C. da Costa Transportes LTDA CNPJ: 10.173.689/0001-00 I.E: 244.793.815.

112

_________________________________________________________________________
DATA DA COLETA ___/___/______
REMENTE:____________________________
DESTINATARIO________________________
KM DE SAIDA DA TRANP ____________________________________________
KM DE CHEGADA NO REMETENTE____________________________________
KM DE CHEGADA NO DESTINATARIO__________________________________
ABASTECIMENTO: R$_______________________________________________

DATA DA COLETA ___/___/______

REMENTE:____________________________
DESTINATARIO________________________
KM DE SAIDA DA TRANP ____________________________________________
KM DE CHEGADA NO REMETENTE____________________________________
KM DE CHEGADA NO DESTINATARIO__________________________________
ABASTECIMENTO: R$_______________________________________________

DATA DA COLETA ___/___/______

REMENTE:____________________________
DESTINATARIO________________________
KM DE SAIDA DA TRANP ____________________________________________
KM DE CHEGADA NO REMETENTE____________________________________
KM DE CHEGADA NO DESTINATARIO__________________________________
ABASTECIMENTO: R$_______________________________________________
Av: Francisco de Paula Oliveira Nazar - n 147 SL 06 Pq industrial
Campinas SP Cep: 13031- 440 -TEL: (19) 3226-3310
_________________________________________________________________________

Rua Onze n 54, JD. Cristina Campinas SP. TEL: (19) 3226-3310 / 9216-1060