PROVINCIAL GOVERNMENT OF ORIENTAL MINDORO

Capitol Complex Camilmil, Calapan City 5200, Oriental Mindoro

PURCHASE REQUEST
P.R.: _______________ _____________________
Department : Regional Trial Court Branch 42,
Pinamalayan Oriental Mindoro No.: __________________ _____________________

Section _____________________________________ SAI No.: ____________________ Date: ___________

OBR No.: __________________ Date: _______________

Item Estimated Estimated
No. Unit Cost Cost
Quantity
Unit of Item Description
Issue
1 24 reams Bond Paper long 236.5 5,676
2 24 pcs Ballpen HBW black 9.68 232.32
3 20 pcs Sign pen Hi-tech V-ball 0.5 black 63.3 1,266
4 24 pad Yellow pad 37.75 906
5 4 boxes Carbon Paper long 435.05 1,740.2
6 6 pcs Scotch Tape ‘1 48.4 290.4
7 4 bottle Stamp pad ink purple blue 82.28 329.12
8 7 pcs Pentel pen fine black 49.5 346.5
9 150 pcs Envelope brown long 4.13 619.5
10 20 pcs Correction tape 36.3 726
11 2 pack Indexing tab multicolour plastic 30.8 61.6
12 1 pc Tape dispenser big 209 209
13 16 pcs Battery Energizer AA 20.6 329.6
14 1 pc Paper cutler board 1991 1991
15 8 pcs Paste 170grams 36.6 292.8
16 16 pcs Sign pen gel Impact 10 black 75.9 1214.4
17 24 pcs Ballpen Gel 0.5 black 18.7 448.8
18 4 pcs Record Book 500 pp green 102.85 411.4
19 4 pcs Record Book 200 pp green 80.85 323.4

TOTAL AMOUNT 17,414.04

Purpose:

Requested by Cash Availability Approved by

Signature

Printed Name MR. EDMUNDO D. VILLA DEL REY, JR. ASTRONICA G. SALCEDO ALFONSO V. UMALI, JR.
Designation OIC-Branch Clerk of Court Provincial Treasurer Provincial Governor