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VILL AGE BEGWA KHURD 0 TEHIL SILWANI RAISEN MADHYA PREADESH

To Date: 29-04-2019
UltraTech Cement Limited
404, BDA Complex, Ref SO No: 1
Bus Stop No. 7, Shivaji Nagar
Bhopal

Sub: Purchase Order for supply of cement.

Dear Sir,
With reference to the above, we would like to place an order for cement supplies as
per the details given below:

Price per Bag 325


Price Basis F.O.R –Site
Type of Cement OPC
Quantity (variation of (+ / -) 10 %) 1400 bag
Tax type GST (Inclusive)
Packing 50 Kg HDPE
Payment Details Advance
Validity of Contract 1 month from PO date
CATEGORY
(CONTRACTOR / BUILDER / TRUST /
INDUSTRY CEMENT BASED / INDUSTRY-
Contractor
OTHERS
If contractor than project awarded by

End use of material Bridge


Gajanda (arjani), bamhori, tahasil- Silwani,
Site Address:
Distt.- Raisen (M.P.) 464886
Any Charges related with Unloading, Khadi Garai,
Unloading:
Dalla & Hammali are to be borne by Buyer
Order through (TPC dealer name) : saurabh building material silwani

# Any increase in taxes due to change of rules or otherwise, shall be additionally payable by the customer and form part of price.
#We also hereby declare, “The cement purchased from UltraTech Cement Limited shall be used for our own consumption and
not for resale”

Thanking you,

Seal & Signature of Customer


(CUSTUMER CODE CREATION FORM)
S.NO. PARTICULARS Details

1 NAME OF FIRM
Mahakal construction silwani
Mahaveer nagar, silwani
2 ADDRESS OF THE FIRM Tahasil-Silwani
Distt.-Raisen (M. P.) 464886
3 CONTACT PERSON NAME
Jaswant singh raghu
4 CONTACT PERSON Mob. No.
9993180207
5 CONTACT PERSON MAIL ID
CONTACT PERSON DESIGNATION
6
(OWNER/MANAGER ETC.) silwani
7 TIN NUMBER
8 GST NUMBER 23EQLPK4309F1ZZ
9 PAN NUMBER EQLPK4309F
COMPLETE SITE ADDRESS where material to be Gajanda (arjani), bamhori, tahasil- Silwani,
10
delivered Distt.- Raisen (M.P.) 464886

11 TYPE OF CEMENT (OPC/PPC) OPC


END USE OF MATERIAL (Commercial Building,
Residential Building, Road Construction, Bridge
12 Construction, Industrial Building Construction,
Educational Building, Hospital Building, if other
please specify) Bridge Construction,
13 EXPECTED TOTAL REQUIREMENT IN BAGS/ IN MT
1400 BAGS
EXPECTED MONTHLY REQUIREMENT IN BAGS/ IN
14
MT 1400 BAG
LEGAL STATUS (Proprietor/partnership /Pvt ltd/Ltd)
15 # Please Mention Name of partners if status is
partnership firm Proprieto
CUSTOMER CLASS
16
(Contractor/Builder/Industry/other) Contractor
CONTRACTEE NAME (IF CUSTOMER IS
17
CONTRACTOR) Sunil kumar
REMARKS- Please attach the two mandatory SCAN COPY OF PAN NUMBER & GST NUMBER
18
documents: COPY

(Seal & Signature of Customer)

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