Docstoc

ACH Linked Procurement WorkBook

Document Sample
ACH Linked Procurement WorkBook Powered By Docstoc
					                                                                                                                                                                                           0
                                                                   PURCHASE REQUEST FORM

500
                                                                                                                                                                         0045
5000                                                                                                                                          №                 MNR
                          "WARNING!!! This PR should not be used as a template, the workbook has broken linkages. Please use the empty PR template."
                                                                  DELIVERY ADDRESS:                                              Mercy Corps Iraq support office
              Preferred Supplier (if applicable)
                                      N/A                                                                                                  Amman - Jordan
       NAME:
       ADDRESS:                                                   SPECIAL INSTRUCTIONS
       PHONE / E-mail:                                                                                     Fragile - to be handled with care
                   Suggested Purchaser:
                                                                  PROJECT REFERENCE
                          Greg Shortreed                                                                      IT equipment for Sule office

          x     Budgeted Expense
                                                                                                                                                                 Operating Expense
                Unbudgeted Expense                               Direct Program Expense                            Capital Expense                   x
       CANCELLED

               Request Date                 Required Date            Donor               Program                 Account Code                       Sub Code             Cost Center
                7-May-2005                    15-Jun-05               OFDA                  CAP                        3201                              02                    792

       Item         Qty        Unit                                            Description                                                Currency        Estimated      Estimated
         №                                                                                                                                                Unit Cost      Total Cost
                                                                                                                                                                                9,000
          1          5         PCS    IBM ThinkPad Laptop T42                                                                                 USD                1,800
                                                                                                                                                                                     900
          2          2         PCS    HP Laserjet 2300n                                                                                       USD                 450
                                                                                                                                                                                1,850
          3          1         PCS    Sony LCD Data Projector                                                                                 USD                1,850
                                                                                                                                                                                1,360
          4          2         PCS    Pentium 4 Dell Desktop Computers                                                                        USD                 680
                                                                                                                                                                                1,700
          5          5         PCS    Sony Cybershot 5MP Optical Zoom Digital Camera                                                          USD                 340
                                                                                                                                                                                     960
          6          3         PCS    Flat LCD 17" screen monitors                                                                            USD                 320
                                                                                                                                                                                     320
          7          4         PCS    Combo Drives for IBM ThinkPad Laptop T42                                                                USD                  80
                                                                                                                                                                                     480
          8          4         PCS    External USB 2.0 Maxtor 40 GB Hard disk                                                                 USD                 120
                                                                                                                                                                                     560
          9          8         PCS    Kingston 512MB Flash Disk                                                                               USD                  70
                                                                                                                                                                                      96
         10          3         PCS    IBM ThinkPad Laptop Car Charger                                                                         USD                  32
                                                                                                                                                                                     160
         11          4         PCS    IBM ThinPad Laptop Carrying cases                                                                       USD                  40
                                                                                                                                                                                     280
         12          4         PCS    Linksys WRT54G Broadband Router/Firewall                                                                USD                  70
                                                                                                                                                                                     150
         13          2         PCS    Linksys WAP11                                                                                           USD                  75
                                                                                                                                                                                     320
         14          1         PCS    Netgear Wireless Security Firewall 815                                                                  USD                 320
                                                                                                                                                                                      72
         15          2         PCS    HP Printer Server                                                                                       USD                  36
                                                             Mahmoud Khan                                    Field System Administrator
                                      Name:                                        Position:
                Originator                                                                                                                 TOTAL:               USD         18,208
                                                                                                                    07-Jun-05
                                      Signature:                                   Date:
                                                                   N/A                                                  N/A
                                      Name:                                        Program:
          Review / Approval                                                                                                                TOTAL:               USD       18,208
                                                                                                                        N/A
          Program Manager             Signature:                                   Date:
                                                                   N/A
                Approval              Name:                                                                             N/A               Exchange: 1      USD  =
                                                                                   Date:
                                                                                                                                                         PROCUREMENT
                                                                                                                                                                           1          S
                                                                                                                                                                                     UD
              Head of Office          Signature:
                                                 David Holdridge                                                      Out of AOR
            Approval               Name:                                             08-Jun-05     On Site    Local
                                                                 Date:
         Country Director /        Signature:                                                                           PDX
              D.P.O.                             Andrew Davies                                              CHECK ONE
                                   Name:                                             08-Jun-05
           Financial Review                                      Date:
                                   Signature:
                                CONSULT YOUR PROCUREMENT AND FINANCE POLICIES TO ENSURE CORRECT AUTHORIZATION


       NOTES:                                         Before shipment to Iraq, please make sure that all custom documents are ready for the airport in Amman.


                                                    Form Distribution White (Original) to Finance, Yellow to Procurement, Green to Originator

                                                            Mercy Corps Procurement Data Management System Version 5.2 LJ-A4
Account Code               3201                                                                                                                                                           MERCY CORPS 'country name'
Sub Code                   02                                                                                                                                                                                       Address Line 1
                                                                                                                                                                                                                    Address Line 2
Cost Center                792

                                                                                         Request for Quotation                                           Mercy Corps Contact:                                          Name / Title

                                                                                                                                                         E-Mail:                                        Phone: type phone no. here
                                                                                                                                                                       Date                                   PR No.
Name of supplier:
                                                                                                                                                                                                          MNR 0045

                                                                                                                              Extended
                                                                                                             Price/Unit                      Terms of     Delivery                              Validity of        Origin of
Item      Qty.     Unit                                     Description                                                         Price                                       Warranty
                                                                                                                                             payment      schedule                                 offer            Goods
                                                                                                                 USD            USD
   1        5       PCS IBM ThinkPad Laptop T42
   2        2       PCS HP Laserjet 2300n
   3        1       PCS Sony LCD Data Projector
   4        2       PCS Pentium 4 Dell Desktop Computers
   5        5       PCS Sony Cybershot 5MP Optical Zoom Digital Camera
   6        3       PCS Flat LCD 17" screen monitors
   7        4       PCS Combo Drives for IBM ThinkPad Laptop T42
   8        4       PCS External USB 2.0 Maxtor 40 GB Hard disk
   9        8       PCS Kingston 512MB Flash Disk
  10        3       PCS IBM ThinkPad Laptop Car Charger
  11        4       PCS IBM ThinPad Laptop Carrying cases
  12        4       PCS Linksys WRT54G Broadband Router/Firewall
  13        2       PCS Linksys WAP11
  14        1       PCS Netgear Wireless Security Firewall 815
  15        2       PCS HP Printer Server
                                                                                      Insurance+Shipping+Handling
All prices include insurance and the delivery cost to specified delivery location. (C.I.F. parity)      VAT ...%                                                      Additional information attached
                                                                                                                                                                                 (please check box if true)
                                                                                                              TOTAL:
        Documented verbal quote collected by: (please provide name and position below)                         Project Reference:                                      IT equipment for Sule office
        Official written quote provided by: (please provide information below)                                 Delivery Address:                                     Mercy Corps Iraq support office
                                                                                                                                                                              Amman - Jordan




        Address, Contact Information, Stamp and Signature of Supplier                                                                             Reviewed by (name, signature and date)
                                                                                                     (In local language on the other side)
                                                                                      Mercy Corps Procurement Data Management System Version 5.2 LJ-A4
Account Code            3201                                                                                                                                                                               MERCY CORPS 'country name'
Sub Code                02                                                                                                                                                                                                         Address line 1
Cost Center                                                                                                                                                                                                                        Address line 2
                        792

                                                                                Permintaan Penawaran Harga                                                             Mercy Corps Contact:                                           Name / title

                                                                                                                                                                       E-Mail:                                        Phone: 'type phone no. here'
                                                                                                                                                                                    Tanggal                                  PR No:
Nama Suplier:                                                                                                                                                                                                           MNR 0045

