INTERNATIONAL SHIPPING SERVICES - BOOKING FORM
[Link] / Tel: +1-702-979-1823 Fax: 702-472-8658
Party in US / Seller / Origin: (fill out all fields)
Do you need Marine Insurance? YES ____ NO ____
Name:
DECLARED VALUE: ____________ ALL RISK OR TOTAL LOSS
Address (SELECT ONE)
City/State/Zip: View insurance conditions here: [Link]
Tel:
ID NO or EIN: METHOD OF PAYMENT:
Party Overseas / Receiver / Buyer's address: Mail Check or Money Order to our Office ___
Walk-in Deposit in USA (at Bank of America branch) ___
(can be different from port/country of arrival)
Zelle or Direct Transfer (ACH) ___
Bank Wire Transfer (+$25 fee) ___
Name: RETURN TITLE & DOCUMENT TO: ( TYPE THE EXACT MAILING ADDRESS HERE)
Address: Address in USA ______ OR Address Overseas _______
City/Zip/Country:
Tel / Fax: US POSTAL SERVICE (+$45 fee for int'l) ___
Passport#: DHL / FedEx (+ extra fee applies ) ___
Special Instructions (if any) i.e. pick up dates, deadline for arrival to destination, vehicle handling requirements, mailings, etc.
Shipment Information
GAS IN THE TANK MUST BE AT THE MINIMUM Vehicle / Boat / Cargo information ( Year/ Make/ Model )
REMOVE LICENSE PLATES FROM THE VEHICLE ►
► is this a hybrid or electric vehicle? YES or NO
VIN (Vehicle Identification Number) or HULL for Boats ► VIN#
►Ebay motors listing # (if applicable)
CONDITION of the Vehicle / Cargo: __ Good running condition, no visible damages
__ Vehicle doesn't start, but rolls and breaks
__ Vehicle is salvaged, damages all over
Personal or Unrelated Items, Parts, Accessories (if any) ►
NOT ALLOWED WITH RO/RO
Terms and Conditions of Service
Company As Agent / Freight Broker. The Company works solely as the “agent” on behalf of the Customer for the purpose of performing duties
in connection with the ocean transportation of Customer’s cargo and as the one who negotiates between Customer, carrier, and third parties for
the purchase, sale, conditions, and terms of transportation. Sailing and arrival dates are estimated only and are subject to change without notice.
No Liability For The Selection or Services of Third Parties and/or Routes. Unless services are performed by persons or firms engaged
pursuant to express written instructions from the Customer, the Company shall use reasonable care in its selection of third parties, or in selecting
the means, route, and procedure to be followed in the handling, loading, transportation, clearance and delivery of the shipment; advice by the
Company that a particular person or firm has been selected to render services with respect to the goods, shall not be construed to mean that the
Company warrants or represents that such person or firm will render such services nor does Company assume responsibility or liability for any
action(s) and/or inaction(s) of such third parties and/or its agents, and shall not be liable for any delay or loss of any kind, which occurs while a
shipment is in the custody or control of a third party or the agent of a third party; all claims in connection with the Act of a third party shall be
brought solely against such party and/or its agents.
Reliance On Information Furnished. In preparing and submitting shipping quotes, Customs entries, export declarations, applications,
documentation, and/or export data to the United States and/or a third party, the Company relies on the correctness of all information furnished by
Customer; Customer shall use reasonable care to ensure the correctness of all such information and shall indemnify and hold the Company
harmless from any and all claims asserted and/or liability or losses suffered by reason of the Customer’s failure to disclose information or any
incorrect or false statement by the Customer upon which the Company reasonably relied. The customer is solely responsible for verifying and
complying with all Customs / Government laws, rules, regulations, and restrictions in force at the country of destination / importation.
I hereby acknowledge that I read and understood the above Terms and Conditions of Company governing this transaction.
Customer Acknowledgment - Your Name here ► _____________________ Date ________
