CERTIFIKATE LEVRIMI

CERTIFIKAT LVRIMI

DELIVERY CERTIFICATE

Pr mallrat/shrbimet q prjashtohen nga TVSHsipas Statusit t Marrveshjes s Forcave (SOFA),

firmosur m 24 Qershor 1999, ndrmjet Organizats s Atlantikut Verior dhe Republiks s

Shqipris

Emri dhe adresa e furnizuesitName and address of supplier ____________________________________________________

Data dhe numri i kontrats/urdhrit t pagess

Date and number of the contract/ order: __________________________________________________________Emri dhe adresa e agjencis zyrtare t prokurimit:

Name and address of official procurement agency ________________________________________________

Emri dhe adresa e agjencis s pritjes

Name and address of receiving agency

_________________________________________________

Data e lvrimit

Date of deliveryPrshkrimi i mallrave/shrbimeve

Description of goods/services Njsia

Unit Sasia

Quantity mimi

PriceShuma / Amount

leke / lekMonedh e huaj/ foreign currency

123456

Shuma totale n lek / monedh e huajTotal amountlek/Foreign currency

Data / Dat

_____________________________________

Vula dhe firma / Stamp and valid signature

ertificat pranimi dhe pages Certificate of receipt and payment

Mallrat/shrbimet e siprprmendura jan trhequr.

Mallrat/shrbimet e prjashtuara nga TVSH-ja sipas

Marrveshjes SOFA, jan vrtetuar q jan pr prdorim Ekskluziv nga personeli i NATO-s dhe bazat e saj nTerritorin e Shqipris. Shuma totale

eshte ne rregull

The total amount of _______________________________________________________________ is correct

Pagesa bhet nPayment is being made in ___________________________________________________________Cash, ek / data e kalimit

By cash, check/ remittance date _______________________________________________________Nr. i llogaris bankare/no.of bank account ______________________________________________

________________________________

______________________________________

Numri serial / Serial No. 000000

For supplies of goods/services VAT exempted according to the Status of Forces Agreement (SOFA), signed on 24 June 1999, between the North Atlantic Treaty Organization (NATO) and the Governement of the Republic of Albania.

based on Economic Bilateral Agreement between Republic of Albania and United States of America as of 10.06.1992 and letter no. 2219/2, dated 10.06.2005 of General Directorate of Taxes.

Firmosur

Organi

Qedfdf

NIPTVAT No.

The goods/services described here above have been received. The goods/services are VAT exempt according to the Status of Forces Agreement (SOFA), and it is hereby certified that are used from NATO in the territory of Albania.

Data / Date Vula zyrtare/Official stamp Emri /Firma / Name/signature