DATE September 21 2016

BATCH NUMBER
REPLENISHMENT /RETURN FORM
PR /PO #
REPLENISHMENT RETURN
ORIGIN SPM PLDT TAMBO ORIGIN WWWCOMMARINDUQUE A3
Address PLDT TAMBO BLDG.226 QUIRINO AVE. TAMBO Address Bagong Silang Sta Cruz Marinduque 4902
Contact Person RENO A. RUFIN Contact Person LAWRENCE M. ROLLUQUI
Contact Number 9477063295 Contact Number 09212588477
DESTINATION WWWCOMMARINDUQUE A3 DESTINATION SPM PLDT TAMBO
Address Bagong Silang Sta Cruz Marinduque 4902 Address PLDT TAMBO BLDG.226 QUIRINO AVE. TAMBO
Contact Person LAWRENCE M. ROLLUQUI Contact Person RENO RUFIN
Contact Number 9212588477 iHelp Ticket Number Contact Number 9477063295 iHelp Ticket Number

Mode of Transacti Airway Bill Number Mode of Transaction Airway Bill Number
NO ITEM CODE DESCRIPTION QTY SO TYPE REMARKS ITEM CODE DESCRIPTION QTY SO TYPE REMARKS
1 M00132 CANOPY SM 0 Technical Support GOOD M00132 CANOPY SM 0 Technical Support DEFECTIVE
2 M00203 CANOPY POE 2 Technical Support GOOD M00203 CANOPY POE 2 Technical Support DEFECTIVE
3 M00127 FTP 0 Technical Support GOOD M00127 FTP 0 Technical Support DEFECTIVE
4 M00130 UTP 0 Technical Support GOOD M00130 UTP 0 Technical Support DEFECTIVE
5 M00218 SURGE 1 Technical Support GOOD M00218 SURGE 1 Technical Support DEFECTIVE
6 OUTDOOR W 1 Technical Support GOOD OUTDOOR WIMAX 1 Technical Support DEFECTIVE
7 PWM00001 INDOOR WIMAX 1 Technical Support GOOD PWM00001 INDOOR WIMAX 1 Technical Support DEFECTIVE
OUTDOOR WIMAX POE 0 Technical Support DEFECTIVE
M00385DF INDOOR WIMAX POE 0 Technical Support DEFECTIVE
M00384DF INDOOR LTE 0 Technical Support DEFECTIVE
OUTDOOR LTE 0 Technical Support DEFECTIVE
OUTDOOR LTE POE 0 Technical Support DEFECTIVE
M00384DF OUTDOOR LTE ROUTER 0 Technical Support DEFECTIVE
M00132 CANOPY SM 3 PULLOUT VPD / REL PULL OUT
PWM00001 WIMAX INDOOR 1 PULLOUT VPD / REL PULL OUT
WIMAX OUTDOOR 0 PULLOUT VPD / REL PULL OUT
OUTDOOR LTE 0 PULLOUT VPD / REL PULL OUT
OUTDOOR LTE ROUTER 0 PULLOUT VPD / REL PULL OUT

PREPARED BY APPROVED BY PREPARED BY 0.00 APPROVED BY

RENO A. RUFIN JAN JONARD BADILLO

SIGNATURE OVER PRINTED NAME SIGNATURE OVER PRINTED NAME SIGNATURE OVER PRINTED NAME SIGNATURE OVER PRINTED NAME

RECEIVED BY (courier/representative/requisitioner) RECEIVED BY (courier/representative/requisitioner)

RENO A. RUFIN
SIGNATURE OVER PRINTED NAME SIGNATURE OVER PRINTED NAME
 SO TYPE
Technical Support
Pullout IVPD
Pullout Relocation
Pullout VPD
Project/Recovered
0
 EQUIPMENT DETAILS

