SMB31-004P-2021-

Polestar 
Service and Parts Business
Service Manager Bulletin
TITLE:
Shipping and Handling of Polestar Lithium-ion Battery Electric Vehicle (BEV)
Battery Modules to Global Battery Solutions (GBS)
GROUP:
NO:
ISSUING DEPARTMENT:
CAR MARKET:
31
004P
Warranty
Canada only
REVISIONS:
ISSUE DATE:
STATUS DATE:
2021-03-17
2021-04-16
Page 1 of 11
Attention Polestar Parts Managers and Service Managers
There may come a time when a customer’s vehicle will require technical service and you will be
instructed to replace and ship a defective lithium battery electric vehicle (BEV) battery module directly
to our supplier for technical evaluation.
For complete battery packs, please see SMB31-001.
Note: All Polestar Lithium-ion Battery Electric Vehicle (BEV) Batteries modules will be part of our
Polestar Technical Helpdesk Prior Approval Process.
The failed battery electric vehicle (BEV) battery must be shipped directly to the Polestar Battery Center,
operated by Global Battery Solutions (GBS), at the address indicated below and on the shipping labels
attached.
POLESTAR LITHIUM-ION BATTERY ELECTRIC VEHICLE (BEV) BATTERY MODULE SHIPPING
AND HANDLING GUIDELINES:
Remove the replacement module from its shipping box and follow instructions as outline in VIDA
and/or provided by Retailer Technical Support (RTS) for installation.
HANDLING:
Ensure the replacement box and packaging are kept in their original condition. The replacement
battery module shall be removed from its original packaging and installed in the vehicle as soon as
possible in order to maintain protection against mechanical impact or tampering.
Once the replacement module is removed, store the shipping box in a safe and secure place to be
used for the transportation of the defective battery electric vehicle (BEV) battery module.
• Do not remove or cover up any of the hazmat shipping labels on the outside of the replacement
box.
•
Do not damage or disassemble the replacement box.
Produced and printed in the USA and available as an electronic document.
© Polestar 2021
Service Manager Bulletin 31-004P
•
If you damage the box you will be charged for a replacement box plus shipping and hazmat labeling
cost.
Before packaging the module, make sure that it has been emptied of all coolant and dried. It may be
necessary to package the module with an absorbent towel to collect any remaining coolant.
Carefully place the defective battery electric vehicle (BEV) battery module inside of the bag it arrived
in, then repackage the module with all included foam inside of the box. Reseal the box with packaging
tape ensuring the warning labels on the package are not obscuring.
Warning labels “Class 9” and “Cargo Aircraft Only” must be present and unobscured on a minimum of
two sides of the container.
It is mandatory the defective battery electric vehicle (BEV) battery module be shipped to GBS within 2
days of receiving the replacement battery module. The defective battery module must be received by
GBS within 7 days of receipt of the replacement battery module.
SHIPPING:
All core shipments to the Battery Center must include a proper core report. Without the core report
core credit will not be given. See the Core Return Procedure chapter in the Parts Policy and Procedure
manual, found on the Retailer Portal, for instructions on how to create a core report and core packing
list.
Please complete the attached FedEx VICS Bill of lading. Retailers only need to fill out their return
address, RMA number and add the part number in the carrier information section.
Commercial Invoice
You will also need to print and complete the attached Commercial Invoice. Retailers only need to fill
out the Exporter section (Contact Name:, Telephone No., E-Mail, Company Name/Address) as well as
add the battery part number in the Description of Dangerous Goods field. Do not alter any information
on this Commercial Invoice.
All other information is pre-filled. Do not alter any information on this Bill of lading.
Located at the end of this bulletin are 4 GBS return shipping labels pre-addressed to Global Battery
Solutions.
• Cut out one of the labels.
•
Fill out this label completely. Ensure the RMA Number is on the label.
•
Secure the label to the outside of the replacement container.
•
Contact the FedEx Freight at the number below and request a pick-up:
FedEx Freight Customer Service 1.866.393.4585
You must complete the attached Commercial Invoice. Retailers only need to fill out the Exporter
section contact and address information. Retailers must also add the part number under the
Description of Goods section.
Ship to:
Global Battery Solutions (GBS)
581 Ottawa Ave, Suite 100
Holland, MI 49423
Attention: Stacy Trott
Page 2 of 11
2021-04-16
Service Manager Bulletin 31-004P
Once the FedEx Driver arrives, it is important to give the driver the completed FedEx Bill of Lading and
a copy of the Safety Data Sheet. You can print a copy of the Safety Data Sheet from SMB 31-006P.
You should also have attached a copy of the Safety Data Sheet to the outside of the replacement
shipping crate using the Polestar Poly Bags 7777601.
Warranty and Technical Documents
These documents must be included inside the box with the defective module.
•
•
•
•
Technical Helpdesk Vehicle Report - (mandatory) see sample below.
Shipping Label affix to the outside of the replacement box. (mandatory)
Material Data Safety Sheets affix to the outside of the replacement crate. (mandatory)
Copy of the original Repair order-see sample below
NOTE: Failure to include the above documents may result in the package being returned at retailer
expense.
Package Example
PLEASE DO NOT COVER OR REMOVE ANY OF THE HAZMAT LABELS.
2021-04-16
Page 3 of 11
Service Manager Bulletin 31-004P
CUSTOMER #: 1234569
WARRANTY
POLESTAR CANADA RETAILER
ONE POLESTAR DRIVE
SERVICE PH: 201-768-7300 · 201-768-4556
www.polestar.com
HOME:
BUS:
COLOR
PAGE 2
CONT:N/A
CELL:
YEAR
SERVICE ADVISOR 56 John Wayne
MAKE/MODEL
VOID_BLACK 21 POLESTAR 2
DEL. DATE
PROD. DATE WARR. EXP.
T1153
IS
DD
LICENSE
LPSED3KA7ML012077
PROMISED
PO NO.
MILEAGE IN / OUT
3000/3099
RATE
PAYMENT
16:30 15JAN21
0.00 CASH
STK:E054916 ENG:BEV TRN:AUTO
OPTIONS:
READY
TAG
INV. DATE
26JAN21
D
ER
R.O. OPENED
VIN
BE
V
M
O
D
U
LE
R
EP
AI
R
O
R
07:26 15JAN21 13:40 26JAN21
LINE OPCODE TECH TYPE HOURS
LIST
NET
TOTAL
FOUND MESSAGE BECAME PRESENT FOR CHARGING SYSTEM FAILURE, ATTEMPTED TO
CHARGE IN "SAVE" MODE AND MESSAGE WAS DISPLAYED FOR CHARGING SYSTEM
FAILURE. FAULT TRACED PER CSC "YL". CHECKED DTCs AND FOUND BECM-P0DBF00
STORED. FAULT TRACED AND FOUND LIKELY CAUSE IS INTERNAL FAULT IN HV
BATTERY CELL "E". CONTACTED THD PER CASE RE #1234567. ASSISTED THD WITH
REMOTE DIAGNOSTICS, ATTEMPTED BECM RELOAD, BATTERY RESETS AND OTHER
DIAGNOSTICS TO RESTORE CELL BALANCING. ALL ATTEMPTS FAILED TO RESOLVE
CONCERN. PER THD, REPLACED HV BATTERY AND PERFORMED BECM RELOAD.
CLEARED DTCs AND TESTED CHARGING. CHARGING NOW FUNCTIONS BUT LEDs AT
CHARGING OUTLET DO NOT LIGHT OR GIVE ANY INDICATION. FAULT TRACED PER
CSC "YW". FAULT TRACED LED FAULT. DISCONNECTED MANUAL SERVICE
DISCONNECT AND REMOVED LF FENDER LINING TO EXPOSE CHARGING OUTLET.
INSPECTED OUTLET AND FOUND CONNECTOR HAS BEEN PULLED OUT OF LED PORTION
OF CHARGING OUTLET DUE TO ZIP TIE CAUSING TOO MUCH TENSION ON WIRING.
