MATERIAL REQUISITION FORM

HAI LECK ENGINEERING PTE LTD HAI LECK INTEGRATED SERVICES PTE LTD

HAI LECK ENGINEERING & CONSTRUCTION PTE LTD HAI LECK SERVICES PTE LTD

HAI LECK INDUSTRIAL SERVICES PTE LTD

If there are any amendment's or alternation made to quantity & description in the MR, it must be Initial & dated by the respective Managers. Form No: STO-QR-03
T: 6862 2211
Please Tick Accordingly : F: 6862 1202
Winky Metal & Steel Material (Mechanical), Gases, Walkie Talkie New, Insulation, Refractory, Freight Forwarding Reference No:
PPE, Heavy Machinery & Equipment(Purchase only), Blasting Painting, Vehicle & Equipment Spare parts
Date: Monday, July 19, 2021
Miko Bolt/Nut & Gasket, Heavy Machinery & Equipment (Rental only), Diesel, Eletrical
Category : Please tick one of the below in bold
Jesslyn IT, Furniture, Hardware & Consumable, Office supplies Scaffold
Painting
Prakash Calibration & Recertification / Servicing Refractory
Insulation
Venkat Logistics, Scaffold Material , Walkie Talkie(Repair), Vehicle repair & servicing Mechanical
Miscellaneous

For Rental of equipment, please indicate the duration required

From: ______________ To: ________________

For Procurement Use Only

S.No. Description Stock Code Size Qty
PO / WO No Supplier Unit Rate Date Received

1 ANFLEX-AF911-1/2" ISO 1307, 20 BAR AIR/WATER HOSE (300BAR) 1/2" 3 rolls

2 Hose Clip 13mm 13mm 200 pcs

3 Chicago Coupling 50HE 1/2" with hose shank 1/2" 200 pcs

4 O-ring 3/4" 3/4" 500 pcs

5 Aluminium Washer For Nozzle 4.3 cm 50 pcs

4.3cm ID x 7.7cm OD x5cm Thk

6 Rubber Washer 4.4 cm 50 pcs

4.4cm ID x 7 cm OD x 3cm Thk

Remark: To be back-charged to Client Yes No Approval by Procurement Department

To be completed by site Purchased By
Requested By: Saw Wen Shen, Michael Approved By Don Cheng
Site / Dept: HLIS STORE Job Code: 300 Single Source Supply
Approved By: Yvonne Lim Client Specified Product
End User Specified
NOTE : Please separate all request by category.
: All request must be submitted 7 working days in advance. Revised copy : 21