Generator Operation Log

Transcription

1 YMCA Of Liberia Generator Operation Log Date Quantity of fuel before starting Starting time Starting Meter Quantity of fuel refilled Time Generator put off Ending meter Total meter reading ( ending meter Minus starting meter) Total hours run For day Name of Operator or Duty Guard Servicing date Signature of Operator or Duty Guard Remarks Total = Total = Generator Log review Comments by Supervisor : Log Reviewed by Field Supervisor (As Applicable) Name Job Title Signature Date Generator Log review Comments by Logistics Officer: Log verified by Logistics Officer Name Job Title Signature Date

2 YMCA of Liberia Section/Program Motor Cycle LOG SHEET County Type of Motor Cycle: Motor Cycle Plate Number Location Please Mark P or O as Applicable Date Purpose (Personal [P] OR Official [O] Departure Time Starting Meter Reading Destination Arrival time Ending meter Reading Total meter reading Completed ( ending meter Minus starting meter) Quantity of fuel Put in Motorbike (in gallons) Signature of Bike Signature of Rider Total Meter Reading = Motorcycle Log review Comments by Supervisor : Log Reviewed by Field Supervisor Motorcycle Log review Comments by Logistics Officer: Log verified by Logistics Officer Name Job Title Signature Date Name Job Title Signature Date

3 VEHICLE LOG SHEET YMCA of Liberia SECTION/PROGRAM REFERENCE Month Type of Vehicle: Vehicle Plate Number Location Date Please enter as Applicable Purpose (Personal [P] OR Official [O] Departure Time Starting Meter Reading Destination Arrival time Ending meter Reading Total meter reading Completed ( ending meter Minus starting meter) Quantity of fuel in Vehicle (in gallons) Signature of User of Vehicle Driver's Signature Total Meter Reading = Vehicle Log review Comments: by Logistics Officer Vehicle Log Reviewed by: Logistics Officer Name Position Title: Signature Date

4 YMCA of Liberia Work Order/Service Request Form Section/Reference Charge Cost To Date : Name of Contractor /Firm : Category of vendor : Individual [ ] Company/Firm [ ] Specification of type of work or service requested: (Please check as appropriate) Professional/Consultancy Service [ ] Skilled/Technical Labor [ ] Unskilled Labor [ ] Vehicle Rental Service [ ] Catering [ ] Other Work Specification Expected Start Date: Projected Duration of Service period Expected Date of Completion: Recommended/Approved Remuneration for tasks Currency Recommendation to NGS/ Designee regarding approval and payment of contractor. Name Work Order/Service Requested By: Job Title Signature Work Order/ Service Request verified and approved by NGS/Authorized Designee: Name Job Title Signature

5 YMCA of Liberia Work/Service Completion Form Section/Reference Charge Cost To Date Name of Contractor /Firm: Category of vendor that provided Services: Company/Firm [ ] Individual [ ] Specification of type of work or service Rendered: (Please check as appropriate) Professional/Consultancy Service [ ] Skilled/Technical Labor [ ] Unskilled Labor [ ] Vehicle Rental Service [ ] Catering [ ] Other Brief Description of Work Specification Actual Start Date: Proposed Duration of Service period Expected Date of Completion: Actual Date of completion: Currency Amount Recommended/Approved Remuneration for tasks Comment regarding completion: Were services adequately completed as required? Select the most appropriate option below Yes [ ] Comment (if any) No [ ] Comment ( If any) Date VERIFICATION AND APPROVAL OF WORK/ SERVICE COMPLETED Name Job title Signature Recommendation to NGS regarding payment of contractor. Final Authorization for Payment by NGS or Designee Name Signature Date

6 YMCA Of Liberia Purchase Request Form Date: PR No: Currency: Requested By: Section: Job Title Charge Cost To Signature of Requesting Staff Location: Date PR item(s) Needed: No. Description of Items or Service Quantity Unit Estimated Total Price ( If Known) Comments/ Special Instructions: Reviewed by Supervisor : Name Title Signature Date Attested by Finance: Name Title Signature Date Authorized by NGS/DS Name Title Signature Date Copy Originator 1 ; Finance 1, Procurement 1,