REMOVED ZIP TIE AND SECURED CONNECTOR. CHECKED WIRING TO BE SURE WIRING
DOES NOT HAVE EXCESSIVE MOVEMENT-OK. RESTORED HV MSD AND TESTED LEDs
AND FOUND ALL CHARGING INDICATIONS ARE FUNCTIONING PROPERLY. TEST DROVE
AND FOUND ALL FUNCTIONS ARE NOW OPERATIONAL.
****************************************************
YOUR COMPLETE SATISFACTION IS OUR GOAL. IF
FOR ANY REASON YOUR VISIT WAS NOT OUTSTANDING
TECH:
00000 ACTUAL HRS.:
WE APPRECIATE YOUR BUSINESS.
00.00
SOLD HRS.:
0.00 LUB:
0.00 LUB:
START
00:00
00:00
00:00
00:00
SA
M
DATE
01-15-16
PL
E
SALE-LBR: 0000.00 PTS: 0000.00 MSC:
COST-LBR: 000.00 PTS: 0000.00 MSC:
[
] CASH
[
] VISA
[
] AMER XPRESS
FINISH
00:00
00:00
00:00
00:00
DURATION
0.00
0.00
0.00
0.00
00.0
TYPE
W
W
W
W
TECH
00000
00000
00000
00000
0.00 SUB:
0.00 SUB:
LINE(S)
A
C
B
D
0.00 TOTAL 00000
0.00 TOTAL 00000
CHG
DESCRIPTION
[
[
] CHECK
] MASTER CARD
[
] OTHER
CK NO. [
[
] DISCOVER
[
] CHARGE
]
TOTALS
LABOR AMOUNT
PARTS AMOUNT
ADJUSTMENT
SUBLET AMOUNT
SUPPLIES/WASTE DISP.
TOTAL CHARGES
LESS INSURANCE
SALES TAX
PLEASE PAY
THIS AMOUNT
CUSTOMER SIGNATURE
Copyright 2000 ADP, Inc.
SERVICE INVOICE #2 XSI2C
Page 4 of 11
WARRANTY COPY
2021-04-16
Service Manager Bulletin 31-004P
2021-04-16
Page 5 of 11
Service Manager Bulletin 31-004P
UNIFORM STRAIGHT BILL OF LADING ORIGINAL---NOT NEGOTIABLE
SUBJECT TO THE TERMS AND CONDITIONS OF THE UNIFORM BILL OF LADING --- QUESTIONS? CALL 1.866.393.4585
Date
Purchase Order #
Shipper #
Shipper #
OPTIONAL: You may select a money-back guarantee
delivery (charges and tariff limitations may apply).
REQUIRED: Please select a service type
q FedEx Freight® Priority
✔ FedEx Freight® Economy
q
SHIPPER (from) Please provide ZIP codes and phone numbers.
q A.M. Delivery q Close of Business Delivery
CONSIGNEE (to)
Shipper
FXF Acct. #
Consignee
Attn. to
Area Code Phone Number
Attn. to
Area Code Phone Number
Stacy Trott
866
Address
Address
Address (Store, Dept., Ste., Flr., Apt., Div.)
Address (Store, Dept., Ste., Flr., Apt., Div.)
Address
Address
City
City
State/Province
ZIP/Postal Code
Country
FXF Acct. #
Global Battery Solutions (GBS)
327-0318
581 Ottawa Ave
Suite 100
Holland
State/Province
ZIP/Postal Code
MI
49423
Country
USA
Optional or Additional Service Fees and Charges  Liftgate  Inside Pickup  Limited Access
Optional or Additional Service Fees and Charges  Liftgate  Inside Delivery  Limited Access
Shipper Bill of Lading #
 Custom Delivery Window:
Special Instructions
For Clearance carrier must send documents to US Customs Broker: Expeditors, [email protected]
BILL FREIGHT CHARGES TO (if different than above):
Name
FXF Acct. #
Mailing Address
POLESTAR AUTOMOTIVE USA INC. c/o Williams & Associates
FedEx ACCT# 673220215
405 E 78TH ST
City
State
ZIP/Postal Code
Country
BLOOMINGTON
US
MN
55420
Freight charges are PREPAID unless
marked collect.
