Republic of the Philippines

Department of Education
Region I
Schools Division Office I Pangasinan
Calasiao II, Cluster of Schools
Malabago Elementary School

PURCHASE REQUEST
Entity Name: Malabago Elementary School Fund Cluster :18

Office/Section: Calasiao, Pangasinan PR NO.: Date:________

Responsibility Center Code
Stock/ Total
Property No: Unit Item Description Quantity Unit Cost Cost

Purpose:

For School-Based Feeding Program Use.

“OK as to Approved” APP/PPMP

Requested by: Approved by:

Signature: ___________________

Printed Name: ZORAIDA C. BERANIA TERESITA M. USON Ed. D.

Designation: SBFP Coordinator School Head
 Republic of the Philippines
Department of Education
Region I
Schools Division Office I Pangasinan
Calasiao II, Cluster of Schools
Malabago Elementary School

Malabago Elementary School

Entity Name

Supplier : __________________________________ P. O. No. ____________________________________

Address: __________________________________ Date. ___________________________________

Tel/ Fax No: _________________________________ Mode of Procurement ____________________________________

Gentlemen:
Please deliver to Malabago E/S, Calasiao, Pangasinan within ten (10) working days upon receipt hereto of the following:
Place of Delivery: Malabago E/S, Calasiao, Pangasinan Delivery Term: ________________________________
Date of Delivery: _________________________________ Payment Term: Cash Upon Delivery
Item Unit Quantity Description Unit Cost Amount
No.

(Total Amount in words)

In case of failure to make the full delivery within the time specified above, a penalty of one – tenth (1/10) of one percent for every day of delay shall be imposed

Very Truly yours,

TERESITA M. USON Ed.D

Signature over Printed Name Authorized Official
CONFORME:
School Head
Designation
_________________________
(Signature over printed name)
_________
(Date)

Funds Cluster:18
Funds Available: _______________________ ORS/BURS No: __________________________

___________________________________ Date of the ORS/BURS: ___________________

Signature Over Printed Name of Chief
Accountant/ Head of Accounting Division/Unit Amount: ________________________________
 Republic of the Philippines
Department of Education
Region I
Schools Division Office I Pangasinan
Calasiao II, Cluster of Schools
Malabago Elementary School

Inspection and Acceptance Report

Entity Name: Malabago Elementary School Fund Cluster:__18_

Supplier: ________________________________________
PO No: ____________ Date: ______________ INVOICE No.: ______ Date: _____________
Requisition Office/ Dept. _________________________
Stock Property Description Unit Quantity

Inspection Acceptance
Date Inspected: ______________ Date Received: ____________
Inspected verified and found in
Complete
order as to quantity and specification
Partial (please specify quantity)
Inspectorate Team:
1. Medelyn B. Gomez ________________ ZORAIDA C. BERANIA
2. Julie B. Bruan ________________ Supply and/or Property Custodian
3. Giezel C. Sabiaga _______________
Inspection Officer/Inspection Committee
 Republic of the Philippines
Department of Education
Region I
Schools Division Office I Pangasinan
Calasiao II, Cluster of Schools
Malabago Elementary School

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_____________________________________
VENDOR
 Republic of the Philippines
Department of Education
Region I
Schools Division Office I Pangasinan
Calasiao II, Cluster of Schools
Malabago Elementary School

REIMBURSEMENT EXPENSE RECEIPT

Entity Name: MALABAGO E/S Fund Cluster: 18

Date: ___________________ RER No: _______________________

RECEIVE from TERESITA M. USON, HEAD TEACHER III the amount of

(Name) (Official Designation)

____________________________________________(P_________________)
(in Words) (in Figures)

in payment for ____________________________________________________

(Payments for subsistence, services, rental or transportation should
show

_________________________________________________________________
Inclusive dates, purpose, distance, inclusive points of travel, etc)

