PURCHASE REQUISITION FORM

NUNHEMS ETHIOPIA PLC

Date
PR#
Requisitioner Information:
Name:       
Department:
Required Delivery Date:

A short description of purpose/requirement for purchase of the item(s):    

DESCRIPTION

measurem
Quantity

UNIT of
ITEM #

Give all the particulars you know: size, weight, color,

ent
ingredients, material capacity, voltage, etc. (Catalog/part
number, if applicable;)
1
2
3
4
5
6
7
8
9
10
11
12
13
14

Requisitioner: Department Approval:

Signature / Date Signature / Date

Distribution: 1. Accounts 2. Procurement & Logistics 3. Requisitioner department

N.B - Please complete the information and obtain approvals. Forward the completed and approved form to the Procurement and
Logistics Department. Forms that are not approved or incomplete will be returned to the requisitioner.

1 - Farm Store  □
2 -  Addis Ababa office  □
3 -  CSR  □
4 -  HVLM  □