CHECK BOX IF COLLECT 
C.O.D.
 USD
 CAD
AMOUNT
REMIT C.O.D. TO (if different than shipper above):
1.
2.
3.
Area Code
Phone Number
952
884-9959
The letters “C.O.D.” must appear in box before consignee’s name above.
C.O.D. funds to be collected as:
 Certified Funds
 Company Check
C.O.D. fee to be paid by:
 Shipper
 Consignee
Name
 Personal Check
Mailing Address
City
State
ZIP/Postal Code
Country
Country Code
Area Code
Phone Number
RECEIVED, subject to individually determined rates or contracts that have been agreed upon in writing between the carrier and shipper, if applicable, otherwise to the rates, classifications and rules that have been established by the carrier and are available to the shipper, on request, and to all applicable state and federal regulations,
the property described below, in apparent good order, except as noted (contents and condition of contents of packages unknown) marked, consigned and destined as shown hereon, which said carrier agrees to carry to destination, if on its route, or otherwise to deliver to another carrier on the route to destination. Every service to be
performed hereunder shall be subject to all the conditions not prohibited by law, whether printed or written, herein contained, including the conditions on the back hereof, and the conditions of the FXF 100 Series Rules Tariff, or otherwise referenced, which are hereby agreed to by the shipper and accepted for himself and his assigns.
HANDLING H/U PKG.
UNITS (H/U) TYPE
1
CTN
PIECES HM
(X)
1
WEIGHT IN LBS. NMFC ITEM #
(subject to correction)
KIND OF PACKAGE, DESCRIPTION OF ARTICLES, SPECIAL MARKS AND EXCEPTIONS
(subject to correction)
UN3480, LITHIUM ION BATTERIES, 9.11, EMERGENCY GUIDE #147 50.0 LBS
CUBE
CLASS
0606680-01
(optional)
050
Hazardous Material Package Type: Box
Box DIMS: 15 x 10.5 x 10.5 in.
Part Number:
DANGERIOUS GOODS
DO NOT STACK PALLETS
TOTAL H/U: 1
H
MARK “X” OR “RQ” IN THE HM COLUMN TO DESIGNATE HAZARDOUS MATERIALS OR REPORTABLE QUANTITY AS DEFINED IN DOT REGULATIONS.
area code
FOR INTERNATIONAL SHIPMENTS INDICATE BROKER NAME, FAX AND PHONE NUMBERS.
800 ______________________
535-5053
HM EMERGENCY CONTACT PHONE NUMBER (_______)
AREA CODE
CUSTOMER REGISTERED W/EMERGENCY RESPONSE INFO. PROVIDER or CONTRACT #
Volvo Car USA LLC - MIS0004316
___________________________________________________________________
EEI/SED Number or Exception____________________________ Phone # (_______) ___________________
NOTE (1) Where the rate and carrier’s liability for loss or damage may be dependent on value, shippers
must state specifically in writing the agreed or declared value of the property as follows: “The agreed
50
or declared value of the property is specifically stated by the shipper to be not exceeding________
lb
per_________.”
Note (2) liability limitation for loss or damage on this shipment shall be applicable as provided by
contract or in the current NMFC or this carrier’s governing tariffs. See FXF 100 Series Rules Tariff
for complete limited liability provisions. Carrier’s maximum standard liability is limited to $25 per pound
per package for NEW articles and $.50 per pound per package (or its equivalent in Mexican Pesos (MXN)
or Canadian Dollars (CAD), at the rate of exchange which is in effect at the place and on the date of
shipment) for USED or RECONDITIONED articles. In no case shall carrier liability exceed $100,000 per occurrence
(or its equivalent in MXN or CAD at the rate of exchange which is in effect at the place and on the date
of shipment) for NEW articles or $10,000 per occurrence (or its equivalent in MXN or CAD at the rate of
exchange which is in effect at the place and on the date of shipment) for USED or RECONDITIONED articles.
