G O O D S R E C E I P T S L I P No.
5000039340 Page 1
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Goods receipt date : 24.02.2022
Current date : 24.02.2022
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Plant : 2ADA
Description : LSA-Site Plant
Vendor : 3100002469
Name : UD MAGRINA TANI
PO : 1100000147
Pur. group : 193 BC PGRP Site 02 Telephone :
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Itm Material Description
MPN
0001 10121702-0001 FISH FOOD
K 2ADAD12101 YKR 5 PAC
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Digitally signed
Issued by: 13100868 S I G N A T U R E by Yuni Kristiani
Date: 2022.02.24
12:39:01 +08'00'
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Digitally signed
by Irawati Dian
Acknowledge by : Sari
Date: 2022.02.25
08:52:51 +08'00'
GR. 5000039340
Digitally signed
by THR
Date: 2022.02.24
11:27:01 +07'00'
PT LASKAR SEMESTA ALAM
Cyber 2 Tower 24th floor,
Jl. HR Rasuna Said Blok X-5 No. 13
Jakarta Selatan 12950
Phone:622125533000, Fax:622125533000
02.491.421.0-011.000
PURCHASE ORDER
NO: 1100000147
Page : 1 of 2
Vendor
PO Date : 11 February 2022
Quotation No. : 8000123497
[email protected] Agreement No. :
UD MAGRINA TANI PO Type : PO-Ad Hoc
JL JEND A.YANI NO.41 RT.7 Revision : 0
TABALONG 99999 Buyer Name : MOHAMMAD HASNIRA HERLANGGA
Ph:/Fax: Buyer E-mail : MOHAMMAD.HERLANGGA@ADARO.
Delivery Address Invoice Address
BC-LSA-Site Plant Finance & Accounting Dept
Hauling Road Balangan Coal PT LASKAR SEMESTA ALAM
Km 75+500 Cyber 2 Tower 24th floor,
Balangan Paringin 71662 Jl. HR Rasuna Said Blok X-5 No. 13
Jakarta Selatan 12950
Please Supply the following goods or service as per terms stated herein Currency:IDR
No. Material/Service Delivery Date QTY UoM Unit Price Item Disc Total Price
00010 10121702-0001 18 February 5 PAC 270,000.00 0.00 1,350,000.00
FISH FOOD 2022
GENERAL
Pakan Ikan Mas, Nila dan
Patin(karung) @30kg - Aktif protein
18%
Sub Total : 1,350,000.00
Discount : 0.00
Surcharge / Fee : 0.00
Freight : 0.00
Total Net : 1,350,000.00
VAT : 0.00
Total Amount Of Order : 1,350,000.00
Comment or Special Instruction
PR: 1100000064
Form No.
PT LASKAR SEMESTA ALAM
Cyber 2 Tower 24th floor,
Jl. HR Rasuna Said Blok X-5 No. 13
Jakarta Selatan 12950
Phone:622125533000, Fax:622125533000
02.491.421.0-011.000
PURCHASE ORDER
NO: 1100000147
Page : 2 of 2
Vendor
PO Date : 11 February 2022
Quotation No. : 8000123497
[email protected] Agreement No. :
UD MAGRINA TANI PO Type : PO-Ad Hoc
JL JEND A.YANI NO.41 RT.7 Revision : 0
TABALONG 99999 Buyer Name : MOHAMMAD HASNIRA HERLANGGA
Ph:/Fax: Buyer E-mail : MOHAMMAD.HERLANGGA@ADARO.
Delivery Address Invoice Address
BC-LSA-Site Plant Finance & Accounting Dept
Hauling Road Balangan Coal PT LASKAR SEMESTA ALAM
Km 75+500 Cyber 2 Tower 24th floor,
Balangan Paringin 71662 Jl. HR Rasuna Said Blok X-5 No. 13
Jakarta Selatan 12950
Please Supply the following goods or service as per terms stated herein Currency:IDR
Term & Condition
Payment Term : Within 30 Days Due net
DP : 0.00
Inco Terms :
Prepared By/Date Approve By/Date
MOHAMMAD HASNIRA HERLANGGA/10 February 2022 IRAWATI DIAN SARI/11 February 2022
This Document has been approved electronically in the system, no sign required
Form No.
