Book No. Set No.

5319 097
RITES LTD, EASTERN REGION, KOLKATA
Contains 0 Continuation Sheets
Certificate No. Date
E/WR/E23030820/AMIT 23/05/2024 Offered Instt. No. 2

Passed Instt. No. 1ST & FINAL

Contractor Place of Inspection

M/s M.G.M.RUBBER COMPANY 86/1 B.T.ROAD P.O TALA KOLKATA-700 002 KOLKATA-700 002 M/s MGM RUBBER COMPANY 277, JESSORE ROAD-700048
KOLKATA KOLKATA

Contract References Date Bill Paying Officer

PO NO. 22220646101446 23/03/2023 FA&CAO (S), WESTERN RAILWAY, MUMBAI

Consignee Purchasing Authority

DY. CMM//WR/DAHOD PCMM/WR/MUMBAI

Item
Description of Stores Quantity on Qty Still Due
No. Cumulative Qty Prev Qty Now Qty Now
Order Qty Now
Qty Offered Passed Offered Passed Rejected
1 2 3 Previously 4 5 6 7 8 9
1 (P.O.SL. 002 )RUBBER BUCKET FOR PISTON HEAD 67 NIL NIL 67 67 NIL NIL
DISC OF AIR BRAKE CYLINDER TO RDSO DRG. NO. Nos. Nos. Nos.
SKDP-3061 ALT.1 Marking : MGM CAT NO.
96556, 4/24, Batch no. 53024 Materials Passed
vide Joint Test Report No. MGM/143/RITES/ QUANTITY PASSED NOW:- SIXTY SEVEN NOS ONLY (INCLUDING 02 NOS PARTIALLY DESTROYED IN
100524/34 dt. 22.05.2024 TESTING REMNANT SENT TO CONSIGNEE ALONG WITH LOT DULY SEALED) PACKING:- LOOSE

TR Rec. dt.
No. of items checked Date of call No. of Visits Date(s) of inspection
ONE 10/05/2024 THREE 18.05.2024, 21.05.2024, 22.05.2024

Pattern of sealing/stamping & location of seal/stamp/sticker Facsimile of seal/stamp/sticker Inspecting Engineer

% DSUnknown

RITES HOLOGRAM SL.NO. IN BETWEEN FROM E3194305 TO

q
1G
1g
0.1 0 0 0.1 9 0 cm
0 J 0 j 4 M []0 d
1i
0g
313 292 m
313 404 325 453 432 529 c
478 561 504 597 504 645 c
504 736 440 760 391 760 c
286 760 271 681 265 626 c
265 625 l
100 625 l
100 828 253 898 381 898 c
451 898 679 878 679 650 c
679 555 628 499 538 435 c
488 399 467 376 467 292 c
313 292 l
h
308 214 170 -164 re
f
0.44 G
1.2 w
1 1 0.4 rg
287 318 m
287 430 299 479 406 555 c
451 587 478 623 478 671 c
478 762 414 786 365 786 c
260 786 245 707 239 652 c

E3195034 PASTED ON EACH STORE IN PRESENCE OF THE VENDOR

239 651 l
74 651 l
74 854 227 924 355 924 c
425 924 653 904 653 676 c
653 581 602 525 512 461 c
462 425 441 402 441 318 c
287 318 l
h
282 240 170 -164 re
B
Q

Digitally Signed by:

AMIT SINGH JAYPAL SINGH
RITES LTD
Reason of rejection "QA DIVISION

N/A Date: 2024-05-23T16:01:23.1036977+05:30

* IC is valid for 30 days from date of issue for dispatch.