Kopila Valley Sewa Samaj (KVSS)

Birendranagar-4 Surkhet
Purchase requisition/Deman Form
Requested Date:- 2078/8/29 Required Date:- 2078/9/1 PR No:-

Purchase from Market Purpose of Demand:- Fruits and Vegitables for CH

Issue from Store

Brand/Size/ Unit Total
SN Issue from Store Unit QTY Remarks
Specification Rate Amount

1 Banana dzn 10
90 900
Banana dzn 10
2 90 900
Simla kg 5
3 90 450
4 Banana dzn 10
90 900
gajar kg 3
5 60 180
pyaj kg 10
6 65 650
7 khursani kg 3
60 180
alu kg 20
8 45 900
kakra kg 15
9 80 1200
10 kerau kg 15
90 1350
banda kg 15
11 35 525
tamatar kg 10
12 65 650
13
suntala kg 20 70 1400

14 Banana dzn 10 90 900

15 suntala kg 20 70 1400
Total Amount 12485
Vat 13%
Transportation Cost
Gross Amount

Prepared by: Recommended by: Approved by

Name:- Sachyam S Upadhyay Name:- Name:- Top B Malla

Position:- CH Coordinator Position:- Position:- MD

Date:- 2078/8/29 Date:- 2078/8/29 Date:- 2078/8/29

For Administration use only: Suggested Suppliers

Received by: Name Of Suppliers:-

Name:- Address:-

Date: Contact:-
Note:- Request to be receive by store before 3 Days of Material/Service required.
 Kopila Valley Sewa Samaj (KVSS)
Birendranagar-4 Surkhet
Purchase requisition/Deman Form
Requested Date:- 2078/8/29 Required Date:- 2078/9/1 PR No:-

Purchase from Market Purpose of Demand:- Fruits and Vegitables for CH

Issue from Store

Brand/Size/ Unit Total
SN Issue from Store Unit QTY Remarks
Specification Rate Amount

1
suntala local kg 20 80 1600
Kerau kg 3
2 90 270

3 suntala local kg 20 80 1600

4 Banana dzn 10
90 900
Banana dzn 10
5 90 900
Banana dzn 10
6 90 900
7 kerau kg 3
80 240
Banana dzn 10
8 90 900
Apple kg 10
9 120 1200
10 Apple kg 10
120 1200
Apple kg 10
11 120 1200
Apple kg 10
12 120 1200
13

14

15
Total Amount 12110
Vat 13%
Transportation Cost
Gross Amount

Prepared by: Recommended by: Approved by

Name:- Sachyam S Upadhyay Name:- Name:- Top B Malla

Position:- CH Coordinator Position:- Position:- MD

Date:- 2078/8/29 Date:- 2078/8/29 Date:- 2078/8/29

For Administration use only: Suggested Suppliers

Received by: Name Of Suppliers:-

Name:- Address:-

Date: Contact:-
Note:- Request to be receive by store before 3 Days of Material/Service required.