GAP Portal

COMPLAINT ASSESSMENT FORM

Supplier Name

Cakrawala Mega Indah

Complaint No. :

Address

CIF No.: 008/WEB/VI/2023

Phone

PIC

Invoice No. :

PO

Quality Order

Product : HVS ROLL

Quality Complaint

Specification : HVS ROLL 70 73 INDIGO EX PINDO

Problem :

WARNA KERTAS BERBEDA

Kategory of Complaint

Quality	Handling
Packaging	Quantity
Delivery

Claim value (IDR/USD/SGD/EUR) :
Rp. 24.950.800.-

In Words

( Dua puluh empat juta sembilan ratus lima puluh ribu delapan ratus rupiah )

Ect ..................................................................................................................................

Data :

Original sample / before process	Copy of DN
Sample after process	Photo
Comparison sample	Packaging
Inspection Card	Pull Tape ( for Picking / Dusting problem )
Ream Label
Ect

Notes :

NO.DO	1261713933 P2BD021651	
P2BD021651	469	Warna kertas berbeda
P2BD021653	467	Warna kertas berbeda
P2BD021652	473	Warna kertas berbeda
P2BD021553	467	Warna kertas berbeda

Jakarta, 27 Juni 2023

Prepared by,

Checked by,

Approved by,

27-06-2023

( Gita Siti )

27-06-2023

( Maurina Gurning )

( ........................ )

( Staff Pembelian )

( Ka. Bag. Pembelian )

( Supplier )