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 ev. UJANG JAYA
EXPORT - IMPORT
Office: TI. Tangguk Bongkar IX No.90B Medan - Indonesia
Telp I Fax: (62-61) 8453929 - 8454070
Warehouse: n. Garuda 2 No.95 KIn.l3.8 Sei Semayang - Binjai - Medan
Email: u74ng@indosat.net.id

COMMERCIAL INVOICE ORIGINAL

NO.19/UJ/CI/IV/2011

Issued By : SB&TBank
201 E. lamar Street
Americus, GA 31709
Attn: Sam Hunter
Phone: (229) 924-0305
Fax: (229) 928-3747
For account Of Messrs : Cooperative Coffees Inc.
302 W. lamar St. Suite E.
Americus, GA 31709 USA
Tel. +1-229-924-3035
Fax. +1-229-924-6250
Shipment From : Belawan -Indonesia to New York, NY
PerS.SI M.V : Sinar Biak V.239 Dated. April 10, 2010
. V esse
Connectlng Presl·dentAd ams V 0214W
Marks & Number Description Of Goods Quantity Price trons Total Value
MlTons USD USD
015/1607/19 1 X 20 ft CONTAINER
CV. UJANG JAYA FLO-ID 6117

CERTIFIED 100% ORGANIC

300 BAGS
ARABICA COFFEE APKO FLO-ID 18214 100% ORGANIC
"FLO FAIRTRADE"
SUMATRAN SEMI WASHED BEANS ARABICA COFFEE APKO 18 7,297 131,346
CONTRACT# SUG112
FlO-ID 18214
COOPERATIVE COFFEES INC FLO-ID 1341

PRODUCT OF INDONESIA FAIR TRADE PREMIUM

2009/2010 HARVEST FEE 220 3.960

US NOP AND IFOAM CERTFIED FDA Regiestration No.
"

CERTIFIED ORGANIC
11271807930

NEIT 60 KGS

1/300

FOB BELAWAN PORT 18 7,517 135,306

. .
Say Us Dollar: One Hundred Thirty FIve Thousand Three Hundred SIX Only.

B/l NO. BlWNYC041126

CONTAINER & SEAL NO :

HJCU2150189/ S / HB453134
 lJSI
SU~N/~V~E~RSAl SHIPPING, INC.
BILL OF LADING
CTPAT NO. 72545308 OTI LICENSE NO. 17577NF
SHIPPER/EXPORTER: DOCUMENT NO. I
BILL OF LADING NO
BLWNYC041126
CV.UJANGJAYA DOMESTIC ROUTING/EXPORT INSTRUCTION

JL.TANGGUK BONGKAR IX NO.90B MEDAN INDONESV

. TEL: 6261-8453929 FAX: 6261-8454070

FDA REGISTRATION No.l1271807930 SCAC CODE: UNSL

EXPORT REFERENCES:
cONSIe:'C50PERATIVE COFFEES, INC MBL NO : HJSCBLW100651500
302 W.LAMAR STREET SUITE E. FOR CARGO DEUVERY PlEASE CONTACT:

AMERICUS, GA 31709. USA

PHONE: +1-229-924-3035 FAX: +1-229-924-6250 UNIVERSAL SHIPPING, INC.

A TIN : BILL HARRIS 2855 SOUTH RESERVOIR STREET,

POMONA, CA 91766

"I0TIFY PARTY:

EXCELCO 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:

A TIN : GOERGE TSIASTSIOS

·PRECARRIAGE BY: ·PLACE OF RECEIPT:

SINAR BIAK V.239 BELAWAN, INDONESIA CY
EXPORTING CARRIER: PORT OF LOADING: ON - CARRIAGE BY: NO. OF BILLS OF LADING:
PRESIDENT ADAMS V.0214W BELAWAN, INDONESIA CY

PORT OF DISCHARGE' PLACE OF DELIVERY' FINAL DESTINATION:

NEW YORK NEW YORK

PARTICULARS FURNISHED BY SHIPPER

MARKS AND NUMBERS NO. OF PKGS. DESCRIPTION OF PACKAGES AND GOODS GROSS WEIGHT MEASUREMENT
CONTAINER I SEAL SHIPPER'S LOAD, STOW WEIGHT AND COUNT

HJCU2150189 I HB4f 3134 1 X 20'STD CONTAINER: GW: 18,300.00 KC S

MARKING: 300 BAGS NW: 18,000.00 KC S

015/1607/19 100% ORGANIC ARABICA COFFEE APKO

CV UJANG JAVA FLO·ID 6 17 FLO-ID 18214

CERTIFIED 100% ORGANI

ARABICA COFFEE APKO I LO-ID 18214

.. FLO-FAIRTRADE ..

