To make a new request for project, please answer the questions below and submit this form to the C

ALL THE SECTIONS ARE MANDATORY FOR ALL REQUESTS IN THIS FORM (indicate TBD if the
Project Name To supply advantage multi cartridge and half face mask
Buyer Name Naresh Kumar
Date of Request: 3-Feb-17
OPEX
Service Description (Background and Summary of the Project / Other instructions or comments

DESCRIPTION
1) MSA ADVANTAGE MULTI CATDRIGE, GME-P100
P/N : 815366

2) MSA ADVANTAGE 200LS HALF FACE RESPIRATOR

P/N : 815692

Select/Check the Contract/Purchase Type

Annual or Blanket Order

List of Preferred Supplier (If any)

Kejuruteraan Sumber Selia
Short Justification for Supplier
Preference Present Bumi company for PGW Fire Fighting sysytem
List of All Suppliers Please fill in the below supplie

Supplier Name Contact Person

1)
SLINA OSH JAYA SDN.BHD MRS. GRACE SOH

2)
BRISK SAFETY SDN BHD NELSON ING
 4)
5)
6)
7)
8)
9)
10)
Do the above vendors approved Technically?

Do the terms (commercial/non commercial) of the business same for all the suppliers? (Eg.
payment terms, delivery terms , delivery condition, mode of delivery, delivery lead time, terms of
offer)

Would they supply goods/services with similar specification?

Has any negotiation been done with supplier already?

Please attach/embed Supplie

 CCM I Valua Desk- Intake Form
he questions below and submit this form to the CCM I Valua Desk (I Valua Consultant), marking Purchase Manager. The CCM I Va

EQUESTS IN THIS FORM (indicate TBD if the item is to be determined)

ntage multi cartridge and half face mask
Buyer E-mail:
Business Unit CCMC PGW
Budget:
the Project / Other instructions or comments, attach / embed any documentation):

DRIGE, GME-P100

F FACE RESPIRATOR

SOURCING
Sumber Selia

company for PGW Fire Fighting sysytem

Please fill in the below supplier/vendor details (Min. 3 vendors are required)

Contact Number E-mail ID

012-7136127 sales@slinaoshjaya.com.my

016-7708262 nelson@brisksafety.com

Yes No

ess same for all the suppliers? (Eg. Yes No

e of delivery, delivery lead time, terms of

tion? Yes No

Yes No
Please attach/embed Supplier Documentation (proposal/estimate, supplier intake/onboarding form/Qu
ntake Form
Purchase Manager. The CCM I Valua team will get in touch with you shortly to discuss the details of your work request. Thank you

Phone Number: 07 2671313

Immediate Superior Ahmad zaki
Cost Center/Department:

Single (One Time) Purrchase

Quotation Validity Justification in case of less than 3 vendors

14 days

14 days
 Approved by Immediate Superior:

Buyers /Users are to ensure all vendors quoted terms are acceptable. Any dispute in any of the terms will be the responsibility o
buyer.

plier intake/onboarding form/Quotation Comparision, etc)

your work request. Thank you!

endors
erms will be the responsibility of the
 Summ

Technical Specifications

Requirement
Descriptions
(PCS)

MSA ADVANTAGE MULTI CATDRIGE, GME-P100

P/N : 815366 200

MSA ADVANTAGE 200LS HALF FACE RESPIRATOR

P/N : 815692 200

Commercial Terms

Descriptions

Payment Terms

Delivery Time
 Summary Sheet (For Multiple Products)

SLINA OSH JAYA BRISK SAFETY

Unit Price Total Price Unit Price Total Price Unit Price

RM75.00 RM15,000 RM66.00 RM13,200.00

RM58.00 RM11,600.00 RM48.00 RM9,600.00

SLINA OSH JAYA BRISK SAFETY

30 DAYS 30 DAYS

30 DAYS 30 DAYS
Total Price Unit Price Total Price
 Summary Sheet (Single Product)

Description

Any Extra Charges

(Like Delivery Terms Delivery Timelines
S. No. Supplier Name Quantity Unit Price Total Price Payment Terms Remarks/Comments
Packaging/Freight,etc (Staggered/One Time) (No. of Days)
)