The customer of transport:

The contact person. (Name,a post)

Date of loading:

The address of loading:

The address of unloading:

The contact person on a place of unloading (first name, middle initial, last name a post) :

Time of delivery:

The name of a cargo:

The basic characteristics of a cargo:

Cost of a cargo (in case of insurance):

Insurance of a cargo:

Yes, Is not present (necessary to emphasize)

Requirements to motor transport:

Volume of a body (______), a shade-shed, belts, the refrigerator, a temperature mode (___) Necessary to emphasize

Conditions of loading:

(lateral, back, top, full расчехление boards) (necessary to emphasize)

Cost of transportation:

Conditions of payment: ( non-cash, a ready cash)

Term of payment:

The executor: The name of the organization; № vehicle

The contact person: (first name, middle initial, last name a post); first name, middle initial, last name the driver

The note: