Ok Delivery Note & Receipt Bunker PT Dinar Pulihkan

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ALAMAT : Jl. WIJAYA KUSUMA KEL.

AIR PUTIH Date : 19-Nov-2016


KEC. SAMARINDA ULU Delivery Number : 003/DPM
KOTA SAMARINDA Loaded Time :
INDONESIA

DELIVERY NOTE
DELIVERY TO HAULER

Name : Name :
Address : Address :

Tel : Tel :
Fax : Email :
Email : Vahicle :
Attn : Driver :
Reference :
Po # :

COMMODITY

Recipe Name : Dinar_HSD Product : HSD

Seq No Loaded Density Temperature Seal Number

1 L 0
C

Total Loaded 40.000 L

REMARKS

Dinar Representative Commodity received in good order and


condition by customer or hauler for or
on behalf of customer

An.Bobby Rachmat
Authorized Signature Authorized Signature

Driver Name :
Name : Date :
Date :
1. Copy untuk Transportir 2. Copy untuk Customer 3. Copy untuk Arsip
PT JUSTIN BINTANG SAMUDRA MANDIRI

ALAMAT : Jl. WIJAYA KUSUMA KEL. AIR PUTIH Date : 24/11/2016


KEC. SAMARINDA ULU Delivery Number : 005/DPM/SMD/XI/2016
KOTA SAMARINDA Loaded Time :

DELIVERY NOTE

DELIVERY TO HAULER
Name : PT.PELITA SAKTI Name : PT. Dinar Putra Mandiri
Address : Bendara Samarinda Baru Address : Jl. WIJAYA KUSUMA KEL. AIR PUTIH

Jln.Poros Samarinda Bontang KEC. SAMARINDA ULU, KOTA SAMARINDA


Tel : Tlp/Fax :
Fax : Email : [email protected]
Email : Vahicle :
Attn : Driver :
Reference : #REF!
Po # :

COMMODITY

Recipe Name : Dinar_HSD Product : HSD

Seq NO Loaded Density Temperature Seal Number

1 L …………………………………
0C

Total Loaded 5,000

REMARKS :

Dinar Representative Commodity received in good order and


condition by customer or hauler for or
on behelf of costumer

EDI CIPON on behelf of costomer


Authorized Signature Authorized Signature

Driver : Name :
Name : Date :
Date :
1. Copy untuk Transportir 2. Copy untuk Customer 3. Copy untuk Arsip

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