0904 - 普惠制产地证

ORIGINAL 1. Goods consigned from (Exporter's business name, address, country) CHUAWEI (JIANGSU) GLOVES CO., LTD. 2810,Shanghai International Trade Center 2201 Yan An Road(W),SHANGHAI 200336 TEL:+86 21 6278 9099 FAX:+86 21 6278 9569 Reference No. GENERALIZED SYSTEM OF PREFERENCES CERTIFICATE OF ORIGIN (Combined declaration and certificate) 2. Goods consigned to (Consignee's name, address, country) FORM A Issued in J AMES BROWN&SONS #304-310 JaJa Street, Toronto, Canada TEL:(1)7709910,FAX:(1)7701100 3 Means of transport and route (as far as known) THE PEOPLE'S REPUBLIC OF CHINA (country) See Notes overleaf 4. For official use SHIPMENT PROM SHANGHAI TO MONTERAL BY VESSEL 5. Item num- ber 6. Marks and numbers of packages 7. Number and kind of packages; description of goods 1 N/M SALES CONDITIONS: FOB SHANGHAO/CHINA “P” 4095KGS JS03225 SALES CONTRACT NO.F01LCB05127 NOV.25，2003

Latex Full Coated Cotton Woven, Knit Wrist Liner STYLE QTU/DOZW USD/DOZ 1521A 1000 4.47 PVC Dipped Gloves, Interlock Liner, Rough Chip Finish, Gauntlet STYLE QTU/DOZW USD/DOZ 2954C 1200 6.70 8. Origin criterion (see Notes overleaf) 9. Gross weight or other quantity 10. Number and date of invoices 11. Certification 12. Declaration by the exporter It is hereby certified, on the basis of control carried out, that the The undersigned hereby declares that the above details and statements declaration by the exporter is correct. are correct, that all the goods were CHINA produced in (country) and that they comply with the origin requirements specified for those goods in the Generalized System of Preferences for goods exported to SHANGHAI NOV.27,2003 ---------------------------------------------------------------------------------------------------------- Place and date, signature and stamp of certifying authority CANADA ---------------------------------------------------------------------------------------------------------- Place and date, signature and stamp of authorized signatory