❖ 7751 W.

88th Street, Bridgeview, IL 60455

❖ Tel 708-599-9680, 888-615-2148, Fax 708-599-9682
❖ E-mail: INFO@atlanticexpresscorp.com

________________________________________________________________________________________________
SHIPPING INSTRUCTIONS
(To be completed by a shipper. PLEASE PRINT.)
DATE: ______________

1. SHIPPER – Billing Party (Self)

Company name
Contact name *
Street, City, *
Country, Zip Code
Phone *
Email *
SHIPPER EIN or TAX ID or FOREIGN PASSPORT NUMBER# (required)

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*
Please provide the copy of your foreign passport or driver’s licence

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2. Exporter (Third Party) if not the same as #1
Company name

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Contact name *
Street, City, *

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Country, Zip Code
Phone *
Email
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EXPORTER EIN or TAX ID or FOREIGN PASSPORT NUMBER# (required)
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Please provide the copy of your foreign passport or driver’s licence

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3. CONSIGNEE (RECEIVER):
Company name
Contact name
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Street, City, *
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Country, Zip Code

Phone
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Email
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AGENT AT THE DESTINATION

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4. INFORMATION ABOUT VEHICLES:

Year Make/Model Vin# (last 6 digits) Car value
Vehicle (1)
Vehicle (2)
Vehicle (3)
Vehicle (4)
Vehicle (5)
Fuel must be drained from the car, to contain less than ¼ of the tank 5 litres (1.320 gallons)

5. FINAL DESTINATION:
Must be entered, or your vehicles will not be loaded even if branches receive vehicles with full documentation ready.

6. END USE:
o Personal use
o Resale/Wholesale for Business related use

1|P age
 ❖ 7751 W. 88th Street, Bridgeview, IL 60455
❖ Tel 708-599-9680, 888-615-2148, Fax 708-599-9682
❖ E-mail: INFO@atlanticexpresscorp.com

________________________________________________________________________________________________

FOREIGN END-USER:
The non U.S. entity that receives and ultimately uses the exported or re-exported item, even after being incorporated into a
higher level assembly. The end-user is not a forwarding agent or intermediary, but may be the purchaser or the ultimate
consignee.

END USER DETAILS

Name:
Address:
City:
Country:

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I, the undersigned, hereby certify that all of the representations made herein are true and

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correct, and that the above-mentioned commodity(s) are for the stated end-use and end-user, to

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the best of my knowledge and belief.

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Date:___________________________________ Signature:_______________________________________
7. CONSOLIDATION: YES NO

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8. IS THERE ANY ADDITIONAL ITEMS (auto parts, personal/household items):
o NO
o Yes. Please fill out ITEMS LIST FORM.
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9. CONTAINER RELEASING: ○ Original Bill of Lading; ○ Telex Release

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10. TITLE HANDLING:

(Does not include Destination: Lithuania):
o Pick up by yourself
o Get it via mail for additional surcharge to the Shipper-Self
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o Get it via mail for additional surcharge to the Shipper-Exporter

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o List Contact Name and full detail address: _______________________________________________

___________________________________________________(Must be within 50 US States)
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o Get it sent overseas (for additional charge)

o To our Agent
o To Consignee – Receiver address
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o Any other address – International (per special request must contact before handling it, for proper rates
and availability)

IMPORTANT!
For every change requested by a shipper after a Bill of Lading is submitted to the Ocean Carrier, there will be a
documentation revision charge between $150.00 to $300.00, depending which Ocean Carrier is used.

Thank you for shipping with Atlantic Express Corp. We appreciate your business and want to provide the highest quality
service at all times. Please be assured that while every effort is made to ensure safe delivery of your goods, sometimes loss and/or
damage does occur.

2|P age
 ❖ 7751 W. 88th Street, Bridgeview, IL 60455
❖ Tel 708-599-9680, 888-615-2148, Fax 708-599-9682
❖ E-mail: INFO@atlanticexpresscorp.com

________________________________________________________________________________________________
ATLANTIC EXPRESS CORP. ROLE AND THE CARRIER'S LIABILITY

While Atlantic Express Corp. arranges for the transportation of your goods, by law, it is the carrier who bears
responsibility for loss of and/or damage to your freight. The carrier’s liability for freight moving over the ocean is governed
by the Carriage of Goods by Sea Act (COGSA). Under the terms of COGSA, the most you could recover from shipping
lines in the event they are proven negligent is $500.00 for each customary freight unit (CPU). Measurement of the CFU is
widely defined, and it can vary from one container to on pallet.
COGSA is centred on the liability of the carrier. At the heart of the concept of carrier liability is the idea that
the carrier is not responsible for paying claims if they did not cause or contribute to the loss. In the event that Atlantic
Express Corp. acts as an NVOCC and assumes carrier liability, recovery in the event of a claim is still limited by COGSA
in the bill of lading terms and conditions.
In an effort to better define carrier liability, Hague-Visby rules were created to define 17 circumstances under which
the carrier cannot be held liable. I a loss is caused by any one of the following defences, the ocean carrier will not pay any part

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of the loss.

