MATERIAL REQUEST Faisal Rivai Hasibuan

Ahmad Faisal
CT NAME HCPT
Request Date 24-Apr-2020
Requestor Ahmad Faisal

Estimation Price (Rp)

Fuel
Fuel Adjusted
Description Weight (kg) Rate Adjustment Add cost (if any) Total
Amount
(%)
Transportation
Estimation Total (Exclude Tax)
SDR No : LTR-H3I-WPO620-NS-20200329-ES0155-PSLACK Site ID : 23752
Customer PO No : WPO-0620 Site Name : 10 Site Area NS
WPID / WPO : WBS : WPO-0620
Project : HCPT ( H3i ) ETD Date : 24-Apr-2020
Job Type : RAN Expansion (2555) ETA Date : 27-Apr-2020
Scope of Work : New 4G Area : Zone1
Recipient : AGILITY Province : North Sumatera
PIC at Site : Doan Sinaga City : Medan
PIC Mobile Phone at Site : +62 852-9661-7968 District (Kecamatan) :
PIC NSN : Ahmad Faisal Transport Mode : Delivery
PIC Mobile Phone NSN : +62815-3468-9900 Transport Type : LAND
Site Condition : Easy Access Forwarder Company : DHL
Material From : WH CIKARANG Site Type :

NO MAT CODE ITEM DESCRIPTION_Equipment QTY UNIT PL

8 71221_100 Battery 100Ah (Block) 4 pcs for site 23752
14 71222_W1 ODC20-25 Outdoor Cabinet Tall with belt 1 pcs for site 23752

We kindly ask you to deliver the above mentioned materials to: GAP LTE :
Address :

Gg. Mustika, Patumbak Dua, Kec. Patumbak, Kabupaten Deli Serdang, Sumatera Utara 20361
Indonesia

signed,
Approved by Requested by Received by
Name: Ferdinand Name: Ahmad Faisal Name

Date : Date : Date

24-Apr-2020 24-Apr-2020
Company : Company : Company
PT. NSN PT. NSN
* Receiver herewith acknowledge that all material are receipt in good conditions

REV01 (TYPE-L) Universal Mounting Bracket MW 300-600 2 PCS locmat

ATOD1 Grounding cable and its accesories for grounding connection from Ant-ODU and mounting
2 to nearest gro
PCS locmat
IDDO2 Set of material for installation IDU-ODU connection per ODU 2 PCS locmat
CS80005.68 MCB MERLIN GERIN 6A SINGLE PHA 0 PCS locmat
CS73174 Grounding cable NYAF 16mm2 Yellow/Green 0 PCS locmat
CS80005.65 MCB MERLIN GERIN 16 A SINGLE P 2 PCS locmat
CS80000.01 Cable UTP Cat6 Panduit 10 Meter locmat
CS80000.33 RJ-45 Connector, Cover Blue 5 PCS locmat