7 PURCHASE ORDER (P.O) FORM Requesting Organization YMCA of Liberia Address: 126 Broad Street 126 Broad Street Purchase Order Number P.O. Box P.O. BOX Head of Organization E. Edward Gboe Cell # DATE: Organization Cell Number : Section/ Project Purchase Order Delivered To Vendor Goods Are To be Delivered To: Business Name: Name ( Organization): Name (Contact Persons): Name of Head of Organization: Address: Address: Cell # Cell Phone No: Purchase Order Attested by Finance Officer {For Liberia YMCA} Name Job Title Signature Date Name of Person To Receive Goods Name Job Title Signature Date Approved by NGS or Authorized Designee {For Liberia YMCA} Name Job Title Signature Date If you have any questions about this purchase order, please contact YMCA of Liberia through the above address ITEM # DESCRIPTION Quantity Unit UNIT PRICE TOTAL [42] SUBTOTAL Other Comments or Special Instructions OTHER $ TOTAL $ Signature of Supplier (for Vendor ) Name Job Title Signature Date Goods Received For YMCA by ( Signature of Person Receiving Goods) Name Job Title Signature Date

8 Submitted To: Request For Quotation (RFQ) N : Type of Currency: Name of Supplier Address Contact/Telephone Quotation reference and Date No Auth oriz atio Description of items / Serv ice GRAND TOTAL Comment Regarding Vendor Meeting of Required Specifications Delivery Date Promised Bid validity Date Terms of payment Recommended Vendor: Reason: Approval Comments Prepared By ( Name & Signature): Reviewed By( Name & Signature): Approved By ( Name & Signature): Unit/ Section Expected Date of Purchase and delivery Charge Cost To: Quantity Unit Unit Price TOTAL Unit Price TOTAL Unit Price TOTAL NAME Procurement Officer / Bid Committee Comments: POSITION Location Suplier # 1 Suplier # 2 Suplier #3 DATE Liberia YMCA BID COMPARISON/ANALYSIS FORM

9 Submitted To: Name of Staff: Section: Date of Update: YMCA of Liberia Leave Days Calculation and Update Form Administrative Section Charge to Nat'nal or (Project) Position: Name of project (if staff is project staff) Signature of Staff: Submitted To Immediate Supervisor: Name Title Date of Submission Total Annual Leave days accrued per month Annual Leave days calculation = 0.8 days per month for employees in first year of service AND 1.65 days per month for employees in 2 or more years of service NOTE: Annual leave days can not be brought forward from previous year except if authorized by the NGS Total Annual sick Leave days accrued per month Annual Leave days calculation = 1 day per month for each year NOTE: Annual Sick leave can be brought forward form previous year Month of update : Month of update : Description Days Description Days Number of annual leave days accrued last month. Please Insert Name of previous month, 20 1 Total annual leave days accrued this month 201 Grand total annual leave days to date ( End of this month) Proposed annual leave period for staff as scheduled by Admin Section ANNUAL LEAVE REFERENCE DATA Actual annual leave days accrued to date as calculated and counterchecked by Administrative section Number of sick leave days accrued last month. Please Insert Name of previous month, 20 Total sick leave days accrued this month Grand total sick days to date ( End of this month) Actual annual period scheduled by staff SICK LEAVE REFERENCE DATA Actual sick leave days accrued to date as calculated and counterchecked by Less number of days taken for annual leave Remaining balance of annual leave days as of first leave this year Less number of days taken for annual leave taken ( 2nd Time) Remaining balance of annual leave days as of second leave this year Less number of days taken for Sick leave Remaining balance of sick leave days as of first leave this year Less number of days taken for sick leave taken ( 2nd Time) Remaining balance of sick leave days as of second leave this year Counterchecked and Attested by Administrative Section Signature of Administrator/Designee: Date: Comments ( If any)