For availability and limits of excess liability coverage and applicable rates and charges, please refer to FXF 100
Series Rules Tariff. Not selecting an additional coverage option is considered to be a waiver of same and standard
liability coverage will apply.
 Articles are NEW, and require Excess Liability Coverage in the amount of _______________
oUSD o CAD oMXN per olb. or okg. Additional charges will apply.
 Articles are USED or RECONDITIONED and require Excess Liability Coverage. Additional charges will apply.
NOTE (3) Commodities requiring special or additional care or attention in handling or stowing must be so
marked and packaged as to ensure safe transportation with ordinary care. See Sec. 2(e) of NMFC Item 360.
FOR FREIGHT COLLECT SHIPMENTS
Create your next Bill of Lading online at fedex.com/us/freight/main/
Page 6 of 11
AREA CODE
Broker Name _________________________________________ Fax # (_______) _____________________
Subject to Section 7 of conditions of applicable Bill of Lading. If this shipment is to be delivered to the consignee,
without recourse on the consignor, the consignor shall sign the following statement. The carrier may decline to
make delivery of this shipment without payment of freight and all other lawful charges.
Consignor Signature _______________________________________________________________________
SHIPPER CERTIFICATION
I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping
name, and are classified, packaged, marked and labeled/placarded, and are in all respects in proper condition for transport
according to applicable international and national governmental regulations.
Shipper Signature ___________________________________________________ Date ________________
CARRIER CERTIFICATION
Carrier acknowledges receipt of packages and required placards. Carrier certifies emergency response information
was made available and/or carrier has the DOT emergency response guidebook or equivalent document in the vehicle.
DATE
DRIVER/EMPLOYEE NUMBER
FedEx Freight
PIECE COUNT
TRAILER #
CO202/616-FXF
0023776PM
2021-04-16
Service Manager Bulletin 31-004P
UNIFORM STRAIGHT BILL OF LADING
Terms & Conditions
Sec. 1. (a) The carrier or the party in possession of any of the property
described in this Bill of Lading shall be liable as at common law for any loss thereof or
damage thereto, except as hereinafter provided.
(b) No carrier shall be liable for any loss or damage to a shipment
or for any delay caused by an Act of God, the public enemy, the authority of law, or
the act or default of shipper. Except in the case of negligence of the carrier or party in
possession, the carrier or party in possession shall not be liable for loss, damage or
delay which results: when the property is stopped and held in transit upon request of
the shipper, owner or party entitled to make such requests; or from faulty or impassible
highway, or by lack of capacity of a highway bridge or ferry; or from a defect or vice in
the property; or from riots or strikes. The burden to prove freedom from negligence is
on the carrier or the party in possession.
Sec. 2. Unless arranged or agreed upon, in writing, prior to shipment, carrier
is not bound to transport a shipment by a particular schedule or in time for a particular
market, but is responsible to transport with reasonable dispatch. In case of physical
necessity, carrier may forward a shipment via another carrier.
Sec. 3. (a) As a condition precedent to recovery, claims must be filed in
writing with: any participating carrier having sufficient information to identify the
shipment.
(b) Claims for loss or damage must be filed within nine months after
the delivery of the property (or, in the case of export traffic, within nine months after
delivery at the port of export), except that claims for failure to make delivery must be
filed within nine months after a reasonable time for delivery has elapsed.
(c) Suits for loss, damage, injury or delay shall be instituted against
any carrier no later than two years and one day from the day when written notice is
given by the carrier to the claimant that the carrier has disallowed the claim or any
part or parts of the claim specified in the notice. Where claims are not filed or suits are
not instituted thereon in accordance with the foregoing provisions, no carrier shall be
liable, and such claims will not be paid.
(d) Any carrier or party liable for loss of or damage to any of said
property shall have the full benefit of any insurance that may have been effected, upon
or on account of said property, so far as this shall not avoid the policies or contracts
of insurance, PROVIDED, that the carrier receiving the benefit of such insurance will
reimburse the claimant for the premium paid on the insurance policy or contract.
