Certificate of Condition for Transport of
Vehicles, Machines or Equipment
Shipper
Company:
Address:
City & Province:
Country:
Postal Code:
Contact name:
Email:
Consignee
Company:
Address:
City & Province:
Country:
Postal Code:
Attention:
Tel:
Tel:
Please fill in details and check appropriate boxes on BOTH pages and email to: info@upwardpackaging.com
☐ Air
☐ Marine
1.
Mode of Transport -
2.
The Consignment - I certify that this consignment consists of (please indicate number of items):
Vehicle(s) :
Machine(s)/Equipment(s) specify) :
☐ (_____) Automobile(s)
☐ (_____) Powerboat(s)
☐ (_____) Motorcycle(s)
☐ (_____) Powerboat(s)
☐ (_____) Other(s) (specify)
☐ (_____) Generator(s)
☐ (_____) Chainsaw(s)
☐ (_____) Lawnmower(s)
☐ (_____) Outboard Motor(s)
☐ (_____) Other(s) (specify)
Engine(s) Only : ( ______) (specify)
3.
Flammability - I certify that the above consignment is (are):
☐ Flammable LIQUID Powered
☐ Flammable PROPANE Powered
4.
Battery - I certify that the above consignment either
☐ Has NO battery
or
☐ Has a battery and the battery terminals have been disconnected and the terminals taped to prevent short
circuits during transport
5.
Alarm - I certify that theft-protection devices, installed radio communications equipment and/or navigational systems
have/has been disabled.
6.
Fuel - I certify that the gas tank(s)
☐ Is (are) drained of fuel as far as practicable and if any fuel remains it does NOT exceed ¼ of the tank capacity;
any disconnected fluid lines have been sealed with leak-proof caps.
7.
Packaging and NET Weight - The consignment is being offered for transport in the following packaging:
Please indicate number of each packaging and NET Weight of engine(s)/vehicle(s) etc. in each.
☐ (_____) As is, fully visible
KG;
KG;
KG
☐ (_____) In a cardboard box(es)
KG;
KG;
KG
☐ (_____) On a pallet(s) with cardboard covering
KG;
KG;
KG
☐ (_____) In a wooden box(es)
KG;
KG;
KG
☐ (_____) In a slatted wooden crate(s)
KG;
KG;
KG
☐ (_____) Strapped down on pallet(s)
KG;
KG;
KG
☐ (_____) Shrink-Wrapped on a pallet (s)
KG;
KG;
KG
☐ (_____) Other(s)
KG;
KG;
KG
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Certificate of Condition for Transport of
Vehicles, Machines or Equipment
8.
If a Freight Forwarder is being used,
Contact Name:
9.
Telephone #:
I,
certify that the above information is correct.
(Print name)
(Signature)
(Date)
Billing Information:
☐ I have an account with Upward Packaging, P.O. #:
or
☐ I would like to pay with Credit Card:
☐ Visa #:
Expiry:
MM/YY
☐ Mastercard #:
Expiry:
MM/YY
2