Rep CSMI ATS
Rep CSMI ATS
Rep CSMI ATS
&(57,),&$'2'(029,/,=$&,Ï1
1
I. AUTORIZADO PARA MOVILIZAR
7LSRGHHPLVLyQ AUTOSERVICIO GANADEROS )HFKD(PLVLyQ 27/05/2021 14:20 Horas
Autorizado: LEMA CAIZA RICARDO CC/CI/RUC: 0501918916 Tipo: PROPIETARIO
,9'$726'(029,/,=$&,Ï1
DATOS DEL CONDUCTOR '$726'(/9(+Ë&8/2
RUTA A SEGUIR
SALCEDO - LATACUNGA
V. VALIDEZ DEL CERTIFICADO (CSMI)
,QLFLDViEDGRGHPD\RGH+RUDV
)LQDOL]DViEDGRGHPD\RGH+RUDV
VI. TIPO DE PRODUCTO A MOVILIZAR
9,,,1)250$&,Ï1'(/&(57,),&$'2Ò1,&2'(9$&81$&,Ï1(,'(17,),&$&,Ï1'(/26$1,0$/(6
,1)250$&,Ï1'(/&(57,),&$'2Ò1,&2'(9$&81$&,Ï1 ,'(17,),&$&,Ï1'(/26$1,0$/(6
9,,,&Ï',*2'(9(5,),&$&,Ï1),50$6<6(//2'(5(63216$%,/,'$'
&Ï',*245 FIRMA O SELLO DEL SOLICITANTE FIRMA DEL CONDUCTOR SELLO AUT. AGROCALIDAD
F: F:
LEMA CAIZA RICARDO S/N
CC/CI/RUC: 0501918916 0000000000 78605055024988719
'2&80(1726,1&2672$&8(5'20,1,67(5,$/1
(VWHHVXQ'RFXPHQWR2ILFLDO3HUVRQDOH,QWUDQVIHULEOH(OPDOXVRGHOPLVPRVHUiSHQDOL]DGRGHDFXHUGRDOD/H\
0RYLOL]DFLyQGH$0D30$FXHUGR,QWHUPLQLVWHULDO1