PURCHASE REQUEST

Entity Name: USM ANNEX CENTRAL ELEMENTARY SCHOOL Fund Cluster: GENERAL FUND
Office/Section : _____________ PR No.:

_________________________ Responsibility Center Code : ___________

Account No. Unit Item Description Quantity

Payment for Water Bill for

the month of

Purpose: For Gulayan sa Paaralan.

_______________________________________________________________
_______________________________________________________________

Requested by: Approved by:

__________________________
Signature : _________________________
_
Printed Name : FEDERICO P. LACIA JR. ANNE M. ROLIGA
Designation : Property Custodian Principal I
 PURCHASE REQUEST

Entity Name: USM ANNEX CENTRAL ELEMENTARY SCHOOL Fund Cluster: GENERAL FUND
Office/Section : _____________ PR No.:
_________________________ Responsibility Center Code : ___________

Stock/ Property No. Unit Item Description Quantity

Payment for Electric Bill for

680030472
the month of August,2017.

Payment for Electric Bill for

680030472 the month of
September,2017.

Payment for Electric Bill for

680030472
the month of October,2017.

Purpose: Payment for School Electric Bill .

_______________________________________________________________
_______________________________________________________________

Requested by: Approved by:

__________________________
Signature : _________________________
_
Printed Name : FEDERICO P. LACIA JR. ANNE M. ROLIGA
Designation : Property Custodian Principal I
APPEDIX 63
REQUISITION AND ISSUE SLIP

Entity Name: USM ANNEX CENTRAL ELEMENTARY SCHOOL Fund Cluster: GENERAL FUND

Unit Quantity Item Description REMARKS

pc 2 Ink Cartridge (Colored) ISSUED

pc 1 Ink Cartridge ( Black) ISSUED
pc 4 Plastic Organizer ISSUED
pc 2 Record Book ISSUED
pc 2 Sign pen ISSUED
pack 5 Photo paper ISSUED
ream 21 Book Paper Long ISSUED
pc 1 Pilot Ink ISSUED
pc 1 Glue ISSUED
pc 1 pentel pen ISSUED
pc 1 Contruction paper ISSUED

Purpose: For office used.

________________________
________________________
_______________
________________________
_______________

Requested By: Approved By: Issued By: Received by:

ELSIE A. DE JUAN ANNE M. ROLIGA FEDERICO P. LACIA ELSIE A. DE JUAN

T-III Principal - I Supply Officer T-III
 PURCHASE REQUEST

Entity Name: USM ANNEX CENTRAL ELEMENTARY SCHOOL Fund Cluster: GENERAL FUND
Office/Section : _____________ PR No.:
_________________________ Responsibility Center Code : ___________

Stock/ Property No. Unit Item Description Quantity

gal White Latex Gloss 32

can Tinting Colors 72
pc Paint Brush 4" 5
pc Paint Brush 2" 1
pc Paint Roller 2
bag Cement 76
load Sand and Gravel 6
pcs Hollow block 50

Purpose: For Repainting of Fence.

_______________________________________________________________
 _______________________________________________________________

Requested by: Approved by:

__________________________
Signature : _________________________
_
Printed Name : FEDERICO P. LACIA JR. ANNE M. ROLIGA
Designation : Property Custodian Principal I

PURCHASE REQUEST

Entity Name: USM ANNEX CENTRAL ELEMENTARY SCHOOL Fund Cluster: GENERAL FUND
Office/Section : _____________ PR No.:
_________________________ Responsibility Center Code : ___________

Stock/ Property No. Unit Item Description Quantity

bags Cement 76
Purpose: For construction of additional Flooring of Mini Covered Court.

_______________________________________________________________

Requested by: Approved by:

__________________________
Signature : _________________________
_
Printed Name : FEDERICO P. LACIA JR. ANNE P. ROLIGA
Designation : Property Custodian Principal I
 REQUISITION AND ISSUE SLIP

Stock/
Description Unit Quantity
Property No.

Requested by: Released by:

Complete
/
Partial
(pls.
specify
Approved by: quantity)

ANNE M. ROLIGA FEDERICO P. LACIA JR.

