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Transport order NL
Transport order BE
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Transport order NL
Shipper:
Name Institution sender
(Required)
Email address
(Required)
Contactperson
(Required)
Title
(Required)
Mr.
Mrs.
Department
Room / Location
Address
(Required)
Zip Code
(Required)
City
Country
(Required)
Telephone number
(Required)
Account or order reference
(Required)
Consignee
Name institution receiver
(Required)
Contactperson
(Required)
Title
(Required)
Mr.
Mrs.
Department
Address
(Required)
Zip Code
(Required)
City
(Required)
Country
(Required)
Telephone number
(Required)
Email address
(Required)
Pick-up date
(Required)
DD slash MM slash YYYY
Pick-up time from
Hours
:
Minutes
Express shipment (same day shipment at extra costs)?
Yes
No
Is it known or reasonably expected that the goods are infectious?
(Required)
Yes
No
If yes, what is the risk group (WHO) of the material?
2
3
4
Are the goods genetically modified?
(Required)
Yes
No
If yes, what is the licence level or group of the material?
ML I / II
ML III / IV
Description of goods (in case of infectious, description of the virus and if possible carrier)
(Required)
Are the goods subject to export authorisations (EU 428/2009)?
(Required)
Yes
No
If yes, what is the authorization number?
Package
Vials
Jars
Swabs
Boxes
Number
Dimensions
L x W x H mm
Quantity per vial / jar (gram/ml)
Package
Vials
Jars
Swabs
Boxes
Number
Dimensions
L x W x H mm
Quantity per vial / jar (gram/ml)
Package
Vials
Jars
Swabs
Boxes
Number
Dimensions
L x W x H mm
Quantity per vial / jar (gram/ml)
Is the reason of sending for diagnostic purposes?
Yes
No
Do you want to have an additional transport insurance (value > € 87 per kg.)?
Yes
No
If yes, what is the value of the shipment?
Are cooling packs to be used for this shipment?
Yes
No
Are cooling packs to be provided by B.L.S.?
Yes
No
Is Dry Ice to be used for this shipment?
Yes
No
Is Dry Ice to be provided by B.L.S.?
Yes
No
If not, package contains (kg)
Do you have packages which are in accordance with ADR/IATA?
Yes
No
Are packages to be provided by B.L.S.?
(Required)
Yes
No
Is a datalogger to be provided by B.L.S. (at extra costs)?
Yes
No
Extra comments
Privacybeleid
(Required)
I agree with the General conditions
For this order
the General conditions of SGS Nederland B.V.
are applicable, unless otherwise agreed upon, and additionally for transport the following conditions shall apply: for national transport the AVC conditions, for international road transport the CMR conditions and for air transport the Montreal convention.
