MOBILIZATION REQUEST FORM

NO.
DATE: 12/18/2018
MASTER ADDITIONAL FREE OF CHARGE ADVANCE ORDER
✘ SAMPLE/DEMO WARRANTY REPLACEMENT

1. CUSTOMER DETAILS:
Customer Name: MMDA Order Voucher (OV) #

Address / Location: EDSA ORENSE REFERENCE #

Project Engineer/Contact# WILSON SUMALABE

Person-in-charge/Contact#

Contact Person on Site / Tristan Apostol 0906-4231238 Delivery Time Period: 7:00AM
From_ _:_ _(am/pm)To_ _:_ _(am/pm)
Contact# :

2. DELIVERY INSTRUCTIONS: Request Count:

ITEMS FOR PICK-UP AT:OFFICE WAREHOUSE OTHERS _____________________________________
ATTACHED
INDICATE CUSTOMER'S PURCHASE ORDER NUMBER IN THE DELIVERY RECEIPT _____ COPY OF CUSTOMER'S PURCHASE ORDER IN THE DELIVERY RE
PO#________
ORIGINAL COPY OF DELIVERY RECEIPT TO BE RETURN TO THE OFFICE DELIVERY RECEIPT SHOULD BE SIGNED BY CUSTOMER:______________________
✘ OTHERS

3. BILL OF QUANTITIES:

Active Components [Network Switches, Routers, Wireless Devices, Computers / Monitors, UPS, CCTV Cameras, Acces Controls],
Fabrications with drawings [ Cable Trays, Ladders, Wire Gutters / Fittings, Racks & Cabinets, Pull / CP boxes, Wire Managers,
PDU], Generic Branded Structured Cabling Products, APC Brand Products
Availability
Status
Item Brand Code DESCRIPTION Qty Units Date Needed
1 ELECTRICAL TAPE 2 pcs 12/18/2018 ASAP
2 UNIVERSAL POWER EXITENCION 2 m 12/18/2018 ASAP
3 STANDARD TABLE 1 pcs 12/18/2018 ASAP
4 MASKING TAPE 1 pcs 12/18/2018 ASAP
5 MARKER 1 pcs 12/18/2018 ASAP

NOTE: Hikvision provided Ms Julie already in warehouse PTZ, Bullet Tripod

Requested By: equipment already prepared in our warehouse

Project Engineer Department Head

Kick off Meeting Date:

NET PACIFIC INC.

F-PL-OFFICE-013

ISSUED: NOV..2017 Materials checked from Stocks PAL Rep ____________

REVISED:02
 MOBILIZATION REQUEST FORM
NO.
DATE:
MASTER ADDITIONAL FREE OF CHARGE ADVANCE ORDER SAMPLE/DEMO WARRANTY REPLACEMENT
1. CUSTOMER DETAILS:
Customer Name: Order Voucher (OV) #

Address / Location: REFERENCE #

Project Engineer/Contact#

Person-in-charge/Contact#

Contact Person on Site / Delivery Time Period:

From_ _:_ _(am/pm)To_ _:_ _(am/pm)
Contact# :

2. DELIVERY INSTRUCTIONS: Request Count:

ITEMS FOR PICK-UP AT: OFFICE WAREHOUSE OTHERS _____________________________________
ATTACHED
INDICATE CUSTOMER'S PURCHASE ORDER NUMBER IN THE DELIVERY RECEIPT _____ COPY OF CUSTOMER'S PURCHASE ORDER IN THE DELIVER
PO#________
ORIGINAL COPY OF DELIVERY RECEIPT TO BE RETURN TO THE OFFICE DELIVERY RECEIPT SHOULD BE SIGNED BY CUSTOMER:__________________
OTHERS

3. BILL OF QUANTITIES:
FDAS, Panel Boards, Transformers, Paging Systems, Lighting Fixtures, ACU/PACU/FAHU, Others
Description [Pls. indicate complete specifications : Sizes, Dimensions Availability
(Length, Width, Height), Colors, etc.] Status
Item Brand Code Qty Units Date Needed

Requested By: Approved By:

Project Engineer Department Head

NET PACIFIC INC.

F-PL-OFFICE-013

ISSUED: SEPT 10

REVISED:01