                                                                                                                  Harga/Uni                                                                                                       Daerah
                                                                                                                            Penawaran    Cara     Jadwal                                                           Berlaku
Item Jml. Unit                                          Keterangan                                                     t
                                                                                                                                      Pembayaran Pengiriman
                                                                                                                                                                                             Garansi
                                                                                                                                                                                                                   Sampai
                                                                                                                                                                                                                                   Asal
                                                                                                                     IDR       IDR                                                                                                Barang
 1       5
 2       2
 3       1
 4       2
 5       5
 6       3
 7       4
 8       4
 9       8
 10      3
 11      4
 12      4
 13      2
 14      1
 15      2
                                                                                     Asuransi + Biaya Kirim + Handling
                  Semua barang termasuk asuransi dan biaya kirim ke tempat yang di temtukan (CIF)                   10% PPN                                                      Keterangan Tambahan Terlampir
                                                                                                                    Jumlah                                                                  Apabila Ada harap tandai kolom

      Document di kumpulkan secara lisan oleh: (Harap tulis nama dan posisi dibawah)                                 Referensi Proyek:                                             IT equipment for Sule office
 x    Permintaan secara tertulis diberikan oleh: (harap berikan informasi dibawah)                                   Alamat Pengiriman                                           Mercy Corps Iraq support office
                                                                                                                                                                                         Amman - Jordan




             Alamat, detail contact, stempel dan tanda tangan suplier                                                                                              Reviewed by (name, signature and date)
                                                                                                Mercy Corps Procurement Data Management System Version 5.2 LJ-A4




                                                                                                                            MC-PDMS 5.2 RfQ Bahasa Indonesian
                                                                          QUOTATION ANALYSIS
Date:    29-May-05

Project Reference:                                                     IT equipment for Sule office                                                                 CHOSEN VENDOR
Estimated PR Value:       USD 18,208            USD 18,208                                                                                              Name:                 NorthWest Electronics
PR №                     MNR 0045                                                                                                                       Address:                      1022 Broadway

Account Code:             3201                                               Expected                                                                                                Portland OR 97220
                                                                                                                   4-Jun-05
Sub Code:                 02                                                Delivery Date:                                                              Phone/E-mail:                   503 345 8900

Cost Center:              792                                                                                                                           Contact person:                        Mr Browsley



Seria                                                   Quoted Price        Tax        Total Price         Meets            Meets         Delivery                                                     Estimate
                   Name of Vendor                                                                                                                           Payment Terms              Remarks
 l№                                                           USD          USD             USD            Specs?       Compliance?         Time                                                        accuracy

  1               Portland Vendor A                             18,934                      18,934          yes               no              4 weeks              COD                                    96%
                                                                                                                                                                                     not a complete
  2               Portland Vendor B                             12,398                      12,398          yes               yes             2 weeks         50% advance                                147%
                                                                                                                                                                                           offer

  3             NorthWest Electronics                           17,111                      17,111          yes               yes             4 days               COD                                   106%

  4               Portland Vendor C                             22,908                      22,908          yes               yes             1 week               COD                                    79%

  5                                                                                              -                                                                                                       #DIV/0!



                                   Reason / Justification                                                    Recommendation / Approval                             Name & Signature                       Date
NothWest Electronics offered the best price and the quickest delivery ofr all the needed                                                                            Greg Shortreed
   items. Mercy Corps already ordered good from them and in the past we had good                                       Procurement                                                                     29-May-05
 experience dealing with this firm. Portland vedor B total price does not include several
items from the list, Others have longer delivery times and higher prices than NortWest                                                                               Chelsea Catto
                                       Electronics.                                                                       Program                                                                      29-May-05


                                                                                                       Head of Office / Country Director                                 Jim White
                                                                                                                                                                                                       30-May-05
                                                                                                                     or Designate
                                (attach additional sheets if needed)
                                                                                  Form Distribution: Copy 1 - Finance, Copy 2 - Procurement
                                                                          Mercy Corps Procurement Data Management System Version 5.2 LJ-A4
                                                              PURCHASE ORDER                                                                                                           1



 № PDX 0092                                                                                                                                 Date:               30- May - 05

                                                                                                                                           PR №            MNR 0045
ISSUED BY:                      Mercy Corps Portland                                    ISSUED TO:
                                                                                                                                       NorthWest Electronics
                            3015 SW First Avenue                                        Name:
                            Portland, OR 97201                                          Address:                                          1022 Broadway
Contact person:           Greg Shortreed                                                                                                 Portland OR 97220
Phone/Fax:                503-796-6800                                                  Phone:                                              503 345 8900
E-mail:                   gshortreed@mercycorpsfield.org                                Contact:                                             Mr Browsley

SHIP TO:                           Mercy Corps Portland                                 SPECIAL INSTRUCTIONS:

                   3015 SW First Avenue, Portland OR 97201                                                Fr agi l e - t o be handl ed wi t h car e


P.O. Prepared by :        Gr eg Shor t r eed                                            CURRENCY:                      USD                  1 USD =         1           USD
SHIPPING TERMS:           CI F Por t l and                                              PAYMENT TERMS:                                     Cash On Delivery
DELIVERY DATE:            10- Jun- 05                                                   FINANCE CODE:                        3201            02         792


ITEM      Qty.    UNIT                                              DESCRIPTION                                                          UNIT COST         EXTENDED COST

  1        5      PCS     IBM ThinkPad Laptop T42                                                                                              1,650.00                  8,250.00

  2        2      PCS     HP Laserjet 2300n                                                                                                     450.00                    900.00

  3        1      PCS     Sony LCD Data Projector                                                                                              1,450.00                  1,450.00

  4        2      PCS     Pentium 4 Dell Desktop Computers                                                                                      700.00                   1,400.00

  5        5      PCS     Sony Cybershot 5MP Optical Zoom Digital Camera                                                                        300.00                   1,500.00

  6        3      PCS     Flat LCD 17" screen monitors                                                                                          300.00                    900.00

  7        4      PCS     Combo Drives for IBM ThinkPad Laptop T42                                                                              250.00                   1,000.00

  8        4      PCS     External USB 2.0 Maxtor 40 GB Hard disk                                                                                45.00                    180.00

  9        8      PCS     Kingston 512MB Flash Disk                                                                                              80.00                    640.00

 10        3      PCS     IBM ThinkPad Laptop Car Charger                                                                                        15.00                         45.00

 11        4      PCS     IBM ThinPad Laptop Carrying cases                                                                                      45.00                    180.00

 12        4      PCS     Linksys WRT54G Broadband Router/Firewall                                                                               89.00                    356.00

 13        2      PCS     Linksys WAP11                                                                                                          50.00                    100.00

 14        1      PCS     Netgear Wireless Security Firewall 815                                                                                 80.00                         80.00

 15        2      PCS     HP Printer Server                                                                                                      65.00                    130.00
Project Reference:                                                                                                              TOTAL EX-WORKS                          17,111.00
                                                     IT equipment for Sule office
                                                                                                                                               TAXES Included
Authorized on behalf of Mercy Corps:                                                                                                        SHIPPING Included
                                                                                                                                          INSURANCE Included                           0
Name & Title                                                                                                    TOTAL INVOICE           USD               17,111.00
                                                                                                                          Authorized on behalf of Vendor:
Signature:
Date:                                                                                                            Signature:
                                                                                                                 Name&Title:
                                                                                                                 Date:
                                Financial Review                                                                        Understood and agreed with Conditions of Purchase


                                              Please refer to this Purchase Order number in all correspondence concerning the order.
                                                                      Please supply 3 copies of your invoice.