NOTE TO BE FIILED OUT BY CONTRACTOR

DEPOT SMTYPE / BRAND NAME MSN / IMEI ESN / SU MAC SO SRN ACCOUNTNAME
MSC BOAC ICTSC-OFFICE 5
PLDT Tambo MOTOROLA 606IME8255 0A:00:3E:DA:B9:81 3301168 1010541399
ROMULO H MALVAR
MSC BOAC ICTSC-OFFICE 3
PLDT Tambo MOTOROLA 606IMKB345 0A:00:3E:DB:BC:DB 3278639 1010541393
ROMULO H MALVAR
FRANCISCO MACABATA
PLDT Tambo MOTOROLA 606IML6076 0A:00:3E:DB:C7:09 3231576 1011348228
MONSANTO
JOSE MARIO CESAR RICAFORT
PLDT Tambo Green Packet OX 001FFB595834 3302744 4010006711
MARQUEZ
PLDT Tambo Green Packet OX 001FFB84D3C2 3307693 4010125347 LILY GALIAS NICOLAS
 DATE JULY 14, 2016
BATCH NUMBER TAM-16-239

TAILS

CONTRACTOR REMARKS CONTRACTOR DATE TESTING TSQACODE

Pullout VPD Canopy WWWCOMMARINDUQUE A3 September 10, 2016 Pullout VPD Canopy

Pullout VPD Canopy WWWCOMMARINDUQUE A3 July 27, 2016 Pullout VPD Canopy

Pullout VPD Canopy WWWCOMMARINDUQUE A3 July 18, 2016 Pullout VPD Canopy

Pullout VPD wimax ID WWWCOMMARINDUQUE A3 September 10, 2016 Pullout VPD Canopy

unplug no signal WWWCOMMARINDUQUE A3 September 16, 2016 TSCPE1 WID

 BRAND SERIAL# SO SRN

FULRUBELL FTP 3301168 1010541399

1
FULRUBELL FTP 3278639 1010541393
2
Motorolla CANOPY POE 3231576 1011348228
3
FULRUBELL FTP 3231576 1011348228
4
Green Packet OX WID POE 3302744 4010006711
5
FULRUBELL CANOPY POE 3305947 1011429879
6
7 FULRUBELL CANOPY POE 3303102 1010117908
9 Green Packet OX WID POE 3307693 4010125347
10 FULRUBELL FTP 3309785 1011440272
FULRUBELL DSS 3309785 1011440272

19
 ACCOUNTNAME CONTRACTORREMARKS CONTRACTOR

MSC BOAC ICTSC-OFFICE 5 ROMULO Pullout VPD Canopy WWWCOMMARINDUQUE A3

H MALVAR
MSC BOAC ICTSC-OFFICE 3 Pullout VPD Canopy WWWCOMMARINDUQUE A3
ROMULO H MALVAR

FRANCISCO MACABATA MONSANTO Pullout VPD Canopy WWWCOMMARINDUQUE A3

FRANCISCO MACABATA MONSANTO Pullout VPD Canopy WWWCOMMARINDUQUE A3

JOSE MARIO CESAR RICAFORT Pullout VPD WID WWWCOMMARINDUQUE A3

MARQUEZ
REYNALDO II GRIMALDO DELA Unplugged/red ligth WWWCOMMARINDUQUE A3
ROSA
GUILLERMO ANG JAO NO POWER WWWCOMMARINDUQUE A3
LILY GALIAS NICOLAS NO POWER WWWCOMMARINDUQUE A3
MAYNARD COMIA SADIWA Unplugged WWWCOMMARINDUQUE A3
MAYNARD COMIA SADIWA Unplugged WWWCOMMARINDUQUE A3
 DATE TESTED TSQA CODE TESTING REMARKS

September 10, 2016 TSPULLOUT

June 10, 2016 TSPULLOUT

July 27, 2016 TSPULLOUT

July 27, 2016 TSPULLOUT

September 10, 2016 TSPULLOUT

September 11, 2016 TSPOE Unplugged/red ligth

September 10, 2016 TSPOE NO POWER
September 16, 2016 TSPOE NO POWER
September 17, 2016 TSFTP Unplugged/ with cut
September 17, 2016 TSDSS Unplugged