{% load static %} {% load settings %}
Shipper's Name: | DATE | {% now "F d, Y" %} | ||||||
CLSI Department: | {{admin_project.department|cut:"None"|default:""}} | |||||||
Phone: | (If this is a project GL Account complete Code Code, WP, & Job ID information) | |||||||
GL Account #: | Cost Code: | WP: | Job ID: |
Shipping Information: (Consignee) | |||
Company Name: | {{ project.department|cut:"None"|default:"" }}, {{ project.organisation|cut:"None"|default:"" }} | ||
Street Address: | {{ project.address|cut:"None"|default:"" }} | ||
City: | {{ project.city|cut:"None"|default:"" }} | Province / State: | {{ project.province|cut:"None"|default:"" }} |
Country: | {{ project.country|cut:"None"|default:"" }} | Postal Code: | {{ project.postal_code|cut:"None"|default:"" }} |
Att: (Contact Person): | {{ project.contact_person|cut:"None"|default:"" }} | Phone Number | {{ project.contact_phone|cut:"None"|default:"" }} |
Contact Person Email: | {{ project.contact_email|cut:"None"|default:"" }} | ||
CLSI Proposal Number: | Federal Tax # (USA): | ||
Consignee's Courier: | {{ project.carrier.name|cut:"None"|default:"" }} | Courier Account #: | {{ project.account_number|cut:"None"|default:"" }} |
On Loan □ | Chargeable Repair □ | Return to Owner ■ | Other: |
Return of Loan □ | Warranty Repair □ | US Goods Returned □ | |
Return to Vendor □ | RMA# | Other (explain) □ |
Qty (Grams or Litres if Chemical) |
Model # / Serial # / Description | Country of Manufacture | Value | |
{{ num_packages|default:"1" }} | Non-Hazardous Frozen Protein Samples in Dry Shipping Dewar | {{ project.country|cut:"None"|default:"" }} | $200 | |
1 | {{ component.kind }} | {{ project.country|cut:"None"|default:"" }} | $100 | |
Qty Total | H.S. Code |
Any Hazards? | Yes | No | Yes | No | Yes | No | Total | $ | |||
Explosives | □ | ■ | Flammable Liquid | □ | ■ | Poisonous Material | □ | ■ | CAD$ ■ | Euro$ □ | |
Dangerous-When-Wet | □ | ■ | Flammable Solids | □ | ■ | Poisonous Gas | □ | ■ | USA$ □ | GBP$ □ | |
Corrosive Material | □ | ■ | Combustible Liquid | □ | ■ | Radioactive Material | □ | ■ | Yen$ □ | ||
Organic Peroxides | □ | ■ | Infectious Substance | □ | ■ | Oxidizer | □ | ■ | |||
Lead Acid Battery | □ | ■ | Spontaneously Combustible Liquid | □ | ■ | Other Currency | |||||
Lithium Metal Battery | □ | ■ | Nonflammable Compressed Gas | □ | ■ | ||||||
Lithium Ion Battery | □ | ■ | Flammable Compressed Gas | □ | ■ | ||||||
Please Supply Two Copies Of Safety Data Sheet For Each Element Shipped |
Package size L x W x H | Weight | ||||
Package 1 | Measurement Inch □ | Cm □ | |||
Package 2 | Total Shipment Weight | ||||
Package 3 | KGS □ | ||||
Package 4 | LBS □ |