Transport order NL - Biologistic

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- Transport order NL
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Transport order NL

Shipper:

Name Institution sender(Required)

E-mailaddress(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

Number

Dimensions

L x W x H mm

Quantity per vial / jar (gram/ml)

Package

Number

Dimensions

L x W x H mm

Quantity per vial / jar (gram/ml)

Package

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.

BIOLOGISTIC SERVICES
DOUGLASSINGEL 25
1119 MC SCHIPHOL - RIJK
EMERGENCY TELEPHONE: +31 (0) 6 514 96 992

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Transport order NL
Transport order BE

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