy available on request)." The duly authorized contact person of The shipper hereby Certify The above shipment details have been checked & according to requirement ofINT'L CONVENTION FOR SAETY OF LIFE AT SEA (SOLAS), as they have been published in Chapter VI, Part A Regulation 2 - Cargo Information In the event that container being shut out due to weight discrepancy, the relevant costs that arise (transport, weighing costs and administrative) Submission dateNAME & AUTHORISED SIGNATURE & STAMP OF SHIPPER