(Must be completed on company stationary)

 

 

CERTIFICATE OF ORIGIN/HEALTH AND HUMAN CONSUMPTION

This is to certify that the food products displayed at the food show
held at the Koln Messe and shipped to:

             

            Consignee:

 

USA PAVILION

            C/O

            C/O

American Embassy

KN Expo Service

             

Speditionshof Messe

 

50679 Koln, Germany

 

 

(EXHIBITION MATERIALS FOR )

Have been produced by the following registered food manufacturer:

          Company name:

          Address:

The country of origin for all items is the United States. The food and drink products are as per the attached invoices.

We,

 

confirm that the products listed on our invoices

were produced by us within the United States and by the prescribed standards for safety and quality. Furthermore we confirm that the items have been produced with the labeling standards recommended by the Codex Alimentarius Commission.

 

        Type name of Company

        Type representative name:

        Title:

        Signature:

        Date:

Sworn before me this

day of

2007 in accordance with the laws of the State of

            Notary

            Signature:

            Date: