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INSPECTION RELEASE REPORT NO. / REV. NO.:

CERTIFICATE DATE OF ISSUE:

INS’N DATE:

MAIN CLIENT NEOM PO NO.

CLIENT MATERIAL
BI NO IL NO. n/a

GENERAL INFORMATION
Project Title
Vendor Name
Manufacturer Name
Subcontractor Name -
Main Client PO -
Subcontractor PO
Inspection Location
Inspection Level
Inspector Name
Material Requisition No.
Reference Inspection Report No.
IAP No.
PO STATUS Complete Incomplete

Po Item# Po# Description P.o Offered Released

Quantity Quantity Quantity
01

02

03

04

Material is released as per Purchase order and NEOM requirements

Material is released based on the condition that
Material is released for further
Material is Partially release as per

The Issuance of this release notice neither relieve the vendor/ Manufacturer/ Supplier from any responsibility, contractual nor purchase order
obligation or guarantees, nor shall it be interpreted in any way so as to imply acceptance of the goods.
Contractual responsibility for the completeness, compliance and technical accuracy of all items reference above rests completely with the
vendor/ Manufacturer/ Supplier.

Inspector Name: Signature and Stamp: Form No.