Sec. 4. (a) If the consignee refuses the shipment tendered for delivery
by carrier or if carrier is unable to deliver the shipment, because of fault or mistake
of the consignor or consignee, the carrier’s liability shall then become that of a
warehouseman. Carrier shall promptly attempt to provide notice, by telephonic or
electronic communication as provided on the face of the Bill of Lading, if so indicated,
to the shipper or the party, if any, designated to receive notice on this Bill of Lading.
Storage charges, based on carrier’s tariff, shall start no sooner than the next business
day following the attempted notification. Storage may be, at the carrier’s option, in
any location that provides reasonable protection against loss or damage. The carrier
may place the shipment in public storage at the owner’s expense and without liability
to the carrier.
(b) If the carrier does not receive disposition instructions within 48
hours of the time of carrier’s attempted first notification, carrier will attempt to issue a
second and final confirmed notification. Such notice shall advise that if carrier does not
receive disposition instructions within 10 days of that notification, carrier may offer the
shipment for sale at a public auction and the carrier has the right to offer the shipment
for sale. The amount of sale will be applied to the carrier’s invoice for transportation,
storage and other lawful charges. The owner will be responsible for the balance of
charges not covered by the sale of the goods. If there is a balance remaining after all
charges and expenses are paid, such balance will be paid to the owner of the property
sold hereunder, upon claim and proof of ownership.
2021-04-16
(c) Where carrier has attempted to follow the procedure set forth
in subsections 4(a) and (b) above and the procedure provided in this section is not
possible, nothing in this section shall be construed to abridge the right of the carrier
at its option to sell the property under such circumstances and in such manner as may
be authorized by law. When perishable goods cannot be delivered and disposition is
not given within a reasonable time, the carrier may dispose of property to the best
advantage.
(d) Where a carrier is directed by consignee or consignor to unload
or deliver property at a particular location where consignor, consignee, or the agent of
either, is not regularly located, the risk after unloading or delivery shall not be that of
the carrier.
Sec. 5. (a) In all cases not prohibited by law, where a lower value than the
actual value of the said property has been stated in writing by the shipper or has been
agreed upon in writing as the released value of the property as determined by the
classification or tariffs upon which the rate is based, such lower value plus freight
charges if paid shall be the maximum recoverable amount for loss or damage, whether
or not such loss or damage occurs from negligence.
(b) No carrier hereunder will carry or be liable in any way for any
documents, coin money, or for any articles of extraordinary value not specifically rated
in the published classification or tariffs unless a special agreement to do so and a
stipulated value of the articles are endorsed on this bill of lading.
Sec. 6. Every party, whether principal or agent, who ships explosives or
dangerous goods, without previous full written disclosure to the carrier of their nature,
shall be liable for and indemnify the carrier against all loss or damage caused by such
goods. Such goods may be warehoused at owner’s risk and expense or destroyed
without compensation.
Sec. 7. (a) The consignor or consignee shall be liable for the freight and
other lawful charges accruing on the shipment, as billed or corrected, except that
collect shipments may move without recourse to the consignor when the consignor
so stipulates by signature or endorsement in the space provided on the face of the Bill
of Lading. Nevertheless, the consignor shall remain liable for transportation charges
where there has been an erroneous determination of the freight charges assessed,
based upon incomplete or incorrect information provided by the consignor.
(b) Notwithstanding the provisions of subsection (a) above, the
consignee’s liability for payment of additional charges that may be found to be due after
delivery shall be as specified by 49 U.S.C. §13706, except that the consignee need not
provide the specified written notice to the delivering carrier if the consignee is a for-hire
carrier.
(c) Nothing in this Bill of Lading shall limit the right of the carrier to
require the prepayment or guarantee of the charges at the time of shipment or prior to
delivery. If the description of articles or other information on this Bill of Lading is found
to be incorrect or incomplete, the freight charges must be paid based upon the articles
actually shipped.
