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rtca
Grs€nCoftueFOB,C & F, CIFContract
P.rrpadiesEpr6enl thattheyaE familiarwiththe Drovisions,
t€ms .nd @ndiuoisol
lhe @nlr.cls ot lne scAA aneffeclat lhe dar€h€6t

Simp.ngUiamaMraqe No 61

Eens Meiah District,A@h,Indonesia

1. Ou.nrity Thce Hunded (320)Bagsof60 Kitog6hs Nel Each.

Approxim.lely19,200Kitog€msor 42324 |b3NetWeight.
. 2. Ouallt sumlra GayoMouitainPemato G.yo c@p cer ied Fan
T6de Ooanic GEde 1 semi-washedc@n AEbi€
Cotre.
3- P,lce Toboixedbystteds@ttb€tbefEt opening dayotJan
2011.NY'C'Contraci Mar2011+ 0.10FanT6de premiun
+ 0.20Organicpremium+ 0.25Ouatity= ttY"C', M.r 2Otr +
0.55IUS per tb or [inimum guadntoed t.?0 SUSper !h.
4, welg aGis: shipp€dweiohtsI % weighifranchis€
5. Payno.t Nerc$h .oains! ddddts
To ship,€reed by Seler Flffi Shipto Newyoft amun!
ot buyer.
7. shlpment JanuEry2o1l, Fom seaponofB€tawan,Indon6ia
a, De.rin.dof N*Yo*, NY
L Rem.rk: 1. Thie@fee Ms t€ded a@ding io intemationatFan
rEde cdens .s dtabti.hed by FLOandGnifed try
T€nsFan
2. ArbilElion-F endty,Catiiohia if any
3. An oEanictEneclion enii€le wil be issued.
4. Pr*hiprent s6mpleapp@d requircd.
5. sals Ma*ed: FairTEde Cotfee/ Organic/ psnrEi.
GayoC@p/ C@per.tiE Cofie€
6. A dGumentsh@ing% of FoB pri@paidb the @p and
% of FoB pice paidto the fame6 i6 equied.
7. Evoq Ysr CooperalNeCofie€ewrttvtsl lhe coopr\,
cht ({!,at is lhe % or prir* pad lo lhe r6rre

sen#;G.44+44t V/ba
L;,;--II,';'"
 KOPERASI

PERMATA GAYO

Nomor BH : 518/039/BHN/2006
.lIn. Syiah {'tama '\0. (,(, hanqllill~ "'i!llpall~ l tama. h:l'clllIatan Balld;n

h:ahlipatl'lI Bl'lll'r \llTi;~h. ';an~:~ro(' An'll Darussalam - 2~5S2

E-lJlaii : p!·r;II;l!a~a\" _('oop a, :thoo.co.iil

COMMERCIAL INVOICE
No: 009/1nvl PGC/2010/2011
Date. 16.11.2010
Messrs. Cooperative Coffees INC
302 Lamar Street Suite E
Americus, GA 31709, USA
Commodity : Sumatra Pennata Gayo Highland Arabica Coffee
Shipped by : PAC Antlia V.1049
From : Belawan, Indonesia to New York
Date of Shipment : 23rd November 2010
BL Number : BLWNYCl10171
DESCRIPTION OF GOODS AMOUNT
320 (Three Hundred Twenty) Bags of 60 kgs nett each
Gross Weight : 19.520 Kgs
Tare 320 Kgs
Nett Weight : 19.200 Kgs

At USD 2.751 Lbs FOB Belawan

As per contract SUG 111 USD 116.402,88
(Contrac price is Incl. usd.10,-/I00Lbs Fairtrade premium)

Say: One Hundred Sixteen Thousand Four Hundred and Two point Eighty
Eight US Dollars Only
- Insurance to be covered by buyer - Producer & Exporter FLO ID:
- Freight Collect 6589
- Payment C.A.D - Buyer FLO ID : 1341

Consignee: Cooperative Coffees Inc

302 Lamar Street Suite E
Americus GA 31709, USA
Tel: +1 229 924 3035 Fax: +1 229 924 6250
Connecting Vessel: APL Turquoise V.OO97W
n .1 Seal: HTc.T T"O~"QI01 HA925137

Marks & No:

POC Koperasi Pennata Gayo
015/1730/09
SUGlll
SUMATRA PERMA T A GAYO HIGHLAND ARABICA COFFEE
SEMI-WASHED SUMATRA
GA YO MOUNTAIN GREEN ARABICA
COFFEE DP GRADE 1
FLO FAIRTRADE AND ORGANIC CERTIFIED
COOPERATIVE COFFEES FLO ID: 1341
PGC FLO ID: 6589
PGC CU ID: 812234
NETT:60KGS
PROD. OF INDONESIA (Annia)
NEW YORK, NY
1-320
~USI
UNIVERSAL SHIPPING. INC.
BILL OF LADING
CTPAT NO. 72545308 OTI LICENSE NO. 17577NF
SHIPPER/EXPORTER DOCUMENT NO IBILL OF LADING NO
BLWNYC110171
KOPERASI PERMAT A GAYO DOMESTIC ROUTING/EXPORT INSTRUCTION

JLN.5YIAH UTAMA NO.66 KAMPUNG SIMPANG UTAM~,

KECAMATAN BANDAR KABUPATEN BENER

MERIAH, NANGGROE ACEH DARUSSALAM - 24582

EXPORT REFERENCES
CONsffibpERATIVE COFFEES INC
302 W.LAMAR ST. SUITE E. FOR CARGO DELIVERY PLEASE CONTACT
AMERICUS, GA 31709. USA
PHONE: +1-229-924-3035 FAX: +1-229-924-6250 UNIVERSAL SHIPPING, INC.
ATTN: BILL HARRIS 2855 SOUTH RESERVOIR STREET,
POMONA, CA 91766
NOTI'EX"C:~LCO TRADING L.P. TEL: (909) 628-2226 FAX: (909) 628-2221
17 BATTERY PLACE, SUITE 1010

NEW YORK, NY 10004

PHONE: +1-212-344-6771 FAX :+1-212-344-8723 FORWARDING AGENT - REFERENCES

ATTN: GEORGE TSIASTSIOS (gtsiatsios@exceltrade.com)

'PLACE OF RECEIPT:
'PRE~?f~~~rLlA V.1 049 BELAWAN, INDONESIA CY

EXPORTING CARRIER PORT OF LOADING: ON - CARRIAGE BY: NO OF BILLS OF LADING

APL TURQUOISE V.0097W BELAWAN, INDONESIA CY

PLACE OF DELIVERY FINAL DESTINATION 3(THREE)

PORT ~'EWC\lC5~k NY NEW YORK, NY

PARTICULARS FURNISHED BY SHIPPER

MARKS AND NUMBERS NO. OF PKGS. DESCRIPTION OF PACKAGES AND GOODS GROSS WEIGHT MEASUREMENT
CONTAINER / SEAL SHIPPER'S LOAD, STOW WEIGHT AND COUNT
HJCU2082910 I HA921)137 1 X 20'STD CONTAINER: pw: 19,520.00 KG Is 25.000 M3
320 BAGS OF 60 KGS NETT EACH t'Jw: 19,200.00 KG~
SUMATRA PERMATA GAYO HIGHLAND
ARABICA COFFEE SEMI-WASHED SUMATRA GAYO
MOUNTAIN GREEN ARABICA COFFEE DP GRADE 1
FLO FAIRTRADE AND ORGANIC CERTIFIED

CY/CY FDA NO: 13096723740

~.: .. ,,--~­
.;~_\."'.r<,

~'o~UJr~ ~~~·H.b\i
~'J ft. ~ l
FIR S1
o.
\j'te'
•.....
..,.~o ,~~ '---~~
TOTAL NUMBER OF CONTAINERS OR
PACKAGED (IN WORLD) ONE UNIT TWENTY CONTAINER ONLY
RECEIVED by the Carrier the Goods as specified above In apparent good order and condition FREIGHT CHARGES PREPAID COLLECT
unless otherwise stated, to be transported to such place as agreed, authorized or permitted hereon
and subject to all the terms and conditions appearing on the front and reverse of this Bill of Lading
to which the merchant agrees by accepting this Bill of lading, any local privileges and customs
notwrthstanding.

The particulars, given above as stated by the shipper and the weight, measure, quantity condition, FR EIGHT COLLECT
contents and value of the Goods are unknown to the Carrier.

In WITNESS whereof one (1) original Bill of lading has been signed ~ not otherwise stated above
the same being accomplished the other if any to be void if required by the Carrier one (1) Original
Bill of lading must be surrendered duly endorsed In exchange for the goods of delivery order.

