No.

:
NAMA PT/CV Rev. :
Tanggal/Date :
LOGO PERUSAH NAMA PROYEK Hal./Sheet : 1/1

FORMULIR PERMINTAAN PEMBELIAN (PURCHASE REQUISITION)

Divisi Pemohon Tanggal Diperlukan
(Requisitioning Department) Required Date

………………………………………………………………………………………

Tujuan ……………………………………………………………………………………… Anggaran Pembelian ≤ Rp 50 jt

……………………………………………………………………………………… (Purchase Budget)

(Purpose) ≥ Rp 50 jt
Rincian Permintaan / Request Details

Kode Barang Keterangan Kuantitas Estimasi Harga

(Quantity) (Estimated Price)
No. (Material Code) (Description) Qty Satuan Per Unit Total Harga

TOTAL

Catatan/Note:
Normal
Urgent
ASAP

Diminta Oleh / Requested by : Diperiksa Oleh / Verified by : Diterima Oleh / Accepted by :

Department: Construction Manager Procurement

Tgl/Date: Tgl/Date: Tgl/Date:

Disetujui Oleh / Approved by :

Project Manager
Tgl/Date:

Komentar / Comment :
…………………………………………………………………………………………………………………………………………………………….
…………………………………………………………………………………………………………………………………………………………….
…………………………………………………………………………………………………………………………………………………………….
…………………………………………………………………………………………………………………………………………………………….
…………………………………………………………………………………………………………………………………………………………….
MATERIAL CONTROL PROCESS FLOW CHART

Material Initial Issue Review

Receivin Inspectio MIR MIR
g n
Rejec Accept
t Issue MIR Review
with MIDR
MIDR

Return to
Supplier
N
o Take Re-
Segregate to No
Quarantine Area Repairable Remedial Inspectio
? Yes Action n

Urgent Reject
Material

Ye
s
Produce Comply with Yes Release to
Release Note Requirment production

N
o
Deficiency
Cleared ?

No

PANDUAN III - FLOW CHART OF MATERIAL CONTROL

 Joint Store in
Inspectio Accep Designated
n t Area

Rejec
t Issue MR

Release to
Productio
n
Re-
Inspectio Close
n MIDR
Piping /
Structure
Reject Material

Release to Fill-in Fit-up

production Inspection
Report

Deficiency Yes Close Tranfer to cutting

Cleared ? MIDR plan/drawings

No
 No.
NAMA PT/CV Date
Vihicle No.
LOGO PT/CV NAMA PROYEK Driver / Carrier

GATE PASS
Quantity
NO. Material / Equipment Description List Actual Unit

Remarks:
Prepared by Checked by Approved by Driver / Carier by Security
000/GP/Project No./Bulan/Tahun

Remarks
Received by
 No.
Date
LOGO PT/CV

PACKING LIST
Nama PT CONTRACT/ORDER NO. :
To : DATE OF ISSUE :
Project : Job No. :
Attn : FROM :
Cc : Rev. : 0

Fax No. :
SIZE (mm) Weigth / Unit Total REMARKS

NO DESCRIPTION PCWBS L x W x H QTY NET Pack Gross Qty Spool Area (M³) Gross Weigh (Kg)

KOLI -
1

LOOSE PART
1

TOTAL 0 0 0

Prepared by, Checked by, Approved by,

____________________ ____________________ ____________________

Page 8 of 25
 Date : #REF!
Our Ref No. : #REF!
Logo PT/CV Rev. : #REF!

Nama PT
To : #REF!
Project : #REF!
Attn : #REF!
Cc : #REF!

Fax No. : #REF! • Shipping Coordinator

Subject : REQUEST FOR SHIPPING RELEASE

Dear Sirs,

Please release the shipment as described below :

1. Purchase Order No. : #REF!

2. Vendor's Name :

3. Shipping Term :

4. Main Material / Equipment :

5. Loading Port : -

6. Estimated Measurement : #REF! m³

7. Estimated Gross Weight : #REF! kgs

8. Estimated Heavy & Oversize Cargo : - (if any)

9. Estimated Delivery Date : #REF!

Your kind attention will be highly appreciated.

Yours faithfully, Aproved by

Nama PT

Nama PT Q. C. Div. Shipping Dept.

Note :
VENDOR shall inform PURCHASER of above information at the latest 14 calender days before shipment (attached w/
Mill Certificates, Certificates Origin by Chamber of Commerce, Test Report, Certificate of Compliance, Packing List).
 100+7 861

100 + (711 x 2) + 50 12000

1572

SKETCH KOLI B
 TST- MCP-001 rev A
LAMPIRAN II

Logo PT/CV MATERIAL INSPECTION REPORT

Supplier Form No. Rev. Report No.

Job No.
Description PO No.