10 Submitted To: Name of Requesting Staff: Section: Administrative Section YMCA of Liberia Leave Request Form Charge cost to Nat'nal or (Project) Name of project (if staff is project staff) Position: Date of Request: Signature of Requesting Staff: Submitted To Immediate Supervisor: Name Title Date of Submission Type of Leave/Absence (Please Check appropriate box(es) below as application to your leave [ ] Accrued Annual Leave [ ] Restored Annual Leave [ ] Advanced Annual Leave [ ] Accrued Sick Leave [ ] Advanced Sick Leave [ ] Maternity Leave [ ] Paternity Leave From Date Date To Time Total Days Comment Comment Others From To Total Days Compensatory Time Off Compassionate leave/bereavement leave Leave of Absence Without Pay Purpose: [ ] Official for Rest off work/personal [ ] Illness/injury/incapacitation of requesting employee [ ] Medical/dental/optical examination of requesting employee [ ] Bereavement [ ] Care of family member with a serious health condition [ ] Other (Please Explain): Comments: Certification: I hereby request leave/approved absence from duty as indicated above and certify that such leave/absence is requested for the purpose(s) indicated. I understand that I must comply with the organization's procedures for requesting leave/approved absence (and provide additional documentation, if required) and that falsification on this form and additional documentation may be grounds for disciplinary action, including dismissal. Official Action on Request by immediate supervisor : Reason for Disapproval: [ ] Approved [ ] Disapproved (If disapproved, give reason. If annual leave, initiate action to reschedule.) Supervisor Comments (even if approved) : Supervisor's Signature : Date: Section For Management Actual Leave days Accrued: Leave days taken before Previous leave date Counterchecked and Attested by Administrative Section Signature of Administrator/Designee: Date: Remaining leave days to date Official Action on Request by NGS or Designee (Please check as applicable) [ ] Approved [ ] Disapproved Reason for Disapproval: Leave Authorization by Senior Management Note Regarding disapproval: If disapproved, please give reason in below space. If annual leave request is not granted because there is need for staff to stay on job, please initiate action to reschedule leave and at what time. Management Comments (even if approved) : Signature of NGS/Designee: Date:

11 YMCA Liberia Trip/ Vehicle Request Form Name of Requesting Staff Name Date of Request Job Title Duty Station: Duration of Trip Departure Date for Trip: Expected Return Date Brief Summary of purpose of trip Type of Trip (Please check 1) International ( ) Local/National ( ) Mode of Travel ( Please check 1 ) Road ( ) Air ( ) Sea ( ) Name Designation Duty Station Submitted To Date of Submission Signature of Requesting Staff Date Departure/Return From To Primarily Departing From Returning Finally From Traveling Route No of days in use Other areas of visit ( If any) Total number of days for which vehicle is requested by staff for this trip = Number of days authorized for vehicle use for this trip = Total Passengers on Board Team lead for trip Names of YMCA passengers on Trip ( If any) Comment if vehicle will be rented for use or if YMCA vehicle to be used: Approval # 1) Immediate Supervisor/ Program Team Lead : Name Signature Date For use by Logistics Officer Assigned Driver Duty Station Vehicle Plate Number Required fuel Calculated in Gallons Comment Attested # 2 : Logistics Officer Name Signature Date Note: If rented, a contract form is to be attached to the request for payment. A vehicle log must be completed by the driver, if it is a YMCA vehicle regardless of the program or purpose.

12 YMCA Liberia Per diem Request Form Name of Requesting Staff Name Date of Request Job Title Duty Station: Duration of Trip Departure Date for Trip: Expected Return Date Brief Summary of purpose of trip Type of Trip (Please check 1) Mode of Travel (Please check 1 ) Name International ( ) Local/National ( ) Road ( ) Air ( ) Sea ( ) Designation Duty Station Submitted To Date of Submission Signature of Requesting Staff Are required copies attached to Request ( Please check if available: TOR [ ] Trip/Vehicle Request [ ] Note: Per diem request will not be processed if a copy of approved trip request and Brief TOR is not attached. Date Departure/ Return From To Traveling Route No of Overnights Primarily Departing From Returning Finally From Other areas of visit ( If any) Total number of overnight (s) requested by staff for this trip = Number of Overnight (s) Officially Authorized for Trip = # 1 Calculated Per diem Rate for Lodging Per Night = US _$ # 2 Calculated Per diem Rate for Meals and incidental Per day US Total Perdiem Calculated and Approved for Payment for This Trip Approval for Payment Approval # 1) Immediate Supervisor/ Program Team Lead : Name Signature Date Approval # 2 NGS or Designee: Name Signature Date Note: 1) The amount for lodging must be liquidated. Cash receipt voucher is required for meals and incidental and not official receipt. 2) Official receipt is required for lodging.

