NO.

Form : FM-LG-07

Form Material & Services Revisi : 0

Request Tanggal : 25-Des-2017

Unschedule Schedule
Date : 25-Des-2017
Work Request Material Request

Project Name : MEB PROJECT

GT1 GT2 BOP 1 CCPP 1 CHILLER 1
GT3 GT4 BOP 2 CCPP 2 CHILLER 2
TM2500 BOP 3 BOP 4
GS HSE/SEC W/H
Posting Budget # : 6000202004 Technical and CAPEX OPEX
Engineering Fees Local
NB LB RB

Request Stock* Order*

No Technical Specification Estimate Price*
Qty Unit Qty Unit Qty Unit
1 SWITCHGEAR CCPP DEB ASSESSMENT: 1 LOT - LOT 1 LOT 0
1. RELAY TEST: GENERATOR PROTECTION BECKWITH ELECTRIC
M3425A (1PCS)
2. RELAY TEST: MOTOR PROTECTION RELAY SIEMENS (5 PCS)
3. ACB 400 V 800 A (1 PCS)
4. VCB 6,6 KV 630 A (8 PCS)
5. VCB 12KV 1250A (2 PCS)
6. CT (10 PCS)
7. VT (3 PCS)
8. AMPERE TRANSDUCER (1 PCS)
9. VOLTAGE TRANSDUCER (1PCS)
10. AMPEREMETER (1 PCS)
11. VOLTAGEMETER (1 PCS)

Document Attached : Justification :

1 Picture In Diagram
2 Terms Of References
3 Pictures
4 Email Correspondances

USER MANAGER OF DUTY HEAD of DEPARTMENT WAREHOUSE

Date : Date : Date : Date :