Download as xls, pdf, or txt
Download as xls, pdf, or txt
You are on page 1of 39

APR FORM revised May 2015 FORM NO.

002
NAME AND ADDRESS OF GALAS ELEMENTARY SCHOOL AGENCY ACCT. CODE
REQUESTING AGENCY Galas, Dipolog City AGENCY CONTROL No.
TEL. NOS.
AGENCY PROCUREMENT REQUEST PS APR No.

To: PROCUREMENT SERVICE August 03, 2020


DBM Compound, RR Road (Date Prepared)
Cristobal St., Paco, Manila

PLEASE CHECK (/) APPROPRIATE BOX ON ACTION REQUESTED ON THE ITEM/S LISTED BELLOW

[ ] Please issue common-use supplies/materials per Price List No.________________ dated_________________


Mode of Delivery: [ ] Pick-up (Fast Lane) [ ] Pick-up (Schedule) [ ] Delivery (door-to-door)

In case fund is not sufficient: [ ] Reduce Quantity [ ] Bill Us [ ] Charge to Unutilized Deposit, APR No.______________ Date:___

[ ] Please purchase for our agency non-common items. Attached herewith :


[ ] Complete Specifications [ ] Obligation Request (ObR) [ ] Others, pls. specify_____________________
[ ] Certified of Budget Allocation (CAB) [ ] Payment __________________________________________

This form shall be prepared for requisitions of Common-Use goods from the PS Depots & Sub-Depots; and for orders of
Consumables & Non-Common Use Supplies from the PS Main.
For PS Main-Common Use Supplies, please use Form 001 R or Form 001 B

ITEM No. ITEM AND DESCRIPTION/SPECIFICATIONS/STOCK No. QUANTITY UNIT UNIT PRICE AMOUNT
1 US bondpaper Long 80 reams 230.00 18,400.00
2 Ink black for DX2430 12 pcs 1,250.00 15,000.00
3 Master for DX2430 4 pcs 2,150.00 8,600.00
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx -
Nothing Follows…………………………………………. -

TOTAL AMOUNT: ₱ 42,000.00


NOTE: ALL SIGNATURES MUST BE OVER PRINTED NAME
STOCKS REQUESTED ARE CERTIFIED TO BE FUNDS CERTIFIED AVAILABLE: APPROVED:
WITHIN APPROVED PROGRAM:
ROGELIO
JERRY C. E.
REGALADO
ANDAPAT MENCHIE
CRISPINAJ.P.MAGADIA
PAIRAT GEORGINA
KENT M. ADOLFO
G. CIELO
PROPERTY CUSTODIAN/SUPPLY OFFICER AGENCY CHIEF ACCOUNTANT SCHOOL PRINCIPAL III

[ ] FUNDS DEPOSITED WITH PS [ ] ______________CHECK No. ____________________


IN THE AMOUNT OF:__________________________________________(P_____________) ENCLOSED
-
-

-
-
-
Republic of the Philippines
DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
DIVISION OF CITY SCHOOLS
GALAS ELEMENTARY SCHOOL
Dipolog City

February 12, 2020


CERTIFICATION

This is to certify that the following supplies/materials are not available


as reflected in Agency Procurement Request (APR) at PS DBM Zamboanga Sibugay, Sanito,
Ipil, Zamboanga Sibugay.

Item No. Item Description Quantity Unit


1 Parchment Paper Short 5 reams
2 Worx Board Long 222 packs
3 Colored Paper 10 reams
4 Epson Ink 10 sets
5 Steel Pins 10 boxes
6 Photo Paper 20 packs
7 Glue 74 bot
8 My Gel Sign Pen 148 pcs
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Nothing Follows………………………………………….

GEORGINA G. CIELO
School Principal III
Republic of the Philippines
DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
SCHOOLS DIVISION OF ZAMBOANGA DEL NORTE
RIZAL DISTRICT
Appendix 60
PURCHASE REQUEST

Entity Name: RIZAL CENTRAL SCHOOL Fund Cluster:


Office Section: PR No.:
Date:
Responsibility Center Code:

Stock/Property No. Unit Item Description Quantity Unit Cost Total Cost

1 reams long bond paper 23


2 bot short bond paper 46
3 bot A4 bond paper 46
4 bot valliant record book 300 pages 46
5 bot floor wax red dye 46
6 bot folder long 2
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Nothing Follows……………………………..

