Standard Form Number SF - GOOD - 58

Revised on May 24, 2005

Standard Form Title: Purchase Order

PURCHASE ORDER

REPUBLIC HARDWARE REPUBLIC, INC. P.O. No.

Supplier:
Address: BACOLOD CITY Date
E-mail Address: Mode of Shopping or Small Value
Telephone No. Procurement Procurement
TIN:

GENTLEMEN:
Please furnish this office the following articles subject to the terms and conditions contained
herein:

Place of Delivery:
Date of Delivery:

Item
Unit Description Quantity Unit Cost TOTAL
No.
pcs CHAIR, monobloc, with backrest,w/o armrest 50

Conforme:

Name of Supplier School Head

Date
Funds Available:
OBR No.
Amount:
Designated Bookkeeper