AMIGOS MATERIAL / SERVICES REQUISITION FORM

Dong Xuyen Industrial Park

Ward 10, Vung Tau City, SR Vietnam
x MDB RUSH CRITICAL ORDINARY

PROJ. NO.: Dong Xuyen Facility COST CENTRE NAME: Bypass stack

MRF#: 7845 rev.1 COST CODE NO: IND-111

DATE: 4-Apr-07 DATE REQUIRED: 11-Apr-07

SI. Description
Item Unit of Actual To be Supplier P.O. / S.O.
Control Code Material Description, Size, Specs, Remarks In Stock
Code Measure Required Procured Code No.
No.
1 Plate 1mmthk x 1500mmW x 6000mmL A36 pcs 1.00 0 1.00

2 Plate 2mmthk x 1500mmW x 6000mmL A36 pcs 1.00 0 1.00

3 Plate 5mmthk x 1500mmW x 6000mmL A36 pcs 2.00 0 2.00

4 Plate 8mmthk x 1500mmW x 6000mmL A36 pcs 40.00 0 40.00

5 Plate 10mmthk x 1500mmW x 6000mmL A36 pcs 264.00 0 264.00
6 Plate 12mmthk x 1500mmW x 6000mmL A36 pcs 97.00 0 97.00
7 Plate 15mmthk x 1500mmW x 6000mmL A36 pcs 27.00 0 27.00
8 Plate 20mmthk x 1500mmW x 6000mmL A36 pcs 23.00 0 23.00
9 Plate 40mmthk x 1500mmW x 6000mmL A36 pcs 8.00 0 8.00
Note: Material order as per cutting plan

Supplier
Final
Evaluation
Supplier Final Evaluation
Requirement Stock Request Requisition Requisition
Requisition Prepared / Checked by Checked by Approved by Received by Approved by Received by Requisition Closed
Requested by Endorsed
Proj. Services Store Management Procurement Management Purchasing
by

Proj.
Services

Izaac Maslissa

COPY DISTRIBUTION: (1) ORIGINAL : Procurement (2) COPY 1 : Originator (3) COPY 2 : Purchasing (4) COPY 3: Store
NOTE: Once the Requisition is closed, ORIGINAL will be forwarded by Procurement to Purchasing. Form No.: MSR.01 Rev.2 - 01.08.05

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 AMIGOS MATERIAL / SERVICES REQUISITION FORM
Dong Xuyen Industrial Park
Ward 10, Vung Tau City, SR Vietnam
MDB RUSH CRITICAL ORDINARY

PROJ. NO.: COST CENTRE NAME:

MRF#: COST CODE NO:

DATE: DATE REQUIRED:

SI. Description
Item Unit of Actual To be Supplier P.O. /
Control Code In Stock
Code Material Description, Size, Specs, Remarks Measure Required Procured Code S.O. No.
No.

Stock Supplier Final Evaluation Supplier Final Evaluation

Requisition Requirement Request Requisition Requisition
Checked by Requisition
Prepared / Requested Checked by Approved by Received by Received by
Endorsed by Approved by Closed
by Proj. Services Store Management Procurement Proj. Services Management Purchasing

COPY DISTRIBUTION: (1) ORIGINAL : Procurement (2) COPY 1 : Originator (3) COPY 2 : Purchasing (4) COPY 3: Store
NOTE: Once the Requisition is closed, ORIGINAL will be forwarded by Procurement to Purchasing. Form No.: MSR.01 Rev.2 - 01.08.05