Principal -I Supply and/or Property Custodian
 Department of Education
Cotabato Division
MINAPAN HIGH SCHOOL
Minapan, Tulunan, Cotabato

BREAKDOWN OF PHOTOCOPYING

ITEM DESCRIPTION UNIT QUANTITY COST AMOUNT

Photocopy of English Fourth Periodical Test cps. 1490 1.00 1,490.00

Papers
Photocopy of Filipino Fourth Periodical Test cps. 1495 1.00 1,495.00
Papers
Photocopy of Math Fourth Periodical Test cps. 1398 1.00 1,398.00
Papers
Photocopy of Science Fourth Periodical Test cps. 1498 1.00 1,498.00
Papers
Photocopy of Araling Panlipunan Fourth cps. 1406 1.00 1,406.00
Periodical Test Papers

cps. 1384 1.00 1,384.00

Photocopy of TLE Fourth Periodical Test Papers
Photocopy of Values Fourth Periodical Test cps. 1349 1.00 1,349.00
Papers
Photocopy of MAPEH Fourth Periodical Test cps. 1480 1.00 1,480.00
Papers

TOTAL 11500 11,500.00

 Republic of the Philippines
Department of Education
Region XII
Division of Cotabato
USM ANNEX CENTRAL ELEMENTARY SCHOOL
Usm Compound,Kabacan,Cotabato

ACKNOWLEDGEMENT REPORT OF PHOTOCOPYING OF TEST PAPERS

TO WHOM IT MAY CONCERN:

We the undersigned teachers of this school, hereby acknowledged the photocopying of test papers.
English

Filipino

Math

Science

Panlipunan

MAPEH

Signature
TLE

Values
Teachers/Office

Araling
No. of Copies 500 500 500 500 500 500 500 500
Abedin, Baynori A.
Cacpal,Imee P.
Cristobal,Elvira E.
De Juan, Elsie A.
Dilangalen,Emraida K.
Dilangalen,Samrah B.
Eusala,Ma. Azucena T.
Lacia,Federico Jr.P.
Lanticse, Gina L.
Mantawil, Renezol C.
Mantawil,Zulaida C.
Makakena,Baingkong G.
Mamangkas,Grizzle Joy B.
Ontok,Petronila P.
Salvador,Evelinda A.
Solaiman,Salahudin D.
Tomada,Quesa Marie B.
Tumindig,Annie M.
Vergara, Leny Jay J.
Labrador,Jesielyn J.
Hermano,Merlita P.

500 500 500 500 500 500 500 500

 REPUBLIC OF THE PHILIPPINES
DEPARTMENT OF EDUCATION
Division of Cotabato
Amas, Kidapawan City
Form 1
SCHOOL LIQUIDATION FORM
ACCOMPLISHMENT REPORT

SCHOOL : KATIDTUAN CENTRAL ELEMENTARY SCHOOL

ADDRESS : KABACAN, COTABATO
DIVISION : COTABATO DIVISION

NO. OF
ESTIMATED DATE DATE DAYS MATERIALS CONTRACT LABOR TOTAL Supporting
DESCRIPTION OF WORK REMARKS
Item No. COST STARTED COMPLETED (4-3=5) (6+7+8=9) Documents
Atttached
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11)

1 Continuation of Path Way 12,570.00 9/ /2019 9/ /2019 5 days 12,570.00 4,300.00 16,870.00 Implemented POW/
(Grade 5 to Grade 6) Pictures

PREPARED BY: CERTIFIED TRUE AND CORRECT

CAROLYN A. ENDOY EVELYN E. BAREZ JEANETTE A. ABELLERA

SUPPLY OFFICER Principal I INSPECTION OFFICER
 Appendix 62
INSPECTION AND ACCEPTANCE REPORT

Entity Name : CENTRAL ELEMENTARY SCHOOL Fund Cluster : GENERAL FUND

Supplier : IAR No. :

PO No./Date : Date :
Requisitioning Office/Dept. : _______________________________ Invoice No. : ____________
Responsibility Center Code : _______________________________ Date : _________________

Stock/
Description Unit Quantity
Property No.

Sand and Gravel load 6

Hollow block pcs 50

INSPECTION ACCEPTANCE

Date Inspected : Date Received :

Inspected, verified and found in order as to / Complete

quantity and specifications
Partial (pls. specify quantity)

Inspection Officer/Inspection Committee Supply and/or Property Custodian

 Appendix 61

PURCHASE ORDER
L ELEMENTARY SCHOOL
Entity Name

Supplier : P.O. No. :

Address : Kabacan, Cotabato Date : _______________________________
TIN : 926-575-987 Mode of Procurement : _________________
Gentlemen:
Please furnish this Office the following articles subject to the terms and conditions contained herein:

Place of Delivery : USM ANNEX CENTRAL ELEMENTARY SCHOOL Delivery Term : ________________________
Date of Delivery : Payment Term : ________________________

Stock/
Unit Description Quantity Unit Cost Amount
Property No.

