Company : 
Address : 
Telephone : 
Fax :
E-mail :
Contact person :
Shipping agent : 
Ship name : 
Docking harbour : 
Date of delivery :
Products
 
Gasoline :
quantity (M.T.) :
quantity :
viscosity :
Fuel-oil :
 
Lubricants :
   
Description (1)
Quantity (2)
Unit (3)
Lubricant 1 :
Lubricant 2 :
Lubricant 3 :
Comment :
 

(1) Please indicate the name of the AGIP/AGIL lubricant or the name of the currently used lubricant
(2) Number of cans
(3) Select requested cans


 
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