Claim Release and Receipt

Ref.: Name of Vessel-Voy.;

Description of cargo;

Master B/L number; LCL B/L number;

POL-POD

Alleged [describe type of damage/loss].

The undersigned, [Full company name and address], for itself, its successors and assigns and for and in consideration of the sum of [amount in writing] ([amount in numbers]) the receipt and sufficiency of which is hereby acknowledged, does hereby release and forever discharge LauritzenCool Logistics AB and all of their heirs, executors, administrators, successors, officers, directors, stockholders, employees, agents, assigns, insurers and/or underwriters, and all other persons, partnerships, corporations or firms liable, or who might be claimed to be liable, of and from any and all manner of actions, causes of action, claims, debts, dues, demands and suits which the said [full company name] or any other person, legal or physical, ever had, now has, or may or shall hereafter have in connection with the cargo carried under LCL’ Bill of Lading no. [bill of lading number].

The undersigned hereby declares that this Release is intended to make a full and final compromise settlement of any and all aforesaid claims, disputed or otherwise, on account of the matters set out hereinabove; that in entering into this settlement and in executing this Release it has taken into consideration all known losses, damages, expenses and consequences resulting from the matters set out herein; that this Release shall apply to all such losses, damages, expenses and consequences as aforesaid; that the parties hereby released admit no liability of any sort on account of or in connection with any of the matters set out herein; and that this settlement is made and this Release executed to terminate and forever foreclose further any such aforesaid claims by the undersigned, its successors and assigns, as the result of the matters set out herein.

In the event of a claim being presented by any person, legal or physical, against anyone of the persons and entities, as set out above, covered by this Release the undersigned hereby agrees to indemnify the same for any and all costs payable as a result of such claim.

This release and the performance hereof shall be construed in accordance with English law.

Dated this the ___ day of _______________, [Year]

Signed and stamped by [Company name]

Name: __________________________

Position: ________________________