ANNEX 16.

F ORDER REQUEST

ORDER REQUEST
Page (X/Y):      
OR:       Project Number:       Budget Lines:      
From (Program): Requested Delivery Destination: Final Destination:
                 

Date of OR:  Requested Delivery Currency:

  Date:
                   
 
  To be filled by Procurement:
Estima- Estima- Actual
Item #

Description: Qty: Unit: ted Unit ted Total Price Remarks:

Price: Price: Paid:
                                         
                                         
                                         
                                         
                                         
                                         
                                         
                                         
                                         
                                         
                                         
                                         
                                         
Total number of items requested:                  
  Remarks:       Actual Delivery Date:      
Project Manager Finance Review Authorised by:
Requestor:
  Approval: Approval:
Name:
                       
  Title:
                       
 
  Signature:
 
Date: