Sample Material Receiving Report Form
“SAMPLE” MATERIAL RECEIVING REPORT FORM
Receiving Report
County of ____________________, Tennessee
Department:____________________
Purchase Order No:______________
Requisition No:__________________
Item No. Description Quantity Unit Price Extension
Freight Charge:____________
Total:____________
“I hereby certify that the material or services has been received,
inspected and found satisfactory for the purpose for which they
were purchased:”
____________ __________________________
Date Received Inspector
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