JABATAN BENDAHARI

KAMPUS KESIHATAN
UNIVERSITI SAINS MALAYSIA
PESANAN RASMU
ffilj,,Tvl' 16150 KUBANG KERIAN KELANTAN
Tel :09-7672114
PURCHASE ORDER

Ulilvlfl$Tl SAll6 }lALAnlA

No Pesanan /Qrder No:

farikh /Date.
Kepada /To:
2410512021
MEDILIANCE (M) SDN BHD PSHPEMB2000000004880
NO.11-2, SRI MANJA SQUARE II
.rnlnu PJS 3/59, TAMAN sRl MANJA Tarikh Penghantaran:
No. Permohonan:
46000 PETALING JAYA Delivery Date:
SELANGOR Requisltion No.:

2310712021
000000004880

No. Sebutharga/Tender:
Kod Pembekal & No SST: N=--o.
Ketutusan Aset: (ika berkenaan)
Quotation/Tender No. :
Vendor Code & SSf No.:
SH3/21lBM/HUSM/U/122
vD486369-P

RujukanllReferencel:KERJA-KERJA''MAINTENANCESERVICEFoRMICRoScoPE

Rujukan 2 I Reference 2: CARL ZEISS" KE HOSPITAL USM'

Rujukan 3l Reference3:

Rujukan 4l Reference4:

Rujukan 5l Reference 5: HOSPITAL UNIVERSITI SAINS MALAYSIA

Akaun Dikenakan I Chargeable Accounts: 100 HPEMB

pada harga seperti tercatat:

Sila bekalkan barang-barang / perkhldmatan
price as stafed below;
Please supply goods /services at the
Harga Unit Cukai Jumlah Harga
Unit
Bit. Kod ltem Keterangan ltem
Unit Pice Per Unit Tax Total

No ltem Code Desci?tion

3,892.50
1.00 TIME 3,892.50 0.00
@cARL zElss-oPMl vARo 7oo
S/N: 663610'l 102 2,885.00
1.00 TIME 2,885.00 0.00
2 28902-1 CARL ZEISS-OPMI VARIO / S88
S/N: 366007 2,885.00
1.00 TIME 2,885.00 0.00
3 28902-1 CARL ZEISS-OPMIVARIO / S88
FID STAND
S/N: 512894
2,226.00 0.00 2,226.00
1.00 TIME
4 28902-1 CARL ZEISS-OPM I PO-MAGISiSS
S/N: 330921 6,066.50
1.00 TIME 6,066.50 0.00
5 28902-1 CARL ZEISS.PANTERO
S/N : 40'l 42416631 401 424
4,675.00 0.00 4,675.00
1.00 TIME
6 CARL ZEISS-OPMI NEURO/NC4
28902-',1
S/N: 319804 2,862.00
1 OO TIME 2,862.00 0.00
7 28902-1 CARL ZEISS-OPMI LUMERA T/S8
S/N:6215'145994
TEMPOH KONTRAK: 1 TAHUN
20 APRIL 2021 - 19 APRIL 2022
KEKERAPAN : 2 KALI SETAHUN
KALI PERTAMA / 2 LiJ
i f"1
L'J
a!

*
*J

6
o
 JABATAN BENDAHARI
KAMPUS KESIHATAN
UNIVERSITI SAINS MALAYSIA
ffilffilvl
t.wgr- 16150 KUBANG KERIAN KELANTAN PESANAN RASMU
Tel:09-7672114
${UENSITI SAINS MAIAYSIA

Jumlah: MYR 25,492.00

Silaambilperhatianpembekalperlumencatatkanayat.ayatberikutdiatasinvoisyangdikemukakanuntukbayaran:
for payment:
sentence on the invoice submitted
Please note the supplier must include the following which the contract was awarded or to the
quality laid down in
,,Thisis to cedify that thequarity of stores delivered in the consignment is not infeior to the sample for
"
the specifications, whichever is applicable

lnstructions To SuDolier:
Arahan Keoada Pembekal:
with supplef s invoice for
bersama invois pembekal 1 . Please return the ORIGINAL COPY of this order
1. SALINAN ASAL pesanan ini IVESTI dikembalikan payment
sebagai syarat bayaran. be sent to the address
dialamatkan kepada 2. All conespondence relating to this order should
2. Surat-menyurat yang berkaitan dengan pesanan ini hendaklah below.
alamat Penghantaran.
di bawah' 3. All invoices M]ST be sent to \NVOICE ADDRESS below'
3. Semua invois MESTILAH dihantar ke ALAMAT INVOIS 4. The Order No and Vendor Code must be quoted in all coneswndence
dicatatkan di dalam semua
4 No. Pesanan dan Kod Pembekal hendakiah
and invoice.
surat-menyurat dan invois. via lnter Bank
Pembekal melalui 5. Alt payments wilt be credited to the Suppliefs bank account
5. Semua pembayaran akan dikreditkan ke akaun bank Giro facility.
kemudahan lnter Bank Giro. parcel'
di setiap bungkusan' 6. The following shipping marks should appear on every
6. Tanda perkapalan/penghantaran berikut mestilah ditulis

,,sava bernama dan betlandatangan di bawah dengan ini mengisytiharkan bahawa tiada
TANDA PERKAPALAN; ;:i.;;;;;';;;;;iiiiii iiii-x;rusa terdekat v;ns mempunvai apa-apa kepentinsan
mana-mana ,*""n p"roaiz|"iiig-Jixzniaritirm
o6n si,ya saya iuga mengakujanii
Shipplng Slgns dalam
"riii'o,iiil,iggiiig1awat ternaaap i'eiiraig tindakan dan keputusan saya dan akan sentiasa
memastikan urus tadbir baik t)nii"iitiiirl;iin'u*
d"
sega/a proses peru ndangan Universiti
"
o,irx,iiian pemoetian, pesanan dan perolehan dipatuhi

Disediakan oleh: Diluluskan oleh:

Prepared bY:
gtrj$i{u
ALAMAT PENGHANTARAN
Delivery Address

Kepada:

NOOR HISYAMUDDIN BIN ALW

UNIT BIOMEDIKAL,
ine. prMenNcuNAN & PENGURUSAN ASET,
KAMPUS KESIHATAN,
UNIVERSITI SAINS MALAYSIA' Signature & Chop of Head of Depadment

24 'T'Ll
16150 KUBANG KERIAN
KELANTAN DARUL NAIM Tarikh/Date:
Tarikh /Date: 2410512021

ACKNOWLEDGEMENT RECEIPT
ALAMAT INVOIS
lnvoice Address lAA/e hereby acknowledge receipt.a copy
ofthe Purchase Order and agree
Terms and Conditions contained hereln'
to abide by the
Kepada:

EN. MOHD ROSDI BIN ZAKARIA

UNIT BIOMEDIKAL,
JAB, PEMBANGUNAN & PENGURUSAN ASET,
KAMPUS KESIHATAN,
Signed on behalf of the comPanY bY
UNIVERSITI SAINS MALAYSIA, Name :
16150 KUBANG KERIAN
KELANTAN
Company StamP :

Date :

G
m
m
s*+

tl
6
o