(Total Amount in Words) ***TEN THOUSAND ONLY *** -

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 on the undelivered item/s.

Conforme: Very truly yours,

Signature over Printed Name of Supplier

Principal I

Date

Fund Cluster : GENERAL FUND ORS/BURS No. : ______________________

Funds Available : _________________________________ Date of the ORS/BURS: _______________
Amount : ____________________________

Signature over Printed Name of Chief Accountant/Head of

Accounting Division/Unit
 OFFICE OF THE PHILIPPINES
Kidapawan City

(Date of Advertisement) (Time of Opening (Date of Opening)

ABSTRACT OF BIDS (QUOTATIONS)

(Bid /Canvass No.

NAME OF DEALERS AND PRICES QUOTED

QTY. UNIT RIV. ARTICLES CALLED FOR
MFM HARDWARE NEMO HARDWARE JGC HARDWARE
Amount Unit Cost Amount Unit Cost Amount
4 pcs Shovel 545.00 2,180.00 550.00 2,200.00 545.00 2,180.00
1 pc Wheel Barrow 2,145.00 2,145.00 2,150.00 2,150.00 2,150.00 2,150.00
50 m Garden hose 33.00 1,650.00 35.00 1,750.00 35.00 1,750.00
1 pc noozle 140.00 140.00 140.00 140.00 145.00 145.00
1 pc Digging Bar 385.00 385.00 390.00 390.00 395.00 395.00
4 pc Rake 385.00 1,540.00 390.00 1,560.00 395.00 1,580.00
6 pcs Bolo 180.00 1,080.00 185.00 1,110.00 180.00 1,080.00

9,120.00 9,300.00 9,280.00

We hereby certify that the foregoing is true and correct abstract of the bids/ RECOMMENDATION OF THE REQUISITIONERS:
canvass submitted by the dealers above-indicated which are opened in our presence
this ___________________________. 10: 00 AM, Amas, Kidapawan City. Awarded to as the lowest bidder.
Price is deemed reasonable.

BAC CHAIRMAN Member Member

Requisitioner:
Member
Supply Officer II
Approved:

PRINCIPAL
 Republic of the Philippines
Department of Education
Region XII
KABACAN WEST DISTRICT

INVITATION TO BID / CANVASS

No. 2017-11-002
Date 11/13/2017 Kabacan,Cotab
Sir: Sir:
Please quote your prices for the article described below, with the request that the
desired conditions and/ or requirements herein be complied with: desired conditi

ITEM BRAND UNIT ITEM

QTY. UNIT ARTICLES TOTAL
NO. MAKE COST NO.
1 1
2 2
3 3
4 4
5 5
6 6
7 7

1. To specify the brand or trademark and other pertinent data of your product or articles. 1. To specify th
2. To qoute the price for articles actually verified and found in your store. 2. To qoute th
3. Tto deliver the articles to the Office of the Principal within two ( 2 ) days 3. Tto deliver t
from the receipt of the Purchase Award. from the rece
4. To return the canvass paper to the Office of the Principal on or before 4. To return th
opening the canvass on ____________________________ at 10:00 A.M.
5. To accept the flag law and other laws (foreigner only). 5. To accept th
6. To participate as bonafide dealer. 6. To participa
7. The business is duly licensed and permitted by the government. 7. The busines
8. The government reserves the right to accept or reject any bids depending upon compliance or non-compliance 8. The governm
with the above mentioned requirements and other lawful reasons most advantegeous to the government. with the above

Very truly yours,

To the BAC CHAIRMAN BAC Chairman To the

I accept the condition and / or requirements in this canvass. Filipino on my part to comply with the
requirement in this cnavass is enough reason to disequality me from particapating in future canvassess. requirement in

Dealer Signature
 Republic of the Philippines
Department of Education
Region XII
KABACAN WEST DISTRICT

INVITATION TO BID / CANVASS

No. 2017-11-002
Kabacan,CotabatO Date 11/13/2017 Kabacan,CotabatO
Sir:
Please quote your prices for the article described below, with the request that the
desired conditions and/ or requirements herein be complied with: desired conditions

