No. !

cFlcAM/M POlFlo3
INTEGRAL COACH FACTORY,CHENNAI - 38 DATE 09.02.202L

5-1302 REQUEST FORM PAGE 1 OF 2

To be filled by Process Planning

Pla n ning
2L-06-2023 63
S 1302lndent Request No. 034120231s663 Date Group
Whether Verification done for using alternate items yes

Physical 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.MDlDlPaintlT3A dated 19.06.2023 (copy enclosed)
Complete Description with Drawing No.& Specification

Supply of Sealant along with accessories, one set consists of

i.lTW PLEXUS MA 8110 lN 400M1TWO PACK METHACRYLATE ADHESIVE- 12 Nos
ii.DISPENSER FOR 400M11:1 RATIO MMAADHESIVE MAKE HILTI- 1 No

Total Required Qty L set Consignee 430A PL No. 3053N082

sl. Coach No.of B.O. Major Sub

Coach Description PCRT Qtv B.O.No.
No. Code sets Qtv Grp Grp
1 889 TS DTC 1 L L 540775 38 30 63

Request Prepared By
I
Narne N.SRINIVASA RAGHAVAN Signature
Nff__ Date 2L,O6,2023

uest roved

Narne T.RAVICHANDRAN Signature \"P*n*rLftmrA. Date 21.06.2023

 No tcF/cAM/M PO/F/03
INTEGRAL COACH FACTORY,CHENNAI - 38
DATE
5-1302 REQUEST FORM PAGEzOF2
Rate Reference & Source of Supply (ESTIMATE ILPR/BQ Details)
ESTIMATE DCIAiIS
PRICING FORMAT ESTIMATE DATE ESTIMATE QUANTITY ESTIMATE VALUE
NUMBER
PMIE/FU R/s068 2L.06.2023 1 SET Rs.643 10/-

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

Code

B.q Details copi

I RE PSI Un it Rate
Sl. No. Vendor Name with Address B.Q.Ref. Qtv
All incl. rate
Vendor code

SOURCE OF SUPPLY DETAIL

sl. TREPS/
Vendor Name with Address
No Vendor code
L lndira Enterprises 1057212

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

submitted)
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
lndent No.
Drawing requisition sent on
lndent submitted on
Target date for submission of lndent
No. days delayed Beyond Target Date

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ssE/M PO/FU R APLE-I