PT Leighton Contractors Indonesia

DELIVERY DOCKET

DIVISION /PROJECT OFFICE: Supreme Energy Project

PROJECT NO.: ID 232
DOCKET NO.: 053/V/SUP/-ID/232-2014

Date : 25-May-2014
Delivery To : PT. C.H.I Pekanbaru
Carrier : PT. BANGGUA RAYA

Item Part Number Description Quantity Remarks

1. PM2004 / 101524 Sykes Pump Set 6 1 Unit CP150 (Manual Pump)

Driver Name : Eka

Truck Police No : B 9472 TYV

Phone No : 0852 84841093

Carrier By PT. BANGGUA RAYA

Delivery Point :

PT. Coates Hire Indonesia (C.H.I)

Komp Pergudangan Avian

Jl. Arengka II Blok D No. 7

Pekanbaru 28292

PIC : Bp. Burhan

(M : +62 812 751 4783)

Issued By : Edoardo Sadrax Received By :

Date : 25-May-2014

Approved By : Tony Curran (Carrier) (Project Warehouse)

Aug 2009 Page 1 of 1 LCI-P&E-FM-022R(01)