Security Level 2

INSPECTION RELEASE NOTE

This issue of inspection release note does not relieve the vendor nor supplier from PROJECT
the responsibility and guarantee stipulated in the conditions of purchase order.
i III
Work No. 18123 Req. No. - Report No. 18123-ISP-IRN-RUP-CVL-0021-IRN-001

Vendor PT. DUTA HITA JAYA Manufacturer

PO No. i-III-RUP-CVL-021

1. This order has been inspected completely (whole lot) partially (partial lot)

2. Are there any Licensable good included in below listed items (ref. Contractor's Shipping Instructions)

Yes No If yes, mark Asterisk ( * ) behind the Item / Tag No's

Quantity
Item No. Item Description PO Req. Released Balance Remark
(Kg) (Kg) (Kg)

- Steel Structure RUP 21 1371.00 1371.00 -

- Bolt M20 x 55 mm 25 Pcs 25 Pcs -

=== END ===

Note: *Packing List No 068

*Delivery Note
*Inspection Report
Vendor Person contacted : Date (D/M/Y) : 12-Dec-20

Inspector : Nurhamsyah S.