Document No.

:
FORM Revision : 03
PURCHASE ORDER Effective Date :

Vendor Vendor Number PO Number

Date of PO
Delivery Date
Term of Payment

Account

No Description Quantity Unit Price Discount Amount

Sub Total
PPN
PPh
TOTAL

Note:
Each Supplier must provide Personal Protective Equipment when delivery/visit/working on company depend on the risk.
Setiap supplier wajib menyediakan APD ketika melakukan pengiriman/kunjungan/bekerja di area Perusahaan

Ordered By, Acknowledged By, Confirmed By, Approved By,

Issuer Requestor Requestor Superior Acct. Dept. Head President Director

Supplier Confirmation, *) Please send us back the PO confirmation by Email to the Issuer
*) Apabila sudah terima PO, mohon dikirim kembali ke kami
melalui email sebagai konfirmasi PO.

Name: Date: