Amtrak

Reving Report for AMTRAK Furnished Mial

THE ORIGINATOR IS RESPONSIBLE FOR COMPLETING ALL BLOCKS IN THEIR ENTIRETY.
(SEE INSTRUCTIONS ON REVERSE SIDE)

Rec. No. RR 142879

Amtrak Purchase Order No..

Date of Material Receipt

The below listed material has been received at:

The below listed material was received from:

Please indicate method of shipment and name of carrier for material received (e.g. commercial truck, air freight, vendors truck, Parcel Post, etc.) Note: If shipment is collect, attach freight bill to Accounting copy of Receiving Report.

Note to Receiving Facility:

Material Received by

(Please Print)

Signature

Material Received by

Telephone

After recording the above data in its entirety please retain the No. 2 copy and forward copies No. 1, No. 3, and No. 4, within twenty-four (24) hours of receipt to:

1. ALL BLOCKS MUST BE COMPLETED IN THEIR ENTIRETY.

2. THE REMARKS COLUMN IS TO BE UTILIZED FOR UNDER/OVER RECEIPTS, DAMAGED MATERIAL, INCORRECT MATERIAL RECEIVED, ETC.*

3. IT IS EXTREMELY IMPORTANT THAT THE BLOCKS REGARDING PARTIAL, COMPLETE OR FINAL RECEIVINGS BE PROPERLY CHECKED, ESPECIALLY WHEN THE REQUIREMENTS OF THE AMTRAK PURCHASE ORDER HAVE BEEN SATISFIED.

4. PLEASE BE SPECIFIC AS TO UNIT OF MEASURE I.E. EA, SQ. YDS, FT, CASE ETC.

*RESOLUTION FOR THESE ITEMS WILL BE SETTLED SOLELY BY AMTRAK'S PROCUREMENT

DEPARTMENT.

31-665 - 78 - 14

OTE:

AMTRAK NORTHEAST CORRIDOR.

QUALITY CONTROL INSPECTION SHEET

During inspections any deficiency which constitutes a possible safety hazard must be corrected on the spot if possible.