BRAND UNIT ITEM

QTY. UNIT ARTICLES TOTAL
MAKE COST NO.
1
2
3
4
5
6
7

1. To specify the brand or trademark and other pertinent data of your product or articles. 1. To specify the b
2. To qoute the price for articles actually verified and found in your store. 2. To qoute the pri
3. Tto deliver the articles to the Office of the Principal within two ( 2 ) days 3. Tto deliver the a
from the receipt of the Purchase Award. from the receipt o
4. To return the canvass paper to the Office of the Principal on or before 4. To return the ca
opening the canvass on ____________________________ at 10:00 A.M.
5. To accept the flag law and other laws (foreigner only). 5. To accept the fla
6. To participate as bonafide dealer. 6. To participate as
7. The business is duly licensed and permitted by the government. 7. The business is
8. The government reserves the right to accept or reject any bids depending upon compliance or non-compliance 8. The governmen
with the above mentioned requirements and other lawful reasons most advantegeous to the government. with the above me

Very truly yours,

BAC CHAIRMAN BAC Chairman To the

I accept the condition and / or requirements in this canvass. Filipino on my part to comply with the
requirement in this cnavass is enough reason to disequality me from particapating in future canvassess. requirement in thi

Dealer Signature
 Republic of the Philippines
Department of Education
Region XII
KABACAN WEST DISTRICT

INVITATION TO BID / CANVASS

No. 2017-11-002
Kabacan,CotabatO Date 11/13/2017
Sir:
Please quote your prices for the article described below, with the request that the
desired conditions and/ or requirements herein be complied with: desired conditions and/

BRAND UNIT ITEM

QTY. UNIT ARTICLES TOTAL
MAKE COST NO.

1. To specify the brand or trademark and other pertinent data of your product or articles. 1. To specify the brand
2. To qoute the price for articles actually verified and found in your store. 2. To qoute the price fo
3. Tto deliver the articles to the Office of the Principal within two ( 2 ) days 3. Tto deliver the article
from the receipt of the Purchase Award. from the receipt of the
4. To return the canvass paper to the Office of the Principal on or before 4. To return the canvass
opening the canvass on ____________________________ at 10:00 A.M.
5. To accept the flag law and other laws (foreigner only). 5. To accept the flag law
6. To participate as bonafide dealer. 6. To participate as bon
7. The business is duly licensed and permitted by the government. 7. The business is duly l
8. The government reserves the right to accept or reject any bids depending upon compliance or non-compliance 8. The government rese
with the above mentioned requirements and other lawful reasons most advantegeous to the government. with the above mention

Very truly yours,

BAC CHAIRMAN BAC Chairman To the

I accept the condition and / or requirements in this canvass. Filipino on my part to comply with the
requirement in this cnavass is enough reason to disequality me from particapating in future canvassess. requirement in this cna

Dealer Signature
 Republic of the Philippines
Department of Education
Region XII
KABACAN WEST DISTRICT
USM ANNEX CENTRAL ELEMENTARY SCHOOL

INVITATION TO BID / CANVASS

No.
Date

Please quote your prices for the article described below, with the request that the
desired conditions and/ or requirements herein be complied with:

BRAND UNIT
QTY. UNIT ARTICLES TOTAL
MAKE COST

MARKETING

MARKETING

MARKETING

1. To specify the brand or trademark and other pertinent data of your product or articles.
2. To qoute the price for articles actually verified and found in your store.
3. Tto deliver the articles to the Office of the Principal within two ( 2 ) days
from the receipt of the Purchase Award.
4. To return the canvass paper to the Office of the Principal on or before
opening the canvass on ____________________________ at 10:00 A.M.
5. To accept the flag law and other laws (foreigner only).
6. To participate as bonafide dealer.
7. The business is duly licensed and permitted by the government.
8. The government reserves the right to accept or reject any bids depending upon compliance or non-compliance
with the above mentioned requirements and other lawful reasons most advantegeous to the government.

Very truly yours,

BAC CHAIRMAN BAC Chairman

I accept the condition and / or requirements in this canvass. Filipino on my part to comply with the
requirement in this cnavass is enough reason to disequality me from particapating in future canvassess.

Dealer Signature
 1 Appendix 60

PURCHASE REQUEST

Entity Name: Fund Cluster: GENERAL FUND

Office/Section : _____________ PR No.: 2017-11-015 Date:

_________________________ Responsibility Center Code : ___________

Account No. Unit Item Description Quantity Unit Cost Total Cost

-
-
-
-
-
-

-
Purpose:
_______________________________________________________________
_______________________________________________________________

Requested by: Approved by:

Signature : _________________________ ___________________________
Printed Name :
Designation : Supply Officer Principal I
Republic of the Philippine
Department of Education
Region XII