PURCHASE REQUISITION FORM (PR)

REQUESTER INFORMATION: NOTE: Signed Hard And Soft Copy To Be Emailed To: KamoaStore@Ivanplats.com - For Stock And Non-stock Items Only
*Date of the PR: 2-Oct-20 For Any Special Instructions Regarding This PR: RFQ Closing Date: 5-Oct-20
UNDERGROUND CONSTRUCTION RFQ Number:
*Department: RFQ-KCSA
MANAGER (Procurement To Complete)
*Contact Name: Albie Janse Van Rensburg *Operations Order: Yes / No

*Telephone: 243,824,901,282 *Project Order: Yes / No

*e-mail: AlbieJ@KamoaCopper.com *Capital Order: Yes / No

COMPANY ADDRESS: Urgent PR for the Bowie Pump 4 C/W Control Panel.. PRIORITY CLASSIFICATION
.HIGHLY URGENT. AEL *Emergency Breakdown
2153, Avenue Club Nautique, Quartier Golf Les Battants
Critical Process 0
Commune de Lubumbashi, Ville de Lubumbashi *Urgent Process 1
Province du Haut-Katanga, République Démocratique du Congo *Normal Process 2
***If The Above Options Are Not Selected, Operation
Vat No. A0901048A
Order & Normal Process Will Be Selected By Default.
Reg No. 1998/000334/07 *Required By: (DATE)

*UNIT OF *BRAND / *PART

ITEM JDE ITEM NUMBER *QUANTITY QTY ON HAND *ITEM DESCRIPTION / SPECIFICATIONS UNIT PRICE TOTAL PRICE
MEASUREMENT MAKE NUMBER(S)
1 OX 1 0 EACH SUPPLY A BOWIE PUMP 4" C/W CONTROL PANEL AEL 0

2 0

3 0

4 0

5 0

6 0

7 0

8 0

9 0

10 0

11 0

12 0

13 0

14 0

15 0
Total 0
*BUDGET HOLDER SIGNATURE : *NAME: TORRA ENGELBRECHT *DATE: 6/12/2020
Total Amount 0
*COST CODE: *IN BUDGET: YES / NO
(MANDATORY FIELD) 101300001.100120.2265. *WBS CODE: 2265 (MANDATORY FIELD)