13 Type of Trip (Please check 1) Name YMCA Liberia Per diem Liquidation Form Name of Staff Liquidating Perdiem Name Date of Request Job Title Duty Station Actual Duration of Trip Days : From: To: Brief Summary of purpose of trip Departure Date for Trip Return Date From Trip International ( ) Local/National ( ) Mode of Travel ( Please check 1 ) Road ( ) Air ( ) Sea ( ) Submitted To Designation Duty Station Date of Submission: Signature of Staff Liquidating Perdiem: Copies to be attached to Request: Is Copy of Trip Request Available and attached to Request? Yes ( ) No ( ) Is copy the Term of Reference (TOR) for the Trip Attached? Yes ( ) No ( ) Is copy of initial approved per diem request attached? Yes ( ) No ( ) Note: Per diem liquidation will not be processed if the above copies are not attached. Date Departure/ Return From To Traveling Route No of Overnights Primarily Departing From Returning Finally From Other areas visited ( If any) Total number of overnight (s) initially approved for this trip = Number of Extra Overnight (s) approved by Supervisor and NGS/Designee = Number of unused Overnight (s) approved by Supervisor and NGS/Designee = Total Number of Overnight (s) Officially Authorized and used = Signature of National General Secretary or Designee: # 1 Total perdiem for lodging that was approved and received for trip = Total claim of per diem for lodging that is due staff Total amount of per diem for lodging that is refundable by staff to YMCA Management # 2 Total Calculated Per diem Rate for unused overnight (s) (Lodging Per Night) = # 3 Calculated Per diem Rate for extra overnight(s) (Lodging Per Night) = Total Perdiem outstanding Calculated and Approved for Payment for This Trip Note: Rate per night for lodging per night under Cost Line = Rate for meals & incidental per day under Cost Line = Approval Number 1: Immediate Supervisor Approval for Payment Approval Number 2 : NGS OR Designee Name: Designation: Signature: Date: Name : Designation: Signature: Date: Note: 1) Official Receipts must be obtained for lodging. 2) No official receipt is required for meals and incidentals ; however, the receiving staff must submit a cash receipt voucher

14 YMCA Liberia Fuel Request Form Name of Requesting Staff Job Title Duty Station: Date of Request: Type and quantity of Fuel Requested (Please Check as Appropriate) Gasoline ( ) Qty Gals ; Diesel ( ) Gals Major Reason for Fuel Request Please check as applicable : Fuel is requested for Vehicle ( ) Generator ( ) Motorcycle ( ) Other How long do you anticipate supply to last OR period of request ( estimated time) Date on which fuel is expected to be provided Description if requested for generator (Please check as appropriate ) Fuel to be received by: Type of Generator Odeo meter reading Will vehicle, Motorcycle or generator log be completed to account for fuel usage as required for this supply Please check as applicable : Yes ( ) No ( ) Areas of travel ( if fuel request is for vehicle) Verification To be Completed by Logistics Unit ** Was tracking and analysis of log done to update fuel use for previous request? Yes { } No { } ** Is log attached? Comment about the findings in accounting for previous Fuel supply according to tracking ( if Any?) Any other Comment regarding request ( if Any?) Total kilometers of trip required ( if Vehicle) Total kilometers of trip required ( if motorcycle ) Total fuel for Generator based on odometer reading, previous consumption and capacity ( if generator or vehicle as applicable) Specification of equipment for fuel request Total Fuel amount recommended to be supplied Comment about the findings in accounting for previous Fuel supply according to tracking ( if Any?) Any other Comment regarding request ( if Any?) Signature of Logistician/Authorized Designee: Name Job Title Signature Date Request Submitted to: Name Designation Duty Station Date of Submission Signature of Requesting staff Authorization No 1 : Immediate Supervisor Authorization of Fuel Request Authorization No 2: NGS or Designee Name: Name : Designation: Designation: Signature: Signature: Date: Date:

15 YMCA Liberia Asset Movement Form Name of Staff: Job Title: Duty Station Date: No Description Of Asset Quantity Newly Procured Existing Serial number Specification of Assets YMCA Assigned Code From (Staff) Unit/ Section Location To (Staff) Date Received Expected Date of return Signature of receiver (Staff ) Comment By Head of Field Office (If Applicable): Comment By Logistics Officer: Attested by Head of Field Office or Logistics Officer (As Applicable): Name Job Title Signature Date

16 YMCA OF LIBERIA INVENTORY LOG Section: Location: Project Title Date of Inventory: Quarter Inventory Conducted By: No Item Description Unit Quantity Supplied Quantity Used Remaining Quantity On hand Condition Remarks Total = I,THE UNDERSIGNED, DO HEREBY CLAIM THAT ALL THE ABOVE INFORMATION IS CORRECT UPON THE COMPLETION OF THIS INVENTORY Name Title Signature Date YMCA Logistics Officer / Designee Attested for Branch Office Name Title Signature Date Branch Coordinator, YMCA Branch Attested for National Secretariat Name Title Signature Date Authorized Administrative staff

