KLIACS/AD/F/954, Revision 2

WORK ORDER FORM

PART A: GENERAL INFORMATION DATE : 18 AUG 2011 Name Of Contractor / Supplier : SINAR BERSIH ENTERPRISE Contractor / Supplier Ref. No: Work Order No : 020 / 2011

PART B : INSTRUCTION TO THE CONTRACTOR / SUPPLIER Name Of Contractor / Supplier : SINAR BERSIH ENTERPRISE
You are hereby instructed to caary out the following Works/Supplies: - PAINTING WORKS FOR ENTERANCE GATE & GUARD ROOM - GRILL DOOR AT BLOCK 16 5 UNIT GRILL DOOR / ONE LAYER ANTI RUST & TWO LAYER ICI FINISH For a Lump Sum of (Ringgit Malaysia: FOUR THOUSAND NINE HUNDRED ONLY) In accordance with the Specification, Drawing and the Condition for Quotition of Works/Supplies and with the following terms: Commencement Date : Initiated By : Name Signature : Date : : Expected Date of Completion: Approved By : Name Signature Date : : :

PART C : CONFIRMATION BY CONTRACTOR / SUPPLIER I/WE _____________________ hereby confirmed that the above mentioned Works/ Supllies has been completed and returned herewith the Work Order for your verification. We also agree to the payment due to us amounting RM ______________ (Ringgit Malaysia : ) and confirm that no order claims will be made to the Work Order. ___________________________ Signature Company's Chop

Date :

PART D : VERIFICATION OF WORK COMPLETED & CONFIRMATION FOR PAYMENT Verification Of Work Completed Name Signature : Date : : Confirmation For Payment Recommendation Name Signature : Date : : Approval Name :

Signature : Date :

QUALITY RECORD