                                         Form Distribution: White (Original) to Finance, Pink to Vendor, Yellow to Procurement

                                                   Mercy Corps Procurement Data Management System Version 5.2 LJ-A4
                                                GOODS RECEIVED NOTE                                                                                                1



 №         PDX 0221                                                                                                      Account Code              3201
                                                                                                                              Sub Code               02
                                              Mercy Corps Portland                                                        Cost Center               792
  Delivery
  Address:                        3015 SW First Avenue, Portland OR 97201
                                                                                                                       Date:                   2-Jun-05

Supplier:                                                                  Materials                                  Documentation
Name:             NorthWest Electronics                                     Program               x      Waybill №
Address:          1022 Broadway                                    x        Operational           x      Supplier Invoice №
                  Portland OR 97220                                         Consumable            x      Supplier Delivery Note №                 002983
                                                                                                  x      MC Store Release №
Phone:            503 345 8900                                                                    x                    (Other)
Contact:          Mr Browsley

                    This delivery                                        Stock Status                              Materials supplied
      Is a single complete order                                         Regular Stock            x                for M.C. PR №            MNR 0045
  x   Is a part shipment with the balance pending                  x     Transit Stock            x                for M.C. PO №            PDX 0092
      Is a final shipment completing the order                           Returned Materials       x                Donation

Item Quantity                                                                                  Capital   Attractive        Quantity
                   Unit                           Item Description                                                                                Remarks                Balance
 No. Ordered                                                                                   Asset?      Item?           Received
  1         5      PCS    IBM ThinkPad Laptop T42                                                                                5                   OK            ###     0
  2         2      PCS    HP Laserjet 2300n                                                                                      2                   OK            ###     0
  3         1      PCS    Sony LCD Data Projector                                                                                1                   OK            ###     0
  4         2      PCS    Pentium 4 Dell Desktop Computers                                                                       2                   OK            ###     0
  5         5      PCS    Sony Cybershot 5MP Optical Zoom Digital Camera                                     yes                 0                                 ###     5
  6         3      PCS    Flat LCD 17" screen monitors                                                                           3                   OK            ###     0
  7         4      PCS    Combo Drives for IBM ThinkPad Laptop T42                                                               4                   OK            ###     0
  8         4      PCS    External USB 2.0 Maxtor 40 GB Hard disk                                                                4           1 USB cable missing   ###     0
  9         8      PCS    Kingston 512MB Flash Disk                                                          yes                 0                                 ###     8
 10         3      PCS    IBM ThinkPad Laptop Car Charger                                                                        3                   OK            ###     0
 11         4      PCS    IBM ThinPad Laptop Carrying cases                                                                      4                   OK            ###     0
 12         4      PCS    Linksys WRT54G Broadband Router/Firewall                                                               4                   OK            ###     0
 13         2      PCS    Linksys WAP11                                                                                          2                   OK            ###     0
 14         1      PCS    Netgear Wireless Security Firewall 815                                                                 1                   OK            ###     0
 15         2      PCS    HP Printer Server                                                                                      2                   OK            ###      0
                                                                                                                                 37                                        13
Project Reference:                                           IT equipment for Sule office                                              OFDA CAP

Goods delivered by:                                                    Goods Received by:
(Print name)                     FED EX                                (Print name)                             Greg Shortreed
License Plate №                                                        (Title)                                           HQ PLS


(Sign & date)                                                          (Sign & date)

                                                                       Delivery accepted by:
                                                                                                                         Originator
                                 Note: Separate Goods Received Notes must be prepared for individual suppliers or orders.
                             Form Distribution White (Original) to Finance, Pink to Vendor, Yellow to Procurement, Blue to Warehouse

                                              Mercy Corps Procurement Data Management System Version 5.2 LJ-A4
                                              GOODS RECEIVED NOTE                                                                                          0



 №         PDX 0229                                                                                                    Account Code               3201
                                                                                                                          Sub Code                 02
                                           Mercy Corps Portland                                                          Cost Center               792
  Delivery
  Address:                       3015 SW First Avenue, Portland OR 97201
                                                                                                                      Date:                  4-Jun-05

Supplier:                                                             Materials                                      Documentation
Name:             NorthWest Electronics                                Program                  x       Waybill №
Address:          1022 Broadway                             x          Operational              x       Supplier Invoice №
                  Portland OR 97220                                    Consumable               x       Supplier Delivery Note №                 002989
                                                                                                x       MC Store Release №
Phone:            503 345 8900                                                                  x                     (Other)
Contact:          Mr Browsley