17 YMCA Liberia Incident Report Form Name of Staff Making Incident Report Job Title: Duty Station: Date of Report: Date Incident Occurred: Place Incident Occurred: Time of Incident: Type of Incident (please Check as appropriate) Vehicle Accident ( ) Motor Cycle Accident ( ) Damage of Property ( ) Theft ( ) Description of Incident ( Major aspects, Key issues) Initial action taken by Staff/ Team Outcome of initial action taken by staff Describe Management Action Requested For Official Use Only Inhouse Investigation Conducted Yes ( ) No ( ) If Yes, Date Conducted Outcome of InHouse Investigation Police Investigation (If Any/Applicable) Yes ( ) No ( ) If Yes, Date Conducted Outcome of police Investigation ( If any) Total Cost of incident Liberian Dollar US Dollar Equivalent Summary of Final Decision relating to Incident Description of Personnel Responsibility Description of Management Responsibility Approval of Management Action Approval Number 1 Approval Number 2 NGS Name: Name : Designation: Designation: Signature: Signature: Date: Date:

18 YMCA of Liberia Petty Cash Request & Payment Voucher Reference or Program: Voucher No. Date Requested by: Position: Signature: Purpose of Request : Cash needed on: Make Payment to: Amount of cash needed in Words: Amount In figures $ No Details of Payment (please describe fully) Description Currency Amount Initial approval by ( Immediate Supervisor) : Total Payment> AUTHORIZATION Name: Position Signature Date Verified by: Attested by: Accountant (Name & Signature) Financial Officer ( Name & Signature ) Payment Authorized by NGS: Name: Signature Date This Section Is Only for Use of The Finance Staff Petty Cash voucher # Cashbook #: Date of payment Cash Payment made by ( Cashier): Name Signature Date Cash Received by: Name Signature Date 1 copy to Finance; 1 copy with Accountant; 1 copy with Cashier

19 Liberia YMCA Section OR Program Reference Date Voucher Number Payee: Amount in Words: No DESCRIPTION Amount in Figures = AMOUNT $ TOTAL Initiator of Request : Name: Position Signature Counterchecked by Supervisor : Name: Position Signature Verified by: Attested by: Accountant (Name and Signature ) Finance Officer ( Name & Signature) Request Authorized by NGS: Name: Signature Date

20 YMCA OF LIBERIA OFFICIAL GATE PASS Date: Gate Pass From To Project Section Location KINDLY ALLOW THE FOLLOWING ITEM(S) TO BE TAKEN OUT OF THE YMCA BUILDING/OFFICE FOR THE ABOVE LOCATION No ITEM DESCRIPTION QTY. Unit SERIAL # CONDITION NAME/SIGNATURE & POSITION OF PERSON TAKING ITEM(S) MUST BE CLEARY STATED BELOW AUTHORIZED BY: Administrator/Designee Items Taken Out BY: Name of Staff Person Exit attested by: Security Officer Comment from Security (If any)

21 YMCA of Liberia Cash Receipt Voucher Section/ Unit: Program/Project/ Section Reference : Completed by: Name Job Title Date Received cash amount of (In words) Figures: $ Breakdown No Currency Amount Purpose Total Amount = $ Payment made in by: Name: Job Title: Type of Payment : Cash $ Cheque $ Total $ P payment Received By: Name Job Title Signature Date Received Through: Name Job Title Signature Date YMCA of Liberia Cash Receipt Voucher Section/ Unit: Program/Project/ Section Reference : Completed by: Name Job Title Date Received cash amount of (In words) No Currency Amount Breakdown Figures: $ Purpose Total Amount = $ Payment made in by: Name: Job Title: Type of Payment : Cash $ Cheque $ Total $ P payment Received By: Name Job Title Signature Date P payment Received By: Name Job Title Signature Date

22 Date Prepared YMCA of Liberia Monthly Time Sheet Job Title Section Employee Name: Employee ID: Project/Duty Station Range of Total Hours Worked Month/ Period: DATE: Total Days Project Title/Code: Regular Hours Public Holiday Annual Leave Sick Leave Leave of Absence without pay Others SubTotal: Project Title/Code: Regular Hours Public Holiday Annual Leave Sick Leave Leave of Absence without pay Others SubTotal: T O T A L DATE: Days Total Days Worked/Charged: Comment:

