SRF Form Rev 6 - 2024
SRF Form Rev 6 - 2024
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SRF No. Project Code-0001-001
Appointed freight forwarder in Batam/Contact No.
Shipping Request Form (SRF) Expected ETD
All red fields are mandatory. Please come with completely information required, otherwise LTC could not proceed further. PLEASE TICK ONE
Project Code/Name : PP Marjan D7068-D7394/MIP Package 01- offshore GOSP-4 Develpopment Sea Fright X
Job No : 1417-59507-FC401 Air Freight
Shipping mode:
Please tick temporary if the shipment will be coming back to PTMI at any time and picture is required item by item for BIFZA. Land Transport
Permanent X Hand Carry
Type of Export
Temporary Expected duration: Other information required YES NO
Shipping incoterm : FCA PT MI Shipment consists of any commercial value X
Special Instructions / Reason for Export : : Job Complete Shipment is fabricated item X
Who does pay clearance at destination? : Voith Hazardous material X
Who does pay tax/duty at destination? : Voith Fumigate/Heat Treated/ISPM-15 compliance X
Pick up location within PTMI : Warehouse Receiving Consignee requires certificat of origin X
Area custodian : Suparman
Shipper (name/address/phone) Consignee (name/address/phone): Delivered To/Onward Delivery (name/address/phone):
J.M. Voith SE & Co. KG J.M. Voith SE & Co. KG
Ludwig-Erhardt Str. 20 Ludwig-Erhardt Str. 20
74564 Crailsheim 74564 Crailsheim
Germany Germany
Attn: Logistic Centre Attn: Logistic Centre
PT. McDermott Indonesia
Jln.Bawal,Batu Ampar,
Provinsi Kepulauan Riau
Batam 29452, Po.Box.02033
Batam Centre
Attn : Purnomo / Leo A. Kristian
Tel: +62-778-405220 / 405990
DIMENSION IN MTRS Incoming doc reference
Total Volume Unit Price of Amount of Unit Price of No Amount of No
Country of Total Gross Total Nett Total Amount to
No DESCRIPTION Qty UOM Corrency Commercial Commercial Commercial Commercial Incoming doc reference Warehouse Photo for temp export only
Origin L W H Wt. Kg Wt. Kg Customs PO #
M3 Value Value Value Value (BL No / Local DO No) Incoming Log#
1 Hyd. Unit set MAXIMATOR 4000bar P/N204.02372610 1 PC 80.00 19,942.17 19,942.17 19,942.17
2 Hollow Piston Cyl.LZMH 40/100-37 in P/N TCR.41569410 1 PC 24.00 2,661.38 2,661.38 2,661.38
3 feed rod M30x1000 P/N 206.03799410 1 PC 5.50 428.67 428.67 428.67
4 Hexagon nut M30 12 P/N H01.084830 2 PC 0.45 13.68 27.36 27.36
5 washer A31 ST HV140 P/N TCR.03100031 2 PC 0.10 0.19 0.38 0.38
6 Feed rod M36x1000 P/N 206.03797910 1 PC 7.90 587.40 587.40 587.40
7 Hexagon nut M30 12 P/N H01.084830 2 PC 0.45 13.68 27.36 27.36
8 washer A31 ST HV140 P/N TCR.03100031 2 PC 0.45 0.19 0.38 0.38
9 Installation disc 167/82x19 P/N 206.04560610 1 PC 1.50 50.00 50.00 50.00
10 Installation disc 155/81x31 P/N 206.04560710 1 PC 1.50 50.00 50.00 50.00
11 Spacer tube 133/110.2x250 P/N 41574530 1 PC 8.20 150.00 150.00 150.00
12 Coupling VBK antrieb P/N 205.02696610 1 PC 20.00 1,500.00 1,500.00 1,500.00
TOTAL PACKAGE: TOTAL - 121.84 - 25,425.10 25,425.10
Requestor Signature :
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