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Article/ Services Requisitioned Dealers: Item No. Quantity Articles/Services Re
Article/ Services Requisitioned Dealers: Item No. Quantity Articles/Services Re
offered the lowest price in the locolity which is advantageous in the government.
No.:
OBLIGATION REQUEST
PAYEE ANGELES R. CARLOTO II
OFFICE
ADDRESS Pob. Tampilisan, Z.N.
Responsibilit ACCOUNT
PARTICULARS F.P.P AMOUNT
y Center CODE
Php 374.00
Market Supplies
No.:
OBLIGATION REQUEST
PAYEE ANGELES R. CARLOTO II
OFFICE
ADDRESS Pob. Tampilisan, Z.N.
Responsibilit ACCOUNT
PARTICULARS F.P.P AMOUNT
y Center CODE
Php 374.00
Market Supplies
Please quote your lowest price on the item/s listed below, subject to the General Condition on the
Philippine Bidding Documents on Goods, stating the shortest time of delivery and submit your quotation duly
signed by your representative not later than ________________________.
VIGILUS D. CREDO
NOTE: BAC Chairman
1. ALL ENTRIES MUST BE TYPEWRITTEN
2. DELIVERY PERIOD WITHIN SEVEN (7) CALENDAR DAYS
3. WARRANTY SHALL BE FOR A PERIOD OF THREE (3) MONTHS FOR SUPPLIES & MATERIALS, ONE (1) YEAR FOR
EQUIPMENT, FROM DATE OF ACCEPTANCE BY THE PROCURING ENTITY
4. PRICE VALIDITY SHALL BE FOR A PERIOD OF THIRTY (30) CALENDAR DAYS
5. G-EPS REGISTRATION CERTIFICATE SHALL BE ATTACHED UPON SUBMISSION OF THE QUOTATION, IF AVAILABLE.
6. BIDDERS SHALL SUBMIT ORIGINAL BROCHURES SHOWING CERTIFICATIONS OF THE PRODUCT BEING OFFERED.
ITEM
ITEM & DESCRIPTION QTY. Unit Unit Price TOTAL
NO.
1 snacks 52 pax
Printed Name/Signature
Date
1 CART Epson t6641 black 500 500.00
5 Cactus Long 198 990.00
5 Cactus Short 178 890.00
2,380.00
I HEREBY CERTIFY that personal canvass was made on the articles/services herein requested and it was found that
offered the lowest price in the locolity which is advantageous in the government.
THIS IS TO CERTIFY that the requirements of R.A. No. 9184 otherwise known Total 24,850.00 Total 24,925.00 Total 25,000.00
as the Government Procurement Reform Act ( Rule XVI - Sec.52 ) had been complied with. WE HEREBY CERTIFY to the correctness and authenticity of the above Abstract
of Bids to the best of our knowledge.
Please quote your lowest price on the item/s listed below, subject to the General Condition on the
Philippine Bidding Documents on Goods, stating the shortest time of delivery and submit your quotation duly
signed by your representative not later than ________________________.
VIGILUS D. CREDO
NOTE: BAC Chairman
1. ALL ENTRIES MUST BE TYPEWRITTEN
2. DELIVERY PERIOD WITHIN SEVEN (7) CALENDAR DAYS
3. WARRANTY SHALL BE FOR A PERIOD OF THREE (3) MONTHS FOR SUPPLIES & MATERIALS, ONE (1) YEAR FOR
EQUIPMENT, FROM DATE OF ACCEPTANCE BY THE PROCURING ENTITY
4. PRICE VALIDITY SHALL BE FOR A PERIOD OF THIRTY (30) CALENDAR DAYS
5. G-EPS REGISTRATION CERTIFICATE SHALL BE ATTACHED UPON SUBMISSION OF THE QUOTATION, IF AVAILABLE.
6. BIDDERS SHALL SUBMIT ORIGINAL BROCHURES SHOWING CERTIFICATIONS OF THE PRODUCT BEING OFFERED.
ITEM
ITEM & DESCRIPTION QTY. Unit Unit Price TOTAL
NO.
1 Paracetamol 23 boxes
2 Dicycloverine 10Hcl mg 1 box
3 Amoxicillin 250mg 1 box
4 Metoprolol 100 m 50 pcs.
5 Salbutamol nebule 10 pcs.
6 Nebulizing Kit 1 pc.
7 Oxygen Kit 1 pc.
8 Digital Blood Pressure Monitoring 1 pc.
9 Portable Nebulizer 1 pc.
10 Medical Oxygen complte set 1 pc.
Printed Name/Signature
Date
1 CART Epson t6641 black 500 500.00
5 Cactus Long 198 990.00
5 Cactus Short 178 890.00
2,380.00
PURCHASE REQUEST
Tampilisan, Zamboanga del Norte
LGU
PR No.: Date:
Department: Market SAI No.: Date:
Section: OR No. Date:
936.00
Purpose:
19,064.00
982.71
35.10
936.00 35.0967857
1965.42
982.71
PURCHASE ORDER
Tampilisan, Zamboanga del Norte
LGU
Supplier REMLITS ENTERPRISES P.O. No.
Address Pob. Tampilsian, Z.N. Date
Mode of Procurement:
Gentlemen:
Please furnish this office the following articles subject to the terms and conditions contained herein:
Date
(In case of Negotiated Purchase pursuant toSection 369 (a) of RA 7160, this portion must
be accomplished).
Certified Correct:
No.:
OBLIGATION REQUEST
PAYEE KJB STORE
OFFICE
ADDRESS Pob. Tampilisan, Z.N.
Responsibilit ACCOUNT
PARTICULARS F.P.P AMOUNT
y Center CODE
Php 21,600.00
No.:
OBLIGATION REQUEST
PAYEE KJB STORE
OFFICE
ADDRESS Pob. Tampilisan, Z.N.
Responsibilit ACCOUNT
PARTICULARS F.P.P AMOUNT
y Center CODE
Php 21,600.00
Food supplies for PNP, /PA/SCA Camul
and Sto. Niño
RESPONSIBILITY CENTER
ADDRESSPob. Tampilsian, Z.N.
Office/Unit/Project: Code:
EXPLANATION AMOUNT
To payment of food supplies use in PNP/PA/SCAA Camul Compaq and Sto. Niño ,per
supporting
papers,hereto attached
P ###
Funds Available
Supporting documents complete and paper
Signature Signature
Printed Date: Printed Date:
SHERRY LOU P. DAPROSA CYNTHIA D. ABIL
Name Name
Municipal Accountant Acting Municipal Treasurer
Position Position
(Head,Accounting Unit/Authorized Representative) (Head,Treasury Unit/Authorized Representative)
APPROVED FOR PAYMENT: RECEIVED PAYMENT:
C D
Signature Check No.: Bank Name: Date:
Printed Date: Signature
ANGELES R. CARLOTO II
Name Printed Nam KJB STORE Date:
Municipal Mayor OR. No./Other Documents JEV Date:
Position
(Local Chief Executive/Authorized Representative)
-
-
THIS IS TO CERTIFY that the requirements of R.A. No. 9184 otherwise known Total 18,577.00 Total 19,732.00 Total 20,000.00
as the Government Procurement Reform Act ( Rule XVI - Sec.52 ) had been complied with. WE HEREBY CERTIFY to the correctness and authenticity of the above Abstract
of Bids to the best of our knowledge.
7,547.50
INSPECTION ACCEPTANCE
Date Received:
Inspected, verified and found OK X Complete
as to quantity and specifications. Partial
ALBERTO L. ACAS
Assessment Clerk II
X
MILLER B. MAGHANOY
CYNTHIA D. ABIL Admin. Aide VI/ GSO Designate
RCO II
TOTAL 4,000.00 750.00 1,451.00 1,525.00 2,299.50 250.00 500.00 5,000.00 418.00 217.00 902.00 151.00
VIVIAN N. UBAGAN
MSWDO SHERRY LOU P. DAPROSA PRAXIDES C. ARCINO
Municipal Accountant OIC-Municipal Treasurer