Shipping Certificate of Origin

SHIPPING CERTIFICATE OF ORIGIN

RECITALS

WHEREAS, Exporter Name: (the "Exporter") is the party arranging for the export of the goods described herein; and

WHEREAS, Certifying Agent Name: (the "Certifier") is authorized to issue certificates attesting to country of origin for customs and contractual purposes; and

WHEREAS, the Exporter has requested and the Certifier has agreed to provide certification services for the shipment identified below on the terms set forth in this Certificate and Agreement.

SHIPMENT IDENTIFICATION

Carrier / Vessel / Flight:    Bill of Lading / AWB No.:

Port of Loading:    Port of Discharge:

Commercial Invoice No.:    Country of Export:

Date of Shipment: Month Day Year

DESCRIPTION OF GOODS

Complete description for each line item. Provide HS code and country of origin for each item.

Quantity:    Gross Weight (kg):    Net Weight (kg):

HS Code:    Country of Origin:

Quantity:    Gross Weight (kg):    Net Weight (kg):

HS Code:    Country of Origin:

CERTIFICATION AND DECLARATIONS

The Certifier hereby certifies, to the best of its knowledge and based on documentation provided by the Exporter, that the goods described above were produced in the country(ies) of origin identified for each line item and qualify as such under applicable rules of origin. The Certifier's determination is based upon examination of commercial invoices, production records, and supplier declarations submitted by the Exporter or its suppliers.

The Exporter warrants that all information supplied to the Certifier is true, accurate and complete. The Exporter shall indemnify and hold harmless the Certifier against any claims, fines, penalties or liabilities arising from false or misleading statements supplied by the Exporter or its agents.

Preferential Origin Claimed: Yes No

SCOPE OF WORK

The Certifier will review documents supplied by the Exporter, perform reasonable due diligence regarding country of origin determinations, and issue this Shipping Certificate of Origin. The Certifier does not assume responsibility for classification, customs valuation, or duties except as expressly set forth in a separate written engagement.

PAYMENT TERMS

Fee Amount:    Currency:

Late Payment Fee:

TERM AND TERMINATION

Agreement Start Date: Month Day Year

Agreement End Date: Month Day Year

Either party may terminate this engagement for material breach by the other party, subject to the notice period above, and provided the breaching party fails to cure within a commercially reasonable period after receipt of written notice.

CONFIDENTIALITY

Each party shall maintain as confidential all non-public information received from the other party in connection with this Certificate and Agreement and shall use such information solely for purposes of performing obligations under this Certificate. This obligation shall not apply to information that is or becomes publicly available through no fault of the receiving party, or is required to be disclosed by law or governmental authority.

GOVERNING LAW

This Certificate and Agreement shall be governed by and construed in accordance with the laws of: without regard to principles of conflict of laws.

ENTIRE AGREEMENT

This Certificate, together with any attachments and written engagement letters signed by the parties, constitutes the entire agreement between the parties with respect to the subject matter herein and supersedes all prior agreements, representations, and understandings, whether written or oral.

CERTIFICATION STATEMENT

I hereby certify that the information contained in this Shipping Certificate of Origin is true and correct to the best of my knowledge and that the country of origin designations are accurate for customs and trade purposes. I agree to provide supporting documentation upon request and to cooperate with any verification by competent authorities.

Month   Day   Year

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