Place and date of issue ----r-=~.:..i...:.;.;;;~;;;.;,;.;;,;~~~~(T-­

Signed on behalf of the Carrier'
EXCESS VALUE CHARGE

TOTA L CHARGES

ATTACHMENT FOR B/L NO.BLWNYC110171

MARKS & NUMBER: PGC

015/1730/09
SUG111
SUMATRA PERMATA GAYO HIGHLAND ARABICA COFFEE
SEMI-WASHED SUMATRA GAYO MOUNTAIN GREEN
ARABICA COFFEE DP GRADE 1
FLO FAIRTRADE AND ORGANIC CERTIFIED
COOPERATIVE COFFEES FLO 10:1341
PGC FLO 10:6589
PGC CU 10:812234
NETT: 60 KGS
PROD. OF INDONESIA
NEW YORK, NY
1 - 320

***************************************** END OF BILL OF LADI NG *******************************************

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 TRANSACTION CERTIFICATE

USA FOR PRODUCTS FROM NOP ORGANIC PRODUCTION

I. Body issuing !be certificate (name aod address) 2.The Nariooal Organic Program standards of!be United Slates DepaI1mCllI of
Control Union certifications B.V Agricullure/ConIrOI Union Certi fications slandards
Meeuwenlaan 4-6 Reference number of !he certi ficate: PRJ 812234/ 153446
SOIIBZ ZWOLLE
NETHERLANDS
3. Seller of !be product (name and address) 4. IlIJ!'C'Clion body" (name and ad<k-ess)
Kopernsi PermaIll Gayo ConIrOI Union certifications B.V.
11. Syiab Utama, No. 66 Kampung Simpang Utuna. Poodok Barn. Kab. Bener MeeuweoIaan 4-6
MeriahAceh Teogab SOil BZ ZWOLLE
Naoggroe Aceb Darussalam NETHERLANDS
INDONESIA
5. Producer or processor of the prodllC~ (O8ll1ll and addrcss) 6. Country of dispatch
Kopcrasi Permata Gayo (Export) INDONESIA
11. Kongsi No. 278 Maricodal,Medan
Sumaters Utara
INDONESIA
7. Consignee (name and address) 8. Country of destination
UNITED STATES
Cooperative Coffees Inc.
302 W.L.amarSt. Suite E.
GA 31709 Americus
9. Address and place of destination"
UNITE!> STATES
10. Mades and number.<, contaiDeroo(s); number and kind. Tnde name oftbe product.
Prodw:tion Loctbald> Gross J1I8SS Net mass
III. Gross mass
NO!' certified{1 00% organic 1 organic)
Year DJlIIlben (kgs) (kgs) 19520.00 kgs

190"1. OI'pnic Soma"" Pennata Gayo ·Higbland Arabica Coffee (SEMI-WASHED

SUMATRA OAYO MOUNTAIN GREEN ARABICA COFFEE DP GRADE I) 20 10 19520.00 19200.00 12. Net mass
porclced in units of 60 kgs in 320 bags 19200.00 kgs
fiom organi!: ~iOll meIbods.
'I"voice DO. : 009llDv1PGCl2010l2011 d.d. 16-11-10 13. AIlernarive units •
T"'"sportdocument no.: BLWNYCIIOl71 cLd. 23-1 1-10
ConiBiner 00.: HJCU20829I~
fdentificarion cOOes: 015/ 1730109 C.SUGIII, TrnnsportCompany : Univ<nal Sbipping loc., Seal No : HA925137

1<4. Deelaratioo of!he body i..... iog!be certificale

15. Addiriooal doclaration (ifappropriale)

Notify Porty : Excclco Trading L.P.

16. Place and dale of issue Jakarta. 26 November 20I 0 Stamp of1be issuing body
Name and signature of authorised
00 behalf of Managing

rJ..

'Explanalorynotes

Box 4: The iospeetion and certiflCali.on body for compliance widt the ruks 011 from organic production methods..

Box S: The finn which carried out the last operatioll (processing, packaging, llIbelling) on the balch.

Box 9: The addresB of !be ftrm where the batcb will be delivered, if different fiom !be address in box 7.

Box 13-: .e.l_ volume io meiers, k> be given, where appropriate, in supplemenl In !he decl....tions in boxes II and 12.

1 of 1

CONTROL UNION CERTIFICATIONS