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36 on 9 June 2013

KOPERASI
PERMATA GAYO
Nomor BH : 518 I 039 I BH I V /2006
Jln. Syiab Utama No.66 Kampung Simpang Utama, Kecamatan Bandar
Kabupaten Bener Menah, Aeeh - 24582 - Indonesia
INC
302 W, Lamar S1. Suite E. Americus, GA 31709 USA
Tel. +1-229-924-3035, Fax. +1-229-924-6250
Attn: Chelsea Carter
Shippedby:
ARISARA V.1349
Email:
FLO 10 6589
FLO 10 buyer: 1341
FDA
B/LNumber:
602724026 DO.
I FrDm: TD:
, BELAWAN, INDONESIA. NEWARK, NJ
Consignee: Container/Seal No:
CDntract ND.
SUG137
TO THE ORDER OF COOPERATIVE COFFEES INC MRKU6985438/ ML-ID421527
302 W, Lamar S1. Suite E. Americus, GA 31709 USA -----------------1
Tel.+ 1-229-924-3035, Fax. +1-229-924-6250
Attn: Chelsea Carter
300 (three hundred) Bags of 60 Kgs Net Each Bag
SUMATRA PERMATA GAYO HIGHLAND
ARABICA DP GRADE 1 GREEN COFFEE
FLO F AIRTRADE & ORGANIC CERTIFIED
Gross Weight
Tare
Nett Weight
: 18,300 Kgs
300 Kgs
: 18,000 Kgs
Price
Organic Premium
fairtrade Premtun
: US$.
: US$.
: US$.
4,097.70/Mtons
661.38/Mtons
44O.921Mtons
Price total : US$. 5,200.00/Mtons
FOB Belawan NSW as per contract no.SUG137
say: Ninety Three Thousand and Six Hundred US Dollars Only.
- Insurance to be covered by buyer
- Freight Collect
- Payment C.A.D
"This ca o/coffee has not been refused entry by any count ..
US$. 73,758.60
US$. 11,904.84
US$. 7,936.56
US$. 93,600.00
Narks & Nos. Notify Party:
PGC EXCELCO TRADING L.P.
015/1730/80 17 BATTERY PLACE, SUITE 1010
SUG 137 NEW YORK,NY 10004
FLO ID; 1341 TEL. + 1-212-344-6771.FAX. + 1-212-344-8723
SUMATRA GAYO MOUNTAIN ATTN: GEORGE TSIASTSIOS
GREEN ARABICA COFFEE DP GRADE 1 ( GTSIATSIOS@EXCELTRADE.COM)
FAIRTRADE FW + ORGANIC CERTIFIED .... .. PE 'ATA GAYO ;#0
ID CU : 812234 . . ~ ~ r : : .
FLO ID : 6589 7 : ;f
PROD OF INDONESIA I I /( ,,// /'J
NETI 60 KGS / ; ! - I t f /.>1'
NEWARK,NJ / /11 :V )
1-300 I r . ~ {b
BILL OF LADING FOR OCEAN TRANSPORT
MAEU
1=
OR MULTlMODAL TRANSPORT
MAERSK LINE ,
ISll No,
602724026
i
Shipp'"
IBooIQ"" No,
KOPERASI PERMATA GAYO
;602724026
.
JL.SYIAH UTAMA NO.66 KAMPUNG
IExport references Svc Contracl
SIMPANG
532992
UTAMA KEC.BANDAR,KAB.BENER MERIAH
'o';;;;.rdi0ii1l<l roUting (Not partofCafrlageasdeiined In dau>;! 1. for a=unt 811<1 risk Of
ACEH-24582 INDONESIA

Notify Party (see clause (2) (noegotiable only if COIlSrgned "to order", "to Older of' nanied P.M" or >to order 01 bearer")
EXCELCO TRADING L.P.
INC 302 W.LAMAR ST. SUITE E
TO THE ORDER OF COOPERATIVE COFFEES
17 BAHERY PLACE, SUITE 1010,
AMERICUS, GA 31709 USA. INEW YORK.NY 10004
TEL.+ 1-229-924-3035 .TEL+1-212-344-6771
FAX. + 1-229-924-6250 IFAX+1-212-344-S723
ATTN :CHELSEA CARTER. FLO ID: 1341 IATTN :GEORGEA TSIASTSIOS (GTSIATSIOS@EXCELTRADE.COM)
. . --
Vessel (s.eciaU,el'l9)'
1Voyage No. IPlace 01 Rec.'pt, Appf",.t>Ie only when used OS Muillmodal Transport aiL (see clause 11
ARISARA 1349
,
C----'
Place of Deli""'Y, Applic>ble only when dcKument used as Multimodal T,ansport ell. (see clauS<! 1)

