PT Leighton Contractors Indonesia

DELIVERY DOCKET

DIVISION /PROJECT OFFICE: Supreme Energy Project

PROJECT NO.: ID 232
DOCKET NO.: 068/VI/SUP/-ID/232-2014

Date : 11-June-2014
Delivery To : PT. Uniteda Arkato
Carrier : PT. Logistic One

Part
Item Description Quantity Remarks
Number
1. TC4003 Crawler Dozer 8T D65P (BZ21) 1 Unit # Off Hired
Manufacturer : Komatsu

Machine SN : 65877

Engine SN : S6D125E-2 00112042

Driver Name :

Truck Reg. No :

Phone No :

Carrier By PT. Logistic One Solution

Delivery Point :

Workshop PT. Uniteda Arkato

Jln. Raya Jonggol KM. 4 Desa Mekarsari

Cileungsi
PIC : Bpk Desman Andika

(M : 08118074828)

Issued By : Hidayat. As Received By :

Date : 11-June-2014

Approved By : Leigh Fitzpatrick (Carrier) (Project Warehouse)

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