PURCHASE REQUEST ORDER

BALKON MILK BAR DATE

Jl. H. Hasan No. 19, Lantai 2
Kec. Coblong, Kota Bandung, Jawa Barat 40132 PURCHASE REQUEST ORDER NO.
(+62) 899-728-8820

VENDOR SHIP TO DEPT

BAR
SHIP VIA DELIVERY DATE

NO DESCRIPTION QTY SIZE UNIT PRICE TOTAL

1 IDR -
2 IDR -
3 IDR -
4 IDR -
5 IDR -
6 IDR -
7 IDR -
8 IDR -
9 IDR -
10 IDR -
11 IDR -
12 IDR -
13 IDR -
14 IDR -
Remarks / Instructions: SUBTOTAL IDR -
SHIPPING COST ESTIMATION IDR -
OTHER IDR -
TOTAL IDR -

DATE AUTHORIZED SIGNATURE

For questions concerning this purchase order, please contact

Rezvani, (+62) 899-728-8820, rzv@marezvaconsultant.my.id