BV伊拉克申请表IQ- REQUEST FOR CERTIFICATE FORM 2.9

REPUBLIC OFIRAQREQUEST FORCERTIFICATE/82S

1.Trade PartiesPlace ofInspectionSeller Exporteras perprovided invoice:name andaddressBuyer lmporter_as perprovided invoice:name andaddressTelephone:Telephone:Fax:Fax:Email:Email:Contact name:Contact name:Intermediate Exporter,if any:name andaddress.Payment informationParty responsiblefor payingthe certificationservice appliedfor:Company nameAddress Contactdetails name/email/tel/fax VATnumberLocation wheregoods areavailable forinspection:Address:Contact name:Company nameAddressTelephone:Fax:Email:Expected date of shipment:Date ofavailability ofgoods:口Consignment:FCL:x20FCL x40TCLFCL couldbe ontruck口口口Type ofdelivery:Total PartialFinal口口口Details:LCL:Bulk GeneralCargo/Conventional□trucks size/volume:

2.Proforma Invoice/Contract PurchaseOrderNumbe匚Currency:Freight valueIf applicableDate:Total ValueInsurance valueIf applicableIncoterm:FOB ValueOther valueIf applicable

3.Information onGoodsGoods description:Please attachlist ofproducts proforma invoice…

5.Shipment Methodand Points of EntryInformation onPointsofEntry IsMandatory:口The followingpoints of entry arelocated inCentral Iraq:COC certificate□COI/COV certificate口口口J AirBagdad airport Al-Basra airportAl-Najaf airportAl-Mosul airportUmm Qasr口口口□Sea/river portKhor Al-Zubair portAl-Maaqal portAbu FloosPort BagdadTrain station口□Road AbuGhreib DryPort口口Syria-Rabeaa MosulSyria-Al-Waleed RamadiZarbatiyaJordan-Trebeel RamadiKuwait-Safwan Basra口口口口口Goods conditions:New Secondhand/Used CompleteComplete knock down Semiknockdown

4.ICIGI Program口Goods subject to ICIGI Program:Not subject**Do notfill thefollowings ifnot subjectto ICIGIprogramPlease providecopies ofconformity documentsrelated to the exportedproducts Testreports,reports ofanalysis,certificates...and anyotherdocument demonstratingconformity of the exportedgoods toIraqi requirements口口Other Certification:ISO9001Certificate:Yes No口口口口Test Reportprovided:Yes NoTesting doneby:Own labThird partylab口口BV RegistrationNo if any.:Certificates provided:Yes NoApplicablestandards ifKnown:口口Lab information:IS017025accreditation Yes□No Other:口The followingpoints ofentry arelocated inKurdistan province:COI/COV certificate口口Z]Air ErbilairportAl-Sulaymaniyah airport口□Road Turkey-Ibrahim El-Khalil□Other pointofentry-please specify:Note:Goods shall be quicklydelivered afterissuance ofthe COC,COI orCOV Certificate.Expiry datesifany,remaining shelflife andvalidity oftest reportsshallbein compliancewith applicablestandardsat thedateofarrival referto applicablestandards andNotice toExporters-1for furtherdetails

6.Affidavit ofthe Applicant________________________________________________________________________________________________I herebydeclare thatthe aboveinformation andall supportingdocuments aretrue andcomplete inevery respect.I undertaketo onlyship toIraq goodsispecifically identifiedin thecertificate issuedby Bureau Veritas description,brand/manufacturer name,quantity and,as applicable,productions-expiry dates,batch numberand iicompliant andconsistent withthe conformitydocuments Iprovided.I herebyauthorize Bureau Veritas todisclose to the authoritiesanyand allinformation regardingmy Requestfor Certificate.Applicant name:Title:Company:If differentfrom above:Signature:Email:Date:telephone:Please completethe aboveinformation andkindly returnthe formtogether withproformainvoice,copy ofLC-if applicable-and documentsproving conformitysuch asdetailed descriptionofthegoodswithtechnicalcharacteristicsandproperties,availabletestreports,qualitymanagementsystemcertificates,marksofconformity,nationalapprovals,franchiseagreementorsimilarforsupplyingbrandedgoods,as wellas health,hygienic,phytosanitary,fumigation certificatesas applicable.Remark:The Servicew川be carriedout accordingtotheBureau VeritassGeneral Conditionsof Service.The issuanceof inspectionreport doesnot releasethe Sellerand Buyerfrom theirownresponsibilities andfulfilment oftheir respectiveobligations.BureauVeritasis availableto provideadditional informationregarding theICIGIProgramfor theRepublic of Iraq.If youhave anycomments/complaints/appeals regardingour services,please notifyus at:.This Requestfor Certificateis expresslysubjecttoall applicableCOSQC-Central BankofIraq-Iraqi Ministryof Tradeas thecase maybe regulationsand requirementsandtotheBureauVeritasGeneral Conditionsof Serviceswhich areavailable uponrequest sentto:.IQ-REQUEST FORCERTIFICATE FORMEdition:

2.9。