DHL-FH-0000017 DHL SUPPLY CHAIN BERITA ACARA SERAH TERIMA BARANG Pada hari: Sabtu Tenaga: 23 Bulan: 9 Tahun: 2022 Bahwa yang bertanda tangan di bawah ini talsh melakukan serahterima barang berdararkan [bn free TAMAR "MRF-BAKT-SMT-202209-1422 (coret yp dak pert) _ ae Namaste Nama Proyek lah & Jens Kendaraan Vol Berat/ Kol mode Transport Pelaksanaan pengiriman Pangsung ke site. 10 Relokasi latihkan. Alasonnya 1 Dikembattan ke gudang. Alesannya © Disimpan sementar, sejaktonggal 1 Rusak Kondist kemasan/ peti Karton/ kardus Jumlah & jens Barang sesual dengan dokumen DN /MITR /MTA/MRF a Maa Keterangon lain ME Yang menyerakan Nama ‘Nama oe Tone Tangsst sizsaoe Perusahaan: DML SUPPLY CHAIN Perusahaan He 1266081970 HP joist alee Soe cue ae EH age tage Mf = (60DHL Supply Chain Indones ia DELIVERY NOTE SHIPMENT 1D : MRFBAKTISMT202209142 ShipTo: SMUO00ES 2 INDONESIA KOMINFO 46 BTS Project BAKT! SCHEDULE DT 23 September, 2022 : ORDER TYPE SUMBAR ‘Swasondes: CLOSE DATE +: 23 September 2022 13:51 LOAD NUM 50741 TRIP NUMBER ‘SMU000833 Padang, indonesia - Indonesia cae TRUCK 10 TRUCK SEQ 1 STORE SEQ 1 USERDEFS ME ‘TRANSPORTER No.} Tem ITEM DESC tot | exp.paTe | quantity | REMARK 7]KSS10040000 |Cadwelded Powder 90 Gram | BTSPROJECT |25 Feb 2025 Welee lozao Sub Total TY 70 Prepared By: ‘Acknowledged By: Received By: Checked By: Glens Teer Tr (Admin) (WHS SPViLeaden) Transporter (Store) Date Date [Date [Date Printed 28-Sep-2022 02:56:32 PM Map Coordinate Delivery NoteMaterials Requisition Form |Padang (1017) JI Bypass KM 22 , Kel [Batipuh Panjang , Kec Koto [Tangah , Pergudangan Haji Morsel1 RECEIVER: ISMUO0083 (HILIORAHUA TASUA) [INDONESIA KOMINFO 4G BTS Pro} ject BAKTI (BAD, JAN AKSESIBILITAS TELEKOMUNIKAS! DAN INFORMASI) [c-112023902-1-SMT_ [RECEIVING WBS CODE = [c-112023902-1-SMT-0057 IMRF-BAKTI-SMT-202209-1422 |FORWARDER Ni AME: PT. Bintang Komunika Utama R202209221458255903 [EXPIRE DATE: [20221012 [MATERIAL CODE [NAME OR DESCRIPTION quanriry vom —_ eLeAseo (soufeceiven rece] [xsst00400000240 [cadwelded GunPowder 90 Gram io Pe ‘SMUO0083(HILIORAHUA TASUA) [= Nothing Follows*#= |PIBERHOME APPROVER: Fé, 2 Source: Padang(1017) 24/, Name Date Zane to 2028-09-22 Pack rar Signature Over Printed Name/Date |Signature Over Printed Nane/Date WCAG [SOURCE PROJECT MANAGER: ze RECEIVER: SMUJO0083(HILTORAHUA TASUA) = Wawe/Date ‘ 1 2022-09-22 dp all Signature Over Printed Name/Date Signature Over Printed Nene/Date Material Manager: FETE © pp ae Name /Date: Wann Nionpbe 2022-09-22 \roemsrogr Gor ip Signature Over Printed Nane/Date i Signature Over Printed ) INGTE? Once signed, the Warehouse Reprosentative, Subcontractor and/or Forwarder acknowledge receipt of the total quantity lof materials indicated in this MIA form Should there be any discrepancy in the type or quantity of material/s, coments lor remarks must be written in the columns provided before signing this document.DHL-FH-0000017 DHL SUPPLY CHAIN BERITA ACARA SERAH TERIMA BARANG ~_Sabtu__Tanggal = 23 (Bulan 3 _ahwra yang bertanda tangan di bawah ini telah melakukanserah terima barang berdasarkan Pada hen Tahun [on nee tanner "MRF-BAKTI-SMT-202209-1422, core yg tidak peru) Nama site Nama Proyek Jura & Jens Kendaraan |vol erat) Kali Mode Transport ‘elaksanann penaiiman ‘A Langsung ke site. © Relokasdialinkan. Alasannya (0 Dikembalkan ke gudang. Alasanaya 1 Disimpan sementars, ejok tenggal dd —_ Xondis kemasan/ peti kartor/ kardus oak Baik 1 Rusak Jumlah& jens Barangsesuai dengan dokumen ON /MTR /MTA/MRE oye Tidak ‘eterangon loin Me DDemikian Berita Acara ini dibuat dengan sebenarnya dan untuk dipergunakan sebagaimane mestinya. Yang menyerahian Transporter Penerima — A Taneeat CRG Perusahaan: BW HP Penerima tiba a sie, 18 jam engin tba dst, tl & jam Seles bongka, tl & jam Ul gler — 18%DHL Supply Chain indonesia DELIVERY NOTE SHIPMENT_IO MRFBAKTISMT202209142 StipTo: SMuoG08s 2 INDONESIA KOMINFO 4G BTS Prejct BAKTI SCHEDULE DT 23 September, 2022 ‘ORDER TYPE ‘SUMBAR sums CLOSE DATE 23 September 2022 13:51 LOAD NUM 0741 TRIP NUMBER ‘SMU000883 Padang, Indonesia - Indonesia SEALID TRUCK ID TRUCK SEQ 1 STORE SEQ 1 USERDEFS ME ‘TRANSPORTER No.| ITEM ITEM DESC Lot EXP.DATE | QUANTITY | REMARK 1]KSs1D040000 |Cadwolded Powder 90 Gram IBTSPROJECT |25 Feb 2025 yolec 0249 Sub Total OTY 10 Prepared By: Acknowledged By: Received By: __ Checked By: Vv A. Stange Tra ala (Admin) (WHS SPViLeader) Transporter (Store) Date: Date: Date: Date: Printed 23-Sep-2022 02:55:32 PM Map Coordinate Delivery NoteFiberHome? Materials Requisition Form Eel eet Padang (1017) JJ1 Bypass KM 22, Kel |SOURCE: [Batipuh Panjang , Kec Koto |RECEIVER: —_|SMU00083 (HILIORAHUA TASUA) [Tangah , Pergudangan Haji Morsel1 [PURPOSE: INDONESIA KOMINFO 4G BTS Project BAKTI (BADAN AKSESIBILITAS TELEKOMUNIKASI DAN INFORMASI) ORIGIN WBS CODE: _[¢-112023902-1-sMT RECEIVING WBS CODE (¢-112023902-1-SMT-0057 MRF NO: IMRF-BAKTI-SMT-202209-1422 | FORWARDER NAME: PT. Bintang Komunika Utama Signature Over Printed Nawe/Date Waterial Manager: INane /Date: w Signature Over Printed Name/Date Signature Over Printed Name/Date HON. 102209221458255903. EXPIRE DATE: 20221012 MATERIAL CODE (NAME OR DESCRIPTION QUANTITY uom RELEASED (SOURECEIVED (RECE| NOTES SITEID |KSS1D0400000249 |Cadwelded GunPowder 90 Gram 10 Pc SMU00083(HILIORAHUA TASUA) T= Nothing Follows*>™ [TRERHONE APPROVER: Ft SOURCE: Padang (1017) ) A, |ame/Date Eta 2022-09-22 tr "ep| Signature Over Printed Name/Date Signature Over Printed Name/Date — Here [SOURCE PROJECT MANAGER: = RECEIVER: — SMUOOO83(HILTORAHUA TASUA) ie |Wame/Date s 2022-09-22 hy aq! 2022-09-22 | FORWARDER Signature Over Printed ! oe g Sohn NOTE! Once signed, the Warehouse Representative, Subcontractor and/or Forvarder acknowledge receipt of the total quantity lof materials indicated in this MTA form Should there be any discrepancy in the type or quantity of material/s, comments Jor remarks must be written in the colums provided before signing this document.