KOP SATKER

BLANKO NAMA ANGGOTA YANG DITUNJUK MENJADI PANITIA PENGADAAN

DI LPSE POLDA JATIM

1.

Nama Anggota

: .....................................................................................

2.

NRP/NIP

: .....................................................................................

3.

User ID

: (diisi oleh admin LPSE Polda)*

4.

Password

: (diisi oleh admin LPSE Polda)*

6.

Satuan Kerja

: ..

5.

Alamat

: .....................................................................................
.....................................................................................

6.

Telepon/HP

: .....................................................................................

7.

Email

: .....................................................................................

8.

Pangkat

: .....................................................................................

9.

Jabatan

: .....................................................................................

10.

Golongan

: .....................................................................................

11.

Aktifasi User ID

: (diisi oleh admin LPSE Polda)*

12.

Pengangkatan menjadi

: Panitia )* ( Ketua / sekretaris / anggota )*

13.

Nomor Sprin

: .....................................................................................

14.

Masa Berlaku Sprin

: .....................................................................................
Surabaya,

Pebruari 2013
KASATKER

(nama lengkap)
(Pangkat, NRP)

KOP SATKER

BLANKO PANITIA PENGADAAN DI LPSE POLDA JATIM

1.

Nama Kepanitiaan

: .....................................................................................

2.

Tahun Kepanitiaan

: .....................................................................................

3.

Nomor Sprin

: .....................................................................................

4.

Satker

: ..

5.

Kode Anggaran

: .....................................................................................

6.

Nilai Anggaran

7.

Uraian

: .....................................................................................

8.

Sumber Dana

: ..

: .....................................................................................

Surabaya,

Pebruari 2013
KASATKER

(nama lengkap)
(Pangkat, NRP)