23 Details of hours worked per project and calculation of leave time Specification of hours Worked per project Section/Project Title % of Time Charged Total hours Worked No Grand Total Hours worked = Total annual leave per month = 0.8 days per month for staff of one year of service and 1.65 days for staff of more than one year of service Annual Leave Calculation No of Annual leave days Accrued last Month ( brought forward from last month) No of Annual leave days accrued this month Total Annual leave days to date ( end of this month) Total annual leave per month = 1. Sick leave days per month Sick Leave Calculation No of Sick leave days Accrued last Month ( brought forward from last month) No of Sick leave days accrued this month Total Sick leave days to date ( end of this month) Note: The hours are calculation of percentage of time worked for each project which staff shares time Note ** Annual leave can be accrued every month but can not roll into another year except with approval of NGS Note** Sick leave can be accrued but can not be taken as annual leave. It can only be taken when sick and can roll into another year Employee's Signature: Date: Supervisor's Signature: Comment (Admin Section) Date: Reviewed and Signed by Administrative Section : Name Job Title Signature Date

24 Logistics Section Consolidated Asset Tracking Report Form Date Report Compiled Reporting Period Completed for Period of No Office Location Office Location Asset Description (Name and Type ) Quantity Tracked Make Serial Number Category of Purchase /cost (Please state if direct YMCA or Program) Direct Program YMCA Quantity Assigned to staff YMCA Assigned Code Assigned to Job Title Date of Assignment Number of years in Use Current Condition Recommendation ( Check either maintain or dispose) Keep in use Repair Dispose

25 No Office Location Office Asset Description (Name and Type ) Quantity Tracked Make Serial Number Category of Purchase /cost (Please state if direct YMCA or Program) Direct Program YMCA Quantity Assigned to staff YMCA Assigned Code Assigned to Job Title Date of Assignment Number of years in Use Current Condition Recommendation ( Check either maintain or dispose) Keep in use Repair Dispose

26 YMCA of Liberia Cash/Check Advance Payment Slip and Commitment Form For Reporting Expenditures Funds Requested by: Job Title Date Name of Receiver of Funds: Job Title : Signature: Date cash/check Received Amount in Figures in $ Amount of cash Received in Words: Purpose : Cost Charged To ( Staff Accounts Receivable in name of): Payment Details & Financial Controls Payment Authorized by: (Please check as applicable) National General Secretary [ ] Development Secretary [ ] Payment made by: Name: Signature Date Payment Received by: Name Signature Date Advance Payment made In: Check Payment : [ ] Cash Payment [ ] Payment Voucher Number (Please check as applicable ) Commitment For Reporting on Expenditures I the undersigned recipient, hereby commit to make financial report and submission of quality receipts to the finance office through the Finance Assistance, for all expenditure made in relation to this payment received by me, within the period of five working days upon completion of this task for which payment is received; and not exceeding the deadline of. I hereby agree that the Finance Manager of the Liberia YMCA through the Finance Section, make the deduction of the paid amount in one installment from my monthly salary in the month following the payment received, for any failure on my part to comply and submit required financial receipts and all supporting documents for expenditure made for this payment. In the situation where the amount received is more than my monthly salary, I hereby agree that above amount must be deducted from my monthly salary at 50 percent every month following the date I received this payment until I complete payment of funds not accounted for. I agree that in the event I do not complete payment and resign from YMCA, YMCA should take legal action against me for the funds I do not account for. Signed by Receiver of funds: Name Signature Date Slip Attested by Finance Manager: Name: Signature Date Witness: Finance Assistance Name: Signature Date

27 Goods Received Note Section/Program Reference Receiving Office Location No Item Description Quantity Purchased as per receipt Unit Quantity Received Unit Condition Goods Delivered by: Name Position Signature Date Goods Received by: Name Position Signature Date Copy Originator 1 ; Finance 1, Admin/:Logistics 1,

28 YMCA Of Liberia BiWeekly Internal Stationary/Supply Requisition Form Date: Location Requested By: Job Title: Section: Project ( if Applicable) Charge Request To Date item(s) Needed: Signature of Requesting Staff: Date of Request No. Description of Items Stationery or supply Quantity Unit Expected Duration for use Comments/ Special Instructions: Reviewed and authorized by Supervisor : Title Date: Supplied by: Title Date: Date Name Signature Date Copy Originator 1 ; Finance 1, Admin/:Logistics 1,