BELAWAN,INDONESIA I Newark, NJ, USA
Port of Loading IPort of Discharge
PARTICULARS FURNISHED BY SHIPPER
easur-ernem:
18300 KGS
Welg t
25 CBM
Unit Prepdid Currency Collect
(see 1 ana 14), of issl)e of Bll
of containers or patk9ges received by Carrier, Meda n
1 container
NumbefB..sequenceof
2013-06-19
l/THREE
IloardoatifCOi.'a! Time ) DecklredVilue(See clause 7.3)
2013-06-18
ThiS transport document has one or more numbered pages
Ki1l<l of Packages; DestriptJon of goods; Mari<s and N"mbers; Container No./Sea! No,
1 Container Said to Contain 300 Bag
0901110000 (HS)
300 BAGS OF 60 KGS NET EACH BAG
SUMATRA PERMATA GAYO HIGHLAND ARABICA DP GRADE 1
GREEN COFFEE FLO FAIRTRADE & ORGANIC CERTIFIED
WEIGHT NET = 1
PGC
015/1730/S0
SUG137
FLO ID:1341
SUMATRA GAYO MOUNTAIN
GREEN ARABICA COFFEE
DP GRADE 1
FAIR TRADE FLO + ORGANIC CERTIFIED
ID CU:812234
FLO ID:6589
PROD OF INDONESIA
NETT 60 KGS
NEWARK,NJ
e partlclliars as declared by Ship""" but without responSibility or or representatJon by Carrie< see clau.. 14
Freight 8& Charges
as Maersk Line
As A\lent(s) tor the Carrier
i
1-300
B/l: 602724026 Page: 2
/'
MAERSK LINE
MRKU6985438 ML-ID1421527 20 DRY 8'6 300 Bag 18300 KGS 25 C6M
SHIPPER'S LOAD, STOW, WEIGHT AND COUNT
fREIGHT COLLECT
CY/CY
Prepaid ' Currency / Freight &. Ch.,9"$ Collect
I R.1e
I uon
!
! I I I
TRANSACTION CERTIFICATE
USA FOR PRODUCTS FROM NOP ORGANIC PRODUCTION
L Body issuing the certificate (name and address) 2. The National Organic Program standards of the United States Department of
Comrol Union certifications B.V.
Agriculture/Comrol Union Certifications standards
Meeuwenlaan 4-6
Reference number of the certificate: PRJ 8122341306817
8011 BZ ZWOLLE
NETHERLANDS
3. Seller of the product (name and address)
Koperasi Permata Gayo
11. Syiah Utarna, No. 66 Kampung Simpang VI.rna. Pondok Baru. Kab. Bener
MeriahAteh Tengah
Nanggroe Acen Darussalam
INDO'JESIA
5. Producer or processor of the product* (name. and address)
Koperasi Permala Gayo (Bromo Ujung)
]1. Bromo Ujung, Gang Ikhlas No, 2, Medan,
Sumatera Utara
INDONESIA
7. Consignee (name and address)
Cooperative Coffees Inc.
302 Lamar Street Suite E
GA 31709 Americus
UNITED STATES
10. Marks an<! numbers, container no(s) , number and kind. Trade name of the product.
NOP certified
100";6 ofll"nic Sumatra Permata Gay{) Highland Arabic. Coffee (SUMATRA
PiiRMATA GAYQ.HIGHLA,'JD ARABICA DP GRADE 1 GREEN COFFEE FLO.
fAHtI'RADE & ORGANIC CERTIFIED) packed in units of 60 Kgs in 300 Bags
fTOm organic production methods
lnvojceoo.; OSO!lNVIPGCI2012IZ()13 d,d. 14-06-13
602724026 d.d,1806-13
(:'.ootainer 00:; MRKU598543-8
4, body' (name and address)
Cm;trol Union certifications B.V,
Mccuwenlaan 4-6
8011 BZ ZWOLLE
l'ETHERLANDS
6_ Country of dispatch
INDONESIA
8. Country of destination
UNITED STATES
9. Address and place of destination'
Production
Year
Lot/batch
numbers
Gross Net mass
(kgs) (kgs)
11. Gross mass
18300.00 kg'
2013 18300.00 18000.00 12. Net mass
18000.00 kgs
13. Alternative units'
"fde'nt!ffi;atinrl Codes ;CQOPERATIVE I'ERMll.TA GAYO 015/1730180 SUG137 SEAL NO.ML-1D421527
.RANSRORT COMPANY: MAERSK LINE
. 14: Ikclaration afthe. body issuing the certificate
Jakarta Selatan, 21 June 2013
.,

nt?tC!l
B(lX. kTlIe inSpection and' certlflcation body for compllimce with the rules on from organiC production methods ..
BoX 5: Th<,!fum.whlchcarricd out the last operation (processing, packaging, labelling) on the batch.
address of tll!: firm where the batch will be delivered. if diffcrent from the address in box 1,
e.g.: in 'meterS; to be given, where appropriate, in supplement to the declarations in boxes Ii and 12.
CONTROL UNION CE R T I Fie ATI 0 N S

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