                    This delivery                                   Stock Status                                  Materials supplied
      Is a single complete order                                     Regular Stock              x                 for M.C. PR №            MNR 0045
      Is a part shipment with the balance pending           x        Transit Stock              x                 for M.C. PO №            PDX 0092
  x   Is a final shipment completing the order                       Returned Materials         x                 Donation

Item Quantity
                                                Item Description
                                                                                            Capital     Attractive       Quantity
                                                                                                                                                 Remarks
                                                                                                                                                               Balance   Balance
                   Unit                                                                     Asset?        Item?
 No. Ordered                                                                                                             Received                              GRN 1      GRN 2
  5         5      PCS Sony Cybershot 5MP Optical Zoom Digital Camera                                       yes                 5                  OK      #      5          0
  9         8      PCS Kingston 512MB Flash Disk                                                            yes                 8                  OK      #      8         0
  0         0                                                                                                                                              #      0         0
  0         0                                                                                                                                              #      0         0
  0         0                                                                                                                                              #      0         0
  0         0                                                                                                                                              #      0         0
  0         0                                                                                                                                              #      0         0
  0         0                                                                                                                                              #      0         0
  0         0                                                                                                                                              #      0         0
  0         0                                                                                                                                              #      0         0
  0         0                                                                                                                                              #      0         0
  0         0                                                                                                                                              #      0         0
  0         0                                                                                                                                              #      0         0
  0         0                                                                                                                                              #      0         0
  0         0                                                                                                                                              #      0         0
                                                                                                                                13                                0         0
Project Reference                                        IT equipment for Sule office                                                 OFDA CAP

Goods delivered by:                                               Goods Received by:
(Print name)                     FED EX                           (Print name)                                 Greg Shortreed
License Plate №                                                   (Title)                                               HQ PLS


(Sign & date)                                                     (Sign & date)

                                                                  Delivery accepted by:
                                                                                                                        Originator
                                 Note: Separate Goods Received Notes must be prepared for individual suppliers or orders.
                            Form Distribution White (Original) to Finance, Pink to Vendor, Yellow to Procurement, Blue to Warehouse

                                            Mercy Corps Procurement Data Management System Version 5.2 LJ-A4
                                                                                                    PURCHASE RECORD
                                                                                                                 PR №                  MNR 0 0 4 5                                                                      Account №                                   3201

Project Reference:                                 I T e q u i p me n t           f or      Su l e o f f i c e                                                                                                          Sub Code                                        02
                                                                                                                                                                                                                       Cost Center                                      792

Item    Quantit
                   Unit                                                                    Description                                                                           Currency
                                                                                                                                                                                            Estimated          Estimated         Actual                 Actual
                                                                                                                                                                                                                                                                            Date Received
  №       y                                                                                                                                                                                     Unit Price         Total Price     Unit Price             Total Price
  1         5      PCS IBM ThinkPad Laptop T42                                                                                                                                     USD              1,800                9,000               1,650                8,250          2-Jun-05

  2         2      PCS HP Laserjet 2300n                                                                                                                                           USD                450                  900                    450               900          2-Jun-05

  3         1      PCS Sony LCD Data Projector                                                                                                                                     USD              1,850                1,850               1,450                1,450          2-Jun-05

  4         2      PCS Pentium 4 Dell Desktop Computers                                                                                                                            USD                680                1,360                    700             1,400          2-Jun-05

  5         5      PCS Sony Cybershot 5M P Optical Zoom Digital Camera                                                                                                             USD                340                1,700                    300             1,500
                                                                                                                                                                                                                                                                            multiple dates
                                                                                                                                                                                                                                                                                 (see GRN-s)

  6         3      PCS Flat LCD 17" screen monitors                                                                                                                                USD                320                  960                    300               900          2-Jun-05

