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CANVASS FORM 6/19/2021

*10207*
RCID 010207 Equipment GS-004 Make CATERPILLAR
RQID 006394 Model 500 Mod. Serial
Req # 21014706 Engine Make CATERPILLAR Engine C15
Status ASAP Engine Serial CYY001144 Chasis
QTY 2 Description Radiator Core Assy 4 Rows w/Rubber #283-5481 Jocel Delmonte
Unit pcs 06/03/21

RCID 010207 CANVASS FORM Page 1 of 4


CANVASS FORM 6/19/2021

*10207*
RCID 010207 Equipment GS-004 Make CATERPILLAR
RQID 006394 Model 500 Mod. Serial
Req # 21014706 Engine Make CATERPILLAR Engine C15
Status ASAP Engine Serial CYY001144 Chasis
QTY 2 Description Radiator Core Assy 4 Rows w/Rubber #283-5481 Jocel Delmonte
Unit pcs 06/03/21

RCID 010207 CANVASS FORM Page 2 of 4


CANVASS FORM 6/19/2021

*10207*
RCID 010207 Equipment GS-004 Make CATERPILLAR
RQID 006394 Model 500 Mod. Serial
Req # 21014706 Engine Make CATERPILLAR Engine C15
Status ASAP Engine Serial CYY001144 Chasis
QTY 2 Description Radiator Core Assy 4 Rows w/Rubber #283-5481 Jocel Delmonte
Unit pcs 06/03/21

RCID 010207 CANVASS FORM Page 3 of 4


CANVASS FORM 6/19/2021

*10207*
RCID 010207 Equipment GS-004 Make CATERPILLAR
RQID 006394 Model 500 Mod. Serial
Req # 21014706 Engine Make CATERPILLAR Engine C15
Status ASAP Engine Serial CYY001144 Chasis
QTY 2 Description Radiator Core Assy 4 Rows w/Rubber #283-5481 Jocel Delmonte
Unit pcs 06/03/21

RCID 010207 CANVASS FORM Page 4 of 4

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