No.

rcF/cAM/rv PolF l03

INTEGRAL COACH FACTORY,CHENNAI _ 38.
DATE 09.02.2A21

s-1302 REQUEST FORM PAGE l OF 2

To be filled by Process Planning

Planning
19-06-2023 63
S 1302 lndent Request No a33/2ABls663 Date Grou p
Whether Verification done for using alternate items yes

Physica I stock of alternate item No

Purpose :

Item to be procured through LPC for attending Train set rakes at open Railways as advised by
DY.CME/D-ll vide letter No.MD/D/PaintlT3A dated 19.06.2023 (copy enclosed)
Complete Description with Drawing No.& Specification

Supply of Sealant along with accessories, one set consists of

i.SlKA fast 3131s (AB) straw, product code-192439 - 490 ml- L2 tubes
ii.SlKA cleaner, Prodcut code-D-11X28 -2 litres
iii.Supply of VBM 400 MR manual dispenser, Product code-468400- 1No
iv.Supply of MFHX 10 -18T Mixer Helix 4:1/10:1 (mixer nozzle),Product code-D-LO2477- L No
a ?y
rotal Required Qty fi$ets Consignee 430A PL No.. 3053N081

sl Coach No.of B.O. Major Sub

Coach Description PCRT Qtv B.O.No.
No. Code sets Qty Grp Grp
1 889 TS DTC L L 1.
544775 38 30 63

Request Prepared By

Name N.SRINIVASA RAGHAVAN Signature Date 19.06.2023

Ir
Re

Name T.RAVICHANDRAN Signature T Ra*i*h**4 Date 19.05.2023

u t 3r't / - t x & l3o' )

P{w4 T.. l-.ln Lr.-r..t- - R,l' C

Dgli {e \l ,."q{ d . le'6t - z, I u. )z-s .

 _ 38.
No. tcFlcAM/M POlr l03
INTEG RAL COACH FACTO RY,CH EN NAI
DATE
5-1302 REQUEST FORM PAGE 2 OF 2
Rate Reference & Source of Supply (ESTIMAT'E ILPR/BQ Details)
ESTIMATE Details
Pi{ICING FORMAT ESTIMATE DATE ESTIMATE QUANTITY ESTIMATE VALUE
NUMBER
PMIEIFU R/3s16 19.06.2023 1 SET Rs.6 L,30L/-

LPR Details
P.O. Ref P. O . Date Qtv LPR Vendor Name I RE PS/ P.O. Status
Vendor (Com pleted)
Code

B.Q Details copies

TREPS/ Unit Rate
Sl. No. Vendor Name with Address B.Q.Ref. Qtv
(All incl. rate)
Vendor code

SOURCE OF SUPPLY DETAIL

sl. I REPS/
Vendor Name with Address
No. Vendor code
1 Universal Engineers PW LTD 2498s

Whether PAC ltem (lf PAC ltem, PAC to be No

su bm itted )

Whether Finance Concurrence Required No

Design Vetting Required No

Special conditions (if any ) : (to be mentioned)

To be Filled in MPO
lndent request received date )7*SrcFf% t q- L.Qg
lndent No
Drawinl' requisition sent on
lndent submitted on
Target cate for submission of lndent
Nc. days delayed Beyond Target Date

SSF/M }fu*hebL-'&
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