Purpose: Office and Instructional Materials

Requested by: Approved by:

EJILIN G. SINO-AG IVOR I. ONTOY


Property Custodian School Principal I
80 230.00 18400.00

12 1,080.24 12962.88
4 1,960.00 7840.00

39202.88
Republic of the Philippines
DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
SCHOOLS DIVISION OF ZAMBOANGA DEL NORTE
RIZAL DISTRICT
Appendix 60
PURCHASE REQUEST

Entity Name: RIZAL CENTRAL SCHOOL Fund Cluster:


Office Section: PR No.:
Date:
Responsibility Center Code:

Stock/Property No. Unit Item Description Quantity Unit Cost Total Cost

1 pcs expanded envelop short 455


2 pcs expanded envelop long 455
3 bot elmer's glue 1010G 23
4 roll double sided tape 1" 46
5 pcs digno black ballpen 455
6 pcs digno blue ballpen 455
7 pcs pilot marker fine black 23
8 pcs pilot marker fine blue 23
9 bot pilot ink blue 23
10 bot pilot ink black 23
11 roll masking tape 1" 23
12 pcs ruler plastic 455
13 pcs binder clip 1" 230
14 pcs binder clip 32mm 138
15 pcs folder short 3
16 pc brown envelop short 1
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Nothing Follows……………………………..

Purpose: Office and Instructional Materials

Requested by: Approved by:

EJILIN G. SINO-AG IVOR I. ONTOY


Property Custodian School Principal I
80 230.00 18400.00

12 1,080.24 12962.88
Republic of the Philippines
DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
SCHOOLS DIVISION OF ZAMBOANGA DEL NORTE
RIZAL DISTRICT
Appendix 60
PURCHASE REQUEST

Entity Name: RIZAL CENTRAL SCHOOL Fund Cluster:


Office Section: PR No.:
Date:
Responsibility Center Code:

Stock/Property No. Unit Item Description Quantity Unit Cost Total Cost

1 bot epson ink 664cyan 23


2 bot epson ink 664 magenta 23
3 bot epson ink 664 yellow 23
4 bot epson ink 664 black 23
5 pcs folder short 23
6 pc fastener 1
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Nothing Follows……………………………..

Purpose: Office and Instructional Materials

Requested by: Approved by:

EJILIN G. SINO-AG IVOR I. ONTOY


Property Custodian School Principal I
80 230.00 18400.00

12 1,080.24 12962.88
4 1,960.00 7840.00

39202.88
Republic of the Philippines
DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
SCHOOLS DIVISION OF ZAMBOANGA DEL NORTE
PIÑALAN ELEMENTARY SCHOOL
________________________________________________________ Date: ________________________________
________________________________________________________ No: 1

Please quote your price(s) for the following articles/supplies, materials listed hereunder that will be open on
at 9:00 AM for possible purchase by PIÑALAN ELEMENTARY SCHOOL. Only DepEd
accredited are qualified.
Price quotation should indicate brand and trademark of the manufacturer and origin of manufactured goods for
comparative purposes.
Upon receipt of your Purchase Order (PO), you are requested to deliver the articles/supplies/materials without
delay. Failure to deliver the same at the time specified will adversely affect the goodwill of our business establishment.
Aside from the forgoing, non-compliance to your commitment will constrain Committee on Awards to ban your partici-
pation in failure public biddings.
ARLYN B. MACUL
BAC Chairman

No. Qty. UNIT DESCRIPTION UNIT TOTAL


PRICE
1 8 ream long bond paper
2 16 ream A4 bond paper
3 8 set epson ink 664
4 80 piece folder long
5 8 ream construction paper long
6 40 piece flexstick ballpen
7 1 box paper clip small

TOTAL

THE CHAIRMAN
Committee on Bids/Awards

Sir/Madam:
I have the honor to submit our QUOTATIONS for the above mentioned supplies/articles/materials for appraisal
by the committee.
Name/Signature of Supplier
Republic of the Philippines
DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
SCHOOLS DIVISION OF ZAMBOANGA DEL NORTE
RIZAL CENTRAL SCHOOL
________________________________________________________ Date: ________________________________
________________________________________________________ No: 1

Please quote your price(s) for the following articles/supplies, materials listed hereunder that will be open on
at 9:00 AM for possible purchase by RIZAL CENTRAL SCHOOL. Only DepEd
accredited are qualified.
Price quotation should indicate brand and trademark of the manufacturer and origin of manufactured goods for
comparative purposes.
Upon receipt of your Purchase Order (PO), you are requested to deliver the articles/supplies/materials without
delay. Failure to deliver the same at the time specified will adversely affect the goodwill of our business establishment.
Aside from the forgoing, non-compliance to your commitment will constrain Committee on Awards to ban your partici-
pation in failure public biddings.
JAY T. TUMALA
BAC Chairman

No. Qty. UNIT DESCRIPTION UNIT TOTAL


PRICE
1 455 pcs expanded envelop short
2 455 pcs expanded envelop long
3 23 bot elmer's glue 1010G
4 46 roll double sided tape 1"
5 455 pcs digno black ballpen
6 455 pcs digno blue ballpen
7 23 pcs pilot marker fine black
8 23 pcs pilot marker fine blue
9 23 bot pilot ink blue
10 23 bot pilot ink black
11 23 roll masking tape 1"
12 455 pcs ruler plastic
13 230 pcs binder clip 1"
14 138 pcs binder clip 32mm
15 3 pcs folder short
16 1 pc brown envelop short
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Nothing Follows…………………………………………...