Sec. 8. If this Bill of Lading is issued on the order of the shipper, or his agent,
in exchange or in substitution for another Bill of Lading, the shipper’s signature on the
prior Bill of Lading or in connection with the prior Bill of Lading as to the statement of
value or otherwise, or as to the election of common law or Bill of Lading liability shall
be considered a part of this Bill of Lading as fully as if the same were written on or made
in connection with this Bill of Lading.
Sec. 9. If all or any part of said property is carried by water over any part of
said route, such water carriage shall be performed subject to the terms and provisions
and limitations of liability specified by the “Carriage of Goods By Sea Act” and any
other pertinent laws applicable to water carriers.
Page 7 of 11
Service Manager Bulletin 31-004P
COMMERCIAL INVOICE
This invoice must be completed in English.
EXPORTER:
1
1
Page _______
of _______
Ship Date:
Tax ID#: EIN
Contact Name:
105557987RM0001
Air Waybill No. / Tracking No.:
Telephone No.:
E-Mail:
Company Name/Address:
Invoice No.:
Purchase Order No.:
Payment Terms:
Bill of Lading:
PREPAID FedEx Acct 673220215
Purpose of Shipment:
OTHER (PLEASE SPECIFY)
Used Defective Auto Part.
Country/Territory: Canada
Parties to Transaction:

Related
Non-Related
SOLD TO
TO /(ifIMPORTER
different from
Consignee):
SOLD
(if different
from Consignee):
CONSIGNEE:
Tax ID#: EIN
Contact Name: Stacy Trott
Telephone No.: 866-327-0318
47-490375000
Same as CONSIGNEE:
Tax ID#:
E-Mail: [email protected]
Company Name/Address:
SELECT DOWN ARROW FOR OPTIONS
Company Name/Address:
Polestar Automotive USA Inc.
Global Battery Solutions (GBS)
581 Ottawa Ave, Suite 100
Holland, MI 49423
Country/Territory: United States
Country/Territory:
If there is a designated broker for this shipment, please provide contact information.
[email protected]
Expeditors
734-229-1758
Name of Broker ____________________________________________________
Tel. No. __________________________
Contact Name ____________________________________________
___
Duties and Taxes Payable by
Exporter
No. of
Packages
No. of
Units
Net Weight
Unit of
Measure
1
1
50.0
(LBS / KGS)
LBS
Total
Pkgs
Total
Units
Total Net
Weight
(Indicate
LBS/KGS)
1
1
50
LBS
Consignee

Other
Polestar Automotive USA c/o Williams & Associates ACCT# 673220215
If Other, please specify _______________________________________________________________________
Description of Goods
UN 3480, Lithium - ion Batteries.9.11
DANGEROUS GOODS
Emergency Guide, 147 CLASS 9
Dimensions: 15" L X 10.5" W X 10.5" H
Total Gross
Weight
50
(Indicate
LBS/KGS)
Terms
of Sale:
Harmonized
Tariff Number
8538.90
Country of
Manufacture
KR
FCA=Free Carrier
Total
Value
Unit
Value
1,165.00
1,165.00
0.00
0.00
0.00
0.00
0.00
0.00
Subtotal:
1,165.00
Insurance:
LBS
Special Instructions:
EMERGENCY PHONE NUMBER - CONTACT: CHEMTREC - 800-424-9300
Declaration Statement(s):
0.00
Freight:
0.00
Packing:
0.00
Handling:
0.00
Other:
0.00
I declare that all the information contained in this invoice to be true and correct.
Invoice Total:
Originator or Name of Company Representative if the invoice is being completed on behalf of a company or individual:
Currency Code:
1,165.00
USD
Date:
Signature / Title / Date:
REV. 04.10.13-1.08
Page 8 of 11
2021-04-16
SAMPLE VEHICLE REPORT
Service Manager Bulletin 31-004P
2021-04-16
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Service Manager Bulletin 31-004P
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2021-04-16
Service Manager Bulletin 31-004P
2021-04-16
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