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273 | BPN | 0031-4773 273-0031-4773

Shipper's Name and Address Shipper's Account Number Not negotiable

YUDHI - BALIKPAPAN Air Waybill


(Air Consignment Note)

Issued By Rimbun Air

Copies 1,2, and 3 of this Air Waybill are original and the same validity

Consignee's Name and Address Consignee's Account Number

It is agreed that goods described herein are accepted in apparent good order and condition (exept as nodted) for
Suparno, juliyanto, Ali, Pajar, Iis, Agi, Agus carriage SUBJECT TO THE CONDITIONS OF CONTRACT ON THE REVERSE HERE OF ALL GOODS
Subandi, Hadi Pratama - JAKARTA MAY BE CARRIED BY ANY OTHER MEANS INCLUDING ROAD OR ANY OTHER CARRIER UNLESS
SPECIFIC CONTRARY INSTRUCTIONS ARE GIVEN HEREON BY THE SHIPPER, AND SHIPPER
AGREES THAT THE SHIPMENT MAY BE CARRIED VIA INTERMEDIATE STOPPING PLACES WHICH
THE CARRIER DEEMS APPROPRIATE THE SHIPPER'S ATTENTION IS DRAWN TO THE NOTICE
CONCERNING CARRIER'S THE SHIPPER'S ATTENTION IS DRAWN TO THE NOTICE CONCERNING
CARRIER'S LIMITATION OF LIABILITY, Shipper may increase such limitation of liability by declaring a
higher value for carriage and playing a supplement charge if required.

Issuing Carrier's Agent Name and City Accounting Information

PT ARYA MANDIRI TRANS LOGISTIK - DKI Jakarta

Agent's IATA Code Account No.

Airport of Departure (Addr. of First Carrier) and Requested Routing Reference Number Optional Shipping Information

BPN / Sultan Aji Muhammad Sulaiman Sepinggan International Airport

To By First Routing and To By To By Currency CHGS WT/VAL Other Deciared Value Deciared Value
CGK Carrier Destination Code for Carriage for Customs
RA
PPD COLL PPD COLL

Airport of Destination For Carrier Use Only Amount of Insurance INSURANCE - If Carrier offers insurance, and such insurance is
requested in accordance with the conditions thereof, indicate amount to be

CGK / Soekarno-Hatta International insured in figures in box marked *Amount of insicure*

Airport Flight No Flight Date


201 2024-06-23

Handling Information

SCI

No of Gross Weight kb Rate Class Chargeable Weight Rate Charge Total Nature and Quality of
Pieces lb Goods
RCP (incl. Dimensions or
Commodity Item No Volume)

1 130 130 As Agreed As Agreed


370x20x20
1 pcs
SPART

Prepaid Weight Charge Collect Other Charges


As Agreed
Valuation Charge
As Agreed
As Agreed
Tax
As Agreed
Total Other Charges Due Agent Shipper certifies that the particulars on the face here are correct and that insofar as any part of the
consignment contains dangerous goods, such part is property described by name and is in proper
condition for carriage by according to the applicable Dangerous Goods Regulations
Total Other Charges Due Carrier
As Agreed PT ARYA MANDIRI TRANS LOGISTIK BPN - CGK
Signature of Shipper or his Agent
Total Prepaid Total Collect
As Agreed
Currency Convertion Rates CC Charge in Dest. Currency 2024-06-23 DKI Jakarta PT ARYA MANDIRI TRANS LOGISTIK
Executed on (date) at (place) Signature of issuing Carier of its Agent
For Carrier's Use Only at Destination Charge at Destination Total Collect Charges 273-0031-4773

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