_________________________________________________________________

PAYEE
Name/Signature: ZORAIDA C. BERANIA FEEDING COORDINATOR
Address: LONGOS, CALASIAO, PANGASINAN

WITNESS
Name/Signature:______JULIE B. BRUAN_______________________
Address: _____Malabago Calasiao Pangasinan____________________
 Republic of the Philippines
Department Education
Region I
Schools Division Office I
Lingayen

INVENTORY CUSTODIAN SLIP

Entity Name: Malabago Elementary School

Fund Cluster: 18 ICS No:_________

Quantity Unit Amount Description Inventory Estimated

Unit Cost Total Cost Item No. Useful Life

Received form (Property Custodian) Received by: (End-User)

JULIE B. BRUAN ZORAIDA C. BERANIA

Signature Over Printed Name Signature Over Printed Name

PROPERTY CUSTODIAN SCHOOL FEEDING COORDINATOR

Position/Office Designation/Position

DATE DATE
_____ _____
 PROPERTY ACKNOWLEDGEMENT RECEIPT
DEPARTMENT OF EDUCATION
Schools Division Office I Pangasinan

Entity Name: Malabago Elementary School

Fund Cluster: 18 PAR No:_________

Quantity Unit Description Property Date Acquired Amount

Number

Received by: Issued by:

ZORAIDA C. BERANIA JULIE B. BRUAN

Signature Over Printed Name Signature Over Printed Name

SCHOOL FEEDING COORDINATOR PROPERTY CUSTODIAN

Designation/Position Position/Office

DATE DATE
_____ _____
 MALABAGO ELEMENTARY SCHOOL

Unit Quantity Item Description Unit Cost Total Cost

TOTAL

________________________________
SIGNATURE OVER PRINTED NAME
 Republic of the Philippines
Department Education
Region I
Schools Division Office I
Lingayen
MALABAGO ELEMENTARY SCHOOL

JULY, 2019(1ST 20 DAYS)

DAY 1 – 20

The Malabago Elementary School received the budget for SCHOOL

BASED FEEDING PROGRAM for ___ with an amount of 51,840 pesos and
with check number __ dated__

The parents and teachers pust through in managing and demonstrating the
cooking for the parents and preparatory activities for the pupils to follow before
and after meal. We observed the proper eating habit and cleanliness of the our
beneficiaries and imposed the attendance to our beneficiaries.

Still, the bayanihan of parents and teachers and cooperation of other

stakeholders was established during the feeding.

Prepared by:

ZORAIDA C. BERANIA

School Feeding Coordinator

Noted:

TERESITA M. USON Ed.D.

School Head
 Republic of the Philippines
Department Education
Region I
Schools Division Office I Pangasinan
Lingayen
MALABAGO ELEMENTARY SCHOOL

DATE RECEIVED DATE RECEIVED

ACCOUNTING SECTION RECORDS SECTION

SIGNATURE SIGNATURE

SBFP LIQUIDATION REPORT

MONTH:

DISTRICT: CALASIAO DISTRICT II 3RD DISTRICT

SCHOOL SCHOOL HEAD DATE RECEIVED NO LIQUIDATION

DISTRICT OFFICE REPORT (PUT X)
MALABAGO E/S TERESITA M. USON, ED.D.

Submitted by:

TERESITA M. USON, ED. D.

Head Teacher III

 Republic of the Philippines
Department Education
Region I
Schools Division Office I Pangasinan
Calasiao II Cluster of Schools
MALABAGO ELEMENTARY SCHOOL

NAME OF COOK :________________

COVERED PERIOD :________________

SPECIFIC ACCOMPLISHMENT/WORK DONE:

1. Prepare meals for the feeding program beneficiaries including cooking on a daily bases
2. Assisting the teacher in facilitating every meal
3. Maintain the cleanliness and order of the assigned feeding program
4. Perform other assigned duties involving the school based feeding program

Prepared by:

BRANDO S. LANSEN
COOK

Noted by:
TERESITA M. USON Ed.D.
School Head