GAP Portal

COMPLAINT ASSESSMENT FORM

Supplier Name

Cakrawala Mega Indah

Complaint No. :

Address

CIF No.: 005/WEB/II/2024

Phone

PIC

Invoice No. :

PO

Quality Order

Product : HVS ROLL

Quality Complaint

Specification : HVS ROLL 70 73 INDIGO

Problem :

-BASAH

Kategory of Complaint

Claim value (IDR/USD/SGD/EUR) :
Rp. 4.682.240.-

In Words

( Empat Juta enam ratus delapan puluh dua ribu dua ratus empat puluh 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 :

ID ROLL 213196069 NO.DO	5782045420

Jakarta, 28 Februari 2024

Prepared by,

Checked by,

Approved by,

28-02-2024

( Gita Siti )

28-02-2024

( Maurina Gurning )

01-03-2024

( Oscar )

( Staff Pembelian )

( Ka. Bag. Pembelian )

( Supplier )