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FIXED ASSET PURCHASE REQUEST FORM I.

ASSET DETAILS: Company Name: Category of Asset: Location for Capitalisation: Office: Store: Warehouse: Staff Accomodation: Mall: Others: II. REASON / JUSTIFICATION for PURCHASE: Legal: Replacement: Expansion: Others (Pl. specify): III. QUOTATION DETAILS (in the order of preference): S.No. DESCRIPTION Quantity Unit Price Total Price Other details/ info (Pl. specify Concept/Terr. Common &Floor #) (Pl. specify Name) (Pl. specify Street #) (Pl. specify Name) (Pl. specify Concept/ Terr. Common & Floor) (Pl. specify exact location details) Make/ Model:

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5 6 7 8 9 10 11 12 13 14 TOTAL DISCOUNT Final Approved Cost: QAR. -

Payment Terms :After Delivery Items
PAYMENT: 100% ON DELIVERY DELIVERY: WITHIN 2 WEEKS AFTER CONFIRMATION WARRANTY: 3 YEARS WARRANTY FOR FIXTURES AND 1 YEAR REPLACEMENT WARRANTY FOR ELECTRONIC BALLAST

IV. PROPOSER / APPROVER DETAILS: PROPOSER SIGNATURE NAME DATE V. ACCOUNTING DETAILS: Apps (Oracle Financials) Entry Invoice No. Asset No. ACCOUNTANT NAME/ SIGN. NAME/ SIGN. FINANCE TERRITORY HEAD SIGNATURE NAME DATE