PERFORMA INVOICE

Date of Exportation : 12/01/06

SHIPPER
ADDRESS : GS VISION SDN BHD
UNIT 2F, BLOCK D,

E
PHILEO DAMANSARA, 46100, PETALING JAYA,
SELANGOR, MALAYSIA

PL
TEL : 006 03- 5631 6685

CONSIGNEE
ADDRESS : BIOLIFE INTERNATIONAL
124 MG ROAD, NELSON BUILDING,
3RD FLOOR, UNIT 3,
THANE 401301
MUMBAI, INDIA

TEL :
M0091 22 264 0970
MARKS UNIT TOTAL
QTY FULL DESCRIPTION OF GOODS
/NOS VALUE VALUE
1 2 MEDICAL GLOVES USD 10 USD 20
2 5 THERMOMETER USD 8 USD 40
SA

USD 60

PURPOSE OF SENDING : FOR TEST, NOT FOR RE-SALE

VALUE DECLARED :
(FOR CUSTOM PURPOSES ONLY)

I/We declare that the above item(s),its value and quantity are true and correct.

SIGNATURE DATE

Please Note: Page 1 is a Sample PI. Please print Page 2 of this Document for use.
 PERFORMA INVOICE
Date of Exportation :

SHIPPER
ADDRESS :

TEL :
CONSIGNEE
ADDRESS :

TEL :
MARKS UNIT TOTAL
QTY FULL DESCRIPTION OF GOODS
/NOS VALUE VALUE

PURPOSE OF SENDING :

VALUE DECLARED :
(FOR CUSTOM PURPOSES ONLY)

I/We declare that the above item(s),its value and quantity are true and correct.

SIGNATURE DATE