  7         4      PCS Combo Drives for IBM ThinkPad Laptop T42                                                                                                                    USD                    80               320                    250             1,000          2-Jun-05

  8         4      PCS External USB 2.0 M axtor 40 GB Hard disk                                                                                                                    USD                120                  480                    45                180          2-Jun-05

  9         8      PCS Kingston 512M B Flash Disk                                                                                                                                  USD                    70               560                    80                640
                                                                                                                                                                                                                                                                            multiple dates
                                                                                                                                                                                                                                                                                 (see GRN-s)

 10         3      PCS IBM ThinkPad Laptop Car Charger                                                                                                                             USD                    32                96                    15                 45          2-Jun-05

  11        4      PCS IBM ThinPad Laptop Carrying cases                                                                                                                           USD                    40               160                    45                180          2-Jun-05

  12        4      PCS Linksys WRT54G Broadband Router/Firewall                                                                                                                    USD                    70               280                    89                356          2-Jun-05

  13        2      PCS Linksys WAP11                                                                                                                                               USD                    75               150                    50                100          2-Jun-05

  14        1      PCS Netgear Wireless Security Firewall 815                                                                                                                      USD                320                  320                    80                 80          2-Jun-05

  15        2      PCS HP Printer Server                                                                                                                                           USD                    36                72                    65                130          2-Jun-05
                                                                                                                                                                                                                                                                                               multiple dates
                                                                                                                                                                                                                                                                                                    (see GRN-s)
Delivery Address / Point of Contact:                                                         Special Instructions:                                           0                                                                    Tax+S+H                               0

                       Mercy Corps Iraq support office                                                                                                                       TOTAL              USD                    18,208          Estimate                17,111
                                                                                                                Fragile - to be handled with care                                                                                      Accuracy

                                 Amman - Jordan
                                                                                                                                                                             TOTAL              USD                    18,208           106%                17,111.00
                                                                                                 EXCHANGE RATE:                                                                    (at time of payment)
                                                                                                                                     S
                                                                                                                                  1 UD=                1             S
                                                                                                                                                                    UD
                REQUEST                              REVIEW / APPROVAL                                  PROCUREMENT                                    FINANCE REVIEW                        EXPENSE:                                       APPROVAL
Requested By:     Mahmoud Khan                     Program Manager:                             On Site            Local        Out of AOR Finance Officer:                                                    DPO / Head of Office:                        Country / Regional Director:
Program:          OFDA       CAP                   Program:            N/A                          0                0                 PDX                                                     Budgeted        Name:             N/A                                         David Holdridge
Position:         Field System Administrator       Name:               N/A                                     ( check one)                    Name:             Andrew Davies               Unbudgeted        Date:             N/A                                             08-Jun-05
                                                                                                    x                                   x                                                      Program
Date:             7-May-05                         Date:               N/A                          0                                   0      Date:             8-Jun-05                     Operating
                                                                                                                                        0      Data provided by Finance                         Capital
P.R. NOTES:                  Before shipment to Iraq, please make sure that all custom documents are ready for the airport in Amman.             Purchase Record NOTES:
                                                                                 0                                                                     (additional PO numbers etc.)
                                                                                                                                                                            e
                                                                                                                                                                  No r t h W s t         El e c t r o n i c s                                                  3 0 - Ma y - 0 5
            Documentation:                                                     PO №                 PDX       0092              Ve n d o r :                                                                                           Da t e :
(P.O. №, Vendor, GRN №, Invoice №,                                            GRN №
                                                                            PDX 0221                                                   PDX     0229                     0    0                            0    0                                  0     0
             Payment Voucher №)
                                                    Payment Voucher. № 0 0 2 9 4
                                                            I nv oi c e № 009228
                                                                                             Form Distribution: Copy 1 to Finance, Copy 2 to Procurement, Copy 3 to Originator
                                                                                                    Mercy Corps Procurement Data Management System Version 5.2 LJ-A4

				
DOCUMENT INFO
Categories:
Tags:
Stats:
views:4
posted:3/4/2012
language:
pages:12