PURCHASE REQUEST FORM

Requested By: Roni Fauzi PRF No: PR.1609250001 Received PR date: Budgeted :

Department: Engineering Date Raised: 24-Sep-16 Entry Pronto date: Yes, No_____________
Un-budgeted
Proposed Supplier: Date Required: 8-Oct-16 PIC

Estimate/Quote
No. Part # Item Description Qty UOM Currency Price (per/unit) Total Price General Ledger Code/Project #
(by S/C) (by S/C)

Add Silo 3 x 200 T

1 Deformed Bar D10, 12m per Length 24 Lgh

2 Deformed Bar D19, 12m per Length 40 Lgh

3 Deformed Bar D32, 12m per Length 100 Lgh

4 Wiremesh #M8 - 150 Size 5,4m x 2,4 m 20 Sheets

5 HD-M24-B1-600-120 Anchor Bolt 48 Units

Note:
Anchor bolt material shall be Hot deep Galvanized
C/W with 2 nut + 1 washer + 1 lock washer
Holding downbolt material shall be grade 4.6
Material Certificate Required

Wire mesh Material shall be comply to SNI-07-0663-1989 (Yield Strength of 500 MPa)
Material Certificate Required

Rebar Material shall be comply to SNI-07-2052-2002 '(Round Bar, Yield Strength of 240 MPa)
(Deformed Bar, Yield Strength of 400 MPa)
Rebar shall be delivered to Site in Straight Condition
Material Certificate Required

TOTAL -
Approved by, Important Instructions:-
All requests must be sent to the Supply Chain department. Forms may be either handwritten or
Requested by, Acknowledged by, Checked by cost control Project / Plant Manager typed and emailed to all.supplychain@bsibatu.com
End user should endeavour to check to ensure sufficient budget exists for a request
Requests for spare parts must include Model/Type, and OEM Part #
Any quotation information, & photographs of samples should be included with form.
All requests must include the allocation of a cost code or Project #
All requests must include an X in a “Requesting Department” box

Roni Fauzi Arya Perdana