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• Acts of god • Water Damage • Hijacking

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• Act of war • Fire Lightning • Earthquake, Hail
• Act of public enemies • Explosion • General average

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• Arrest, restraint or • Derailment • Vandalism
seizure

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This summary provided for informational purposes. It does not grant or extend coverage. All coverage is governed by
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the terms and conditions set forth in the policy (available upon request). Atlantic Express Corp is not the insurance company.
Atlantic Express Corp purchases insurance for its clients from Navigators
Insurance Conditions are specified as follows:
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Warrant professionally packed and containerized. If any of these warranties are breached, coverage is reverted to
F.P.A. only. Warrant pre-condition survey with pictures taken of all four sides of vehicle. If warranty is breached, coverage
excludes marring, denting, chipping, scratching, electrical and or mechanical derangement, rust, oxidation, discoloration and
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corrosion. No coverage while under own power. Coverage for manufacturer permanently installed items only. Each loss or
occurrence subject to a deductible of 3% of insured value, minimum $250.00 each loss.
Please tell us how you would like to proceed:
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o I wish to insure this shipment. Please contact me to discuss my options.

o I do not wish to insure his shipment and I understand that my recovery will be limited in the event of loss
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___________________________________ _________________________________
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_
Signature, Date Printed Name
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By submitting this form I affirm that I am the owner of the cargo being shipped or I have been granted a power of
attorney to act on the owners behalf.
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I understand and agree that it is mine, as shippers, responsibility to know the import laws and regulations of the
country of final destination. I confirm that the container will be picked up by the receiver within 30 calendar days of
the arrival. In case the cargo is not picked up on time, I waive all rights to the cargo and agree for it to be auctioned
out in order to cover demurrage charges and custom fines.

___________________________________ __________________________________
Signature, Date Printed Name

3|P age
 ❖ 7751 W. 88th Street, Bridgeview, IL 60455
❖ Tel 708-599-9680, 888-615-2148, Fax 708-599-9682
❖ E-mail: INFO@atlanticexpresscorp.com

________________________________________________________________________________________________

Note regarding the U.S. Customs examinations

If an import or export shipment is selected by the U.S. Customs for examination, a shipper of the goods
is responsible for all the fees associated with it.
Atlantic Express Corp. is not responsible for any charges or complications that might arise while
dealing with the U.S. Customs.

Note regarding the charges at the port of destination

Please be informed that the ocean freight charge that you pay in the United States for shipping your
cargo doesn’t cover your destination port charges. Destination port charges such as destination

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handling charge, import customs clearing charge, agency fees have to be paid to an agency at the
port of destination. Please consult agencies in your country of destination about these charges before

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you ship your cargo.

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I declare that my shipment does not contain any of the products below:

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•

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Human corpses, human organs or body parts, human and animal embryos, or cremated or
disinterred human remains.
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Explosives and incendiary devices, pressurized cans, flammable and hazardous materials
• Firearms, weaponry, and their parts or ammunition
•
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Perishable foodstuffs and foods/beverages requiring refrigeration or other environmental control.
• Live animals, eggs, larva, live insects, live spiders.
• Ivory and endangered animals.
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• Plants and plant material, including cut flowers.

• Cigarettes and smokeless tobacco products, alcohol and drug products.
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CUSTOMER NAME: _____________________________________________

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LA

I read and agreed with the notes above: ________________________________

(signature)
Date: ____________________________
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4|P age
 ❖ 7751 W. 88th Street, Bridgeview, IL 60455
❖ Tel 708-599-9680, 888-615-2148, Fax 708-599-9682
❖ E-mail: INFO@atlanticexpresscorp.com

________________________________________________________________________________________________

POWER OF ATTORNEY
U.S. PRINCIPAL PARTY IN INTEREST/AUTHORIZEDAGENT

Know all men by these presents, that __________________________________, the USPPI organized
(Name of U.S. Principal Party in Interest(USPPI))
And doing business under the laws of the State or Country of ____________________________ and

having an office and place of business at __________________________________ hereby authorizes

(Address of USPPI)
ATLANTIC EXPRESS CORP., (Authorized Agent) of 7751 W 88th St, Bridgeview, IL 60455

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(Name of Authorized Agent) (Address of Authorized Agent)
to act for and on its behalf as a true and lawful agent and attorney of the U.S Principal Party in

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Interest(USPPI) for, and in the name, place, and stead of the USPPI, from this date, in the United States

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either in writing, or electronically, or by other authorized means to: act as authorized agent for export
control, U.S Census Bureau (Census Bureau) reporting, and U.S. Customs and Border Protection (CBP)

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purposes. Also, to prepare and transmit any Electronic Export Information(EEI) or other documents or

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records required to be filed by the Census Bureau, CBP, The Bureau of Industry and Security, or any
other U.S. Government agency, and perform any other act that may be required by law or regulation in
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connection with the exportation or transportation of any goods shipped or consigned by or to the USPPI,
and to receive or sip any gods on behalf of the USPPI.
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The USPPI hereby certifies that all statements and information contained in the documentation provided
to the authorized agent and relating to exportation will be true and correct. Furthermore, the USPPI
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understands that civil and criminal penalties may be imposed for making false or fraudulent statements
or for the violation of any United States laws or regulations on exportation.
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This power of attorney is to remain in full force and effect until revocation in writing is duly given by
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the U.S. Principal Party of Interest and received by the Authorized Agent.
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IN WITNESS WHEREOF, _______________________________________ caused these

LA

(Full Name of USPPI.USPPI Company)

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presents to be sealed and signed:

Witness:__________________________ Signature:__________________
Capacity:__________________

Date:_________________________

5|P age
 ❖ 7751 W. 88th Street, Bridgeview, IL 60455
❖ Tel 708-599-9680, 888-615-2148, Fax 708-599-9682
❖ E-mail: INFO@atlanticexpresscorp.com

________________________________________________________________________________________________

THE LIST OF COMMODITIES

# DESCRIPTION QUANTITY PRICE $ WEIGHT
PCS TOTAL TOTAL

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C
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ES
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C
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N
LA
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NAME: _______________________________________________________________________________

SIGNATURE: __________________________________________________________________________

DATE: ________________________________________________________________________________

DESTINATION: ________________________________________________________________________

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