COMMERCIAL INVOICE
Export Reference:
Date of Export:
Country of Export:
Country of Ultimate Destination:
CANADA
Shipper/Exporter:
Consignee:
Population Health Research Institute
237 Barton Street East
CRCTL Research Lab, Access from Copeland St.
Hamilton, Ontario Canada L8L 2X2
Tel: 1-905-527-4322 ext. 44408
COURIER AND AWB#:
Full Description of Goods:
Human Specimens for Analysis Only
Not Infectious, Not Restricted
EXEMPT HUMAN SPECIMEN
HS TARIFF CODE 3002.10.00.10
# vials ______
human blood; in 2 mL plastic storage vials
# vials ______
human urine, in 2 mL plastic storage vials
# blood spot cards _______
human blood; 2 dried blood spots on cotton absorbent
Packaging:
COMPLIANT WITH IATA PI650
Insulated Box; 35 x 35 x 25 cm
Contains Dry Ice as Refrigerant
Total weight of each box with refrigerant: 9 kg
Total # Boxes Shipped:______________
Total Value: $20 CDN
I declare all the information contained in this invoice to be true and correct.
Name – Printed, Signature, Date
Dry Ice , UN 1845, 9 Kg
Total Weight Shipped: ________Kg