Quantity Status
No Material Order Recd Heat no Mill Cert. No. Acc/Rej Remark

Remarks :

PREPARED BY CHECK BY WITNESS BY

Sign
Date
Name

Material Controller QA/QC Client Representative

 TST- MCP-001 rev A
LAMPIRAN III
LOGO PT/CV

MATERIAL INSPECTION DEFICIENCY REPORT

Supplier : Supplier : Supplier :

Pt. of Origin : Pt. of Origin : Pt. of Origin :

Del. Carrier : Del. Carrier : Del. Carrier :

(Truckline, Railroad, Airline) (Truckline, Railroad, Airline)

Carrier's No. : Carrier's No. : Carrier's No. :

(Frt, Bill, Waybill, B/L, Etc) (Frt, Bill, Waybill, B/L, Etc)

QTY
P.O Items Material ORDER RECORD DESCRIPTION OF MATERIAL DEFICIENCY

Remarks :

Proposed Recommendation :

Follow-up / Close-out Comments :

Estimated Cost To Repair Damaged Or Replace : IDR

Exception Taken on Delivery Documents :

Yes No Carrier Notified No.

Insurance Surveyor Notified on Shipment Inspected on

Copy Inspection / Survey Report Attached :

Yes No Photos Attached Yes No

Original Frt. Bill AttachedYes No Delivery Document Attached Yes No

Was Damaged or Loss Due to Poor Packing ? Lack of Precautionary Marks ? Other Reason ?

Explain :

Do not dispose of containers or packing until after inspection by claim agent

Prepared By : Close Out By : Prepared By :

Material Coordinator Material Coordinator Client representative
Date : Date : Date :
 NAMA PT/CV

LOGO PT/CV NAMA PROYEK

DAMAGE, SHORTAGE AND OVERPLUS REPORT FOR DELIVERIES

No.

Receiving date.

Please select:
Damage
Shortage
Overplus
Misdirected

Company or supplier.

Location (Warehouse).

PO or order number.

Serial number and discription (material).

Describe the problem.

Action here in after.

Note:

Checker by Review by Approved by,

 NAMA PT/CV
LOGO PT/CV NAMA PROYEK

MATERIAL TAG
PROJECT :
MIR NO :
INSP. DATE :
INSPECTED BY :

STATUS MATERIAL (FOR USE or Do not Use)

DATE :
PROJECT :
ITEM CODE :
ITEM DESCRIPTION
:
REMARK :
ISSUED BY :
SIGNATURE :
 NAMA PT/CV No. : ………………….

LOGO PT/CV Proyek Date : ………………….

MATERIAL ISSUED SLIP

No. Code Materials Description Qty Unit Serial Number Remarks

White : Chief Procurement (Office)

Yellow : Rek - Warehouseman
Pink : Rek - Receiver

Requested by Reviewed by Approved by Issued by Received by

 NAMA PT/CV No. :

LOGO PT/CV PROYEK Date :

TANDA TERIMA BARANG

No Material Code Materials Description Qty Unit Serial Number Remarks

Note :

Issued by Received by

PT. PT.
 NAMA PT/CV No.

LOGO PT/CV NAMA PROYEK Date

FUEL SLIP
*One Slip One Day

No. Fuel Name (BBMachine / Vihicle / TruckSerial Number Last Hours / KM (E Issued Volume Actual Volume Location

White : Chief Procurement (Office)

Yellow : Rek - Warehouseman / Material Control
Pink : Rek - Receiver
Requested by Checked by Issued by Approved by
 NAMA PT/CV

LOGO PT/CV NAMA PROYEK

OPNAME / INVENTORY FORM

No. Matl. Code Name Description Spec. Size/Dim.

 Date
PIC Name
Sheet

Location
Type/Model Serial No. Code Name Loc. REMARKS
BUKTI KAS MASUK / KAS KELUAR
PLANT :
TANGGAL : NO :

NO KETERANGAN DEBET KETERANGAN KREDIT

JUMLAH JUMLAH
dibuat oleh, diterima , diserahkan, Acc,
 Kepada Yth:

KWITANSI No. .............................

Terima Dari :

Sejumlah Uang :

Untuk Pembayaran : ............................................................................................................................................................................................

............................................................................................................................................................................................
............................................................................................................................................................................................
............................................................................................................................................................................................

Jumlah :

Yang menerima,

(................................)
Pembayaran dianggap sah setelah dicairkan ke rekening kami
 NAMA PT/CV

LOGO PT/CV NAMA PROYEK TANDA TERIMA UANG

Telah diterima dari :
PT :
Uang sebanyak :
Terbilang :

Guna Membayar :

Jakarta, 00 Juni 2022

FUND REQUEST MEAL OVER TIME

Date Ket Over Time :

Supervisor

No Nama Posisi Area Remarks

Note : Form meal over time harus dikembalikan maksimal pukul 15.00 WIB, untuk persiapan pembelian kons

Prepared By, Acknowledge Approved by,

PT. YASA INDUSTRI NUSANTARA PT. YASA INDUSTRI NUSANTARA PT. YASA INDUSTRI NUSANTARA

DRAWING DRAWING MATERIAL REQUEST

PCWBS: PCWBS: MR. DETAIL/COVER

LEVEL-1 LEVEL-4 MIS

LEVEL-2

LEVEL-3

(A) (A) (A)

MC / SC MC / SC MC / SC

GPF-JTB (AG) GPF-JTB (AG) GPF-JTB (AG)