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ACKNOWLEDGEMENT RECEIPT OF MATERIALS &

SUPPLIES

DATE: 8/28/2015
ITEM
DESCRIPTION

MEASUREM
ENT

QUANTITY

TOTAL

B8203-CR

1 set of
hinge/piece

96 sets

96 sets of
hinge
B8203

This is to acknowledge that I have received the items


listed above in complete and in good condition.
_____________________________

Checked & approved by: _______________________

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