SUMATRAN SEMI WASHE BEANS

CONTRACT # SUG112 "FREIGHT COLLECT"

COOPERATIVE COFFEES NC FLO·ID 1341

PRODUCT OF INDONESIA .. CY/CY"

2010 1 2011 1 HARVEST

US NOP AND IFOAM CER IFIED

CERTIFIED ORGANIC

NETT 60 KG
FIF:81 OR~( UNAL
~~.,,--_,~~
1/300
TOTAL NUMBER OF CONTAINERS OR ONE UNIT TWENTY CONTAINER ONLY
PACKAGED (IN WORLD)
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 cond~ions 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
notwithstanding.

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

In WITNESS whereof one (1) original Bill of Lading has been signed if 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.

011
Place and date of issue --r==.,.."¢f)=~;111!!:::;;;===,-­
signed on behaif of the Carrier:

EXCESS VALUE CHARGE

TOTAL CHARGES
 CERTIFICATE FOR IMPORT INTO NON EUROPEAN COMMUNITY COUNTRIES OF
PRODUCTS OBTAINED ACCORDING TO ORGANIC PRODUCTION METHODS
1. Body Issuing the CertIficate (Certifying Body) 2. Reference Number

(Name & Address) Article Reference Number of the Certificate

NASM CERTIFIED ORGANIC PlY LTO

UNIT 7, 3 MT BARKER RD

NCO 320
STIRLING SOUTH AUSTRALIA 5152

3. Exporter of the product (Name & Address) 4. Control Body (Name & Address)"

CV. UJANG JAYA NASAA CERTIFIED ORGANIC PlY LTD

JL. TANGGUK BONGKAR IX 90B MEDAN 20226 UNIT 7, 3 MT BARKER RD
INDONESIA STIRLING SA 5152
AUSTRALIA
(IFOAM accredtted)
5. Producer or Processor of the product (Name & Address) 6. Country of Despatch

INDONESIA

CV. UJANG JAYA

,IL. GARUDA 2 NO. 95 KM. 13,8 SEI SEMAYANG 6a. Port of discharge

BINJAI MEDAN 20351 INDONESIA BELAWAN, INDONESIA

7. First consignee of the product (Name & Address) 8. Country of Destination

USA

Cooperative Coffees Inc. 9. Address of the place of

302 W. Lamar SI. Suite E. Destination

Americus, GA 31709 USA NEWYORK,NY

Tel. +1-229-924-3035 Cooperative Coffees Inc.

Fax. +1-229-924-6250 302W. LamarSI. Suite E.

Americus, GA 31709 USA

Tel. +1-229-924-3035
Fax. +1-229-924-e250

10. Marks & Numbers, Container No(s),Number & Kind Trade Name of the Product 11. Gross Weight (kg)

015/1607/19 CV. UJANG JAVA FLo-lD 6117 CERTIFIED 100"10 ORGANIC 18,300

ARABICA COFFEE APKO FLO-ID 18214 "FLo-FAIRTRADE" SUMATRAN SEMI

~ASHED BEANS CONTRACT#SUG112 COOPERATIVE COFFEES INC FLO-ID 1341

PRODUCT OF INDONESIA 201012011 HARVEST US NOP AND IFOAM CERTFIED
CERTIFIED ORGANIC NETT 60 KGS 1/300 12. Nett Weight (k9)
18,000

HJCU2150189/ S / HB453134

100"loOrganic Arabica Coffee APKO FlO-1D 18214 13. Alternative Units

300 BAGS

14. Declaration of the organisation Issuing the certificate.

This is to certify that the products designated above have been obtained In accordance with the rules of production and
on i/l$peclion of the organic production method, as set out and monitored by the control organisation mentioned in Box "4

15. Additional declaration (if appropriate)

15a. Include products from growers
(Registration numbers) 8133PSL1
15b. Date of Departure April 10.2011
15c. Vessel/Flight Details Sinar Blak V. 239

16. Place of Issue of the certificate Stamp of the issuing organisation

Date: Ii Apr;) ;:J..O /I

ORGJI NIe
~
NASAA CERTifiED
0o..d e lee PO BOX 768
STIRLING SA 5152
Name and signature of NASAA Executive OffIcer

PH: {De) 8370 8455

FAX: .08\ 8~70 8381

• Explanatory Notes: NOP ACCREDITED

Box 4: Control body for monitoring compliance with the rules on oriPllic production methods

Box 5: The ftrm which carried out the last operation (processing, packaging, labelling) on the batch

Box 9: The address of the firm where the batch wll be delivered. if different from the address in box 7

Box 13: e.g. volume in lilres in case ofliquids. to be given, where appropriate, in supplement to the declarations in boxes I I and 12