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J.S. Hickey Co., Inc.
                         Donmar Brokerage Corp.
                                  71 S. Central Avenue
                               Valley Stream, NY 11580
                             (516)872-6112 / (718)917-6211
                            Email: info@jshickeydonmar.com


           Application to Insure Ocean Marine Shipment

Request From: Alejeandro Amezquita Marin
Name of insured party: Alejead Pc SAS

Invoice Value: USD$ 129.200,00

Freight charges: USD$ 145.750,00
(*Insurance calculation: Invoice Value + Freight x 110% = Full Insured Value)

Description of Merchandise: 15.6 inch laptop with core i7 8GB
RAM, pc laptop notebook, 500 units.

Containerized: __X__ yes _____ no

Packing: RFC GHE092502HK5

Vessel or Airline: Maersk Line CSCL LE HAVRE / 0029W

B/L or AWB #: SSOF090406718

B/L or AWB Date: 15th August 2010

From (place of origin): Shenzhen - China

Port of Loading: Shangai - China

Port of Arrival: Buenaventura - Colombia

To (final destination): Cali - Colombia
Attach the following:
     Commercial Invoice for Entire Shipment
     Bill of Lading or Airwaybill

                      ** Please FAX to: (516)568-1420 **

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solicitud de serguro internacional

  • 1. J.S. Hickey Co., Inc. Donmar Brokerage Corp. 71 S. Central Avenue Valley Stream, NY 11580 (516)872-6112 / (718)917-6211 Email: info@jshickeydonmar.com Application to Insure Ocean Marine Shipment Request From: Alejeandro Amezquita Marin Name of insured party: Alejead Pc SAS Invoice Value: USD$ 129.200,00 Freight charges: USD$ 145.750,00 (*Insurance calculation: Invoice Value + Freight x 110% = Full Insured Value) Description of Merchandise: 15.6 inch laptop with core i7 8GB RAM, pc laptop notebook, 500 units. Containerized: __X__ yes _____ no Packing: RFC GHE092502HK5 Vessel or Airline: Maersk Line CSCL LE HAVRE / 0029W B/L or AWB #: SSOF090406718 B/L or AWB Date: 15th August 2010 From (place of origin): Shenzhen - China Port of Loading: Shangai - China Port of Arrival: Buenaventura - Colombia To (final destination): Cali - Colombia Attach the following: Commercial Invoice for Entire Shipment Bill of Lading or Airwaybill ** Please FAX to: (516)568-1420 **