TOTAL

THE CHAIRMAN
Committee on Bids/Awards

Sir/Madam:
I have the honor to submit our QUOTATIONS for the above mentioned supplies/articles/materials for appraisal
by the committee.
Name/Signature of Supplier
Republic of the Philippines
DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
SCHOOLS DIVISION OF ZAMBOANGA DEL NORTE
RIZAL CENTRAL SCHOOL
________________________________________________________ Date: ________________________________
________________________________________________________ No: 1

Please quote your price(s) for the following articles/supplies, materials listed hereunder that will be open on
at 9:00 AM for possible purchase by RIZAL CENTRAL SCHOOL. Only DepEd
accredited are qualified.
Price quotation should indicate brand and trademark of the manufacturer and origin of manufactured goods for
comparative purposes.
Upon receipt of your Purchase Order (PO), you are requested to deliver the articles/supplies/materials without
delay. Failure to deliver the same at the time specified will adversely affect the goodwill of our business establishment.
Aside from the forgoing, non-compliance to your commitment will constrain Committee on Awards to ban your partici-
pation in failure public biddings.
JAY T. TUMALA
BAC Chairman

No. Qty. UNIT DESCRIPTION UNIT TOTAL


PRICE
1 11 rolls PLASTIC COVER #8
2 1 box PILOT G-TECH BLACK
3 2 box PAPER CLIP JUMBO
4 1 bot ETHYL ALCOHOL
5 1 set EPSON INK 664
6 6 bot EPSON INK 664 BLACK
7 18 ream LONG BONDPAPER

TOTAL

THE CHAIRMAN
Committee on Bids/Awards

Sir/Madam:
I have the honor to submit our QUOTATIONS for the above mentioned supplies/articles/materials for appraisal
by the committee.
Name/Signature of Supplier
Department of Education
Region IX, Zamboanga Peninsula
Schools Division of
GALAS ELEMENTARY SCHOOL
Galas, Dipolog City

Abstract of Bids No.:1


Date Opening: August 20, 2020
Time Opening: 9:00 AM
Nico's Computer Center
JCC Enterprises Thea Enterprises
& Enterprises
ITEM
QUANTITY UNIT NAME AND DESCRIPTION OF ARTICLES
NO. Unit Price Total Price Unit Price Total Price Unit Price Total Price

1 80 reams US bondpaper Long 230.00 ### 225.00 ### 220.00 ###


2 12 pcs Ink black for DX2430 1,080.24 ### 1,250.00 ### 1,250.00 ###
3 4 pcs Master for DX2430 1,960.00 ### 2,150.00 8600.00 2,150.00 8600.00
xxxxxxxxxxxxxxxxxxxxxxxxxx
Nothing Follows………………….

TOTAL 39,202.88 41,600.00 41,200.00

WE HEREBY CERTIFY that the foregoing is true and correct abstract of canvass/bids submitted by the
dealers which were opened in our presence this August 20, 2020 at Galas Elementary School.

CRISPINA P. PAIRAT MARIFE SOCORRO R. TOMPONG CINDREL R. ESCOTOTO


MARY E. CARDEÑOJOSEPHINE B. BAGARINAO
BAC Chairman BAC Vice-Chairman member member member

RECOMMENDATION OF REQUISITIONER:

COA REPRESENTATIVE:

ACTION OF THE REQUISITIONER: Awarded to JCC Enterprises


because of a complete quotation and lower price.

Approved by:

GEORGINA G. CIELO
School Principal III
F
Republic of the Philippines
DEPARTMENT OF EDUCATION
DIVISION OF CITY SCHOOLS
GALAS ELEMENTARY SCHOOL
Galas, Dipolog City

BIDS AND AWARDS COMMITTEE RESOLUTION NO. 2020-08-001

Pursuant to the provision set forth under Article V of Republic Act 9184 otherwisa known as "An Act
Providing for the Modernization, Standardization and Regulation of the Procurement Activities of the Government
and for Other Purposes", the Committee is hereby vested with powers to conduct pre-procurement and pre-bid
conferences, determine the eligibility of prospective bidders, receive bids, conduct the evaluation of bids,
undertake post-qualification proceedings, recommend the use of Alternative Methods of Procurement and
recommend awards of contracts to proper party/ies on the basis of the procedures provided by law.
Whereas, the COMMITTEE after a thorough evaluation, assessment of individual bid proposals/
quotations submitted to its jurisdiction determined after due deliberation pursuant to proceedings specified
by law, held at DepEd, Division of City Schools, Dipolog City on 20th day of August, 2020, declares that:

1. We witness the competitive bidding or canvassing conducted on the good/s article (School
and Officen Supplies) specified in the request.
2. After careful checking and deliberation of quoted prices, we hereby award the purchase of the
good/s as indicated item by item to the bidder concerned, it being advantageous to the government,
as to the availability of the good/s requested in the Purchase Request and indicated in the attached
Abstract of Bids.
ITEM : 1-3 JCC ENTERPRISES
3. The Alternative Method of Procurement (Shopping) was
justifiably resorted to pursuant to Sec. 52.(a), Article XVI of RA 9184

Issued this 20th day of August 2020, Dipolog City Philippines.

BIDS AND AWARDS COMMITTEE

CRISPINA P. PAIRAT
BAC Chairman

MARIFE SOCORRO R. TOMPONG MARY E. CARDEÑO


BAC Vice Chairman BAC Member

JOSEPHINE B. BAGARINAO CINDREL R. ESCOTOTO


BAC Member BAC Member

APPROVED :

GEORGINA G. CIELO
School Principal III
Republic of the Philippines
DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
SCHOOLS DIVISION OF ZAMBOANGA DEL NORTE
RIZAL DISTRICT
Appendix 61
PURCHASE ORDER
RIZAL CENTRAL SCHOOL
Entity Name
Supplier: ABEL Office and School Supplies PO No. :
Address: Dipolog City Date:
TIN : 943-948-900-000 Mode of Procurement: Shopping
Gentlemen:
Please furnish this office the following articles subject to the terms and conditions contained herrein:

Place of Delivery: Rizal Cental School, Rizal, ZN Delivery Term:


Date Of Delivery: Payment Term: Cash
Stock No. Unit Description Quantity Unit Cost Amount
1 reams long bond paper 23 225.00 5,175.00
2 reams short bond paper 23 220.00 5,060.00
3 box mygel sign pen black 0.5 1 265.00 265.00
-
-
-
xxxxxxxxxxxxxxxxxxxxxxxx
Nothing Follows………………..

10,500.00
(Total Amount in Words)
Ten Thousand Five Hundred Pesos 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,

IVOR I. ONTOY
Signature over Printed Name of Supplier School Principal I
Date
Republic of the Philippines
DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
SCHOOLS DIVISION OF ZAMBOANGA DEL NORTE
RIZAL DISTRICT
Appendix 61
PURCHASE ORDER
RIZAL CENTRAL SCHOOL
Entity Name
Supplier: ABEL Office and School Supplies PO No. :
Address: Dipolog City Date:
TIN : 943-948-900-000 Mode of Procurement: Shopping
Gentlemen:
Please furnish this office the following articles subject to the terms and conditions contained herrein:

Place of Delivery: Rizal Cental School, Rizal, ZN Delivery Term:


Date Of Delivery: Payment Term: Cash
Stock No. Unit Description Quantity Unit Cost Amount
1 pcs expanded envelop short 455 15.00 6,825.00
2 pcs expanded envelop long 455 16.00 7,280.00
3 bot elmer's glue 1010G 23 301.00 6,923.00
4 roll double sided tape 1" 46 33.25 1,529.50
5 pcs digno black ballpen 455 6.00 2,730.00
6 pcs digno blue ballpen 455 6.00 2,730.00
7 pcs pilot marker fine black 23 38.00 874.00
8 pcs pilot marker fine blue 23 36.00 828.00
9 bot pilot ink blue 23 85.00 1,955.00
10 bot pilot ink black 23 85.00 1,955.00
11 roll masking tape 1" 23 20.00 460.00
12 pcs ruler plastic 455 6.25 2,843.75
13 pcs binder clip 1" 230 5.00 1,150.00
14 pcs binder clip 32mm 138 4.00 552.00
15 pcs folder short 3 5.00 15.00
16 pc brown envelop short 1 4.00 4.00

38,654.25
(Total Amount in Words)
Thirty Eight Thousand Six Hundred Fifty Four Pesos and Twenty Five Centavos

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,

IVOR I. ONTOY
Signature over Printed Name of Supplier School Principal I
Date
Republic of the Philippines
DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
SCHOOLS DIVISION OF ZAMBOANGA DEL NORTE
KATIPUNAN DISTRICT
Appendix 61
PURCHASE ORDER
CARUPAY ELEMENTARY SCHOOL
Entity Name
Supplier: ABEL Office and School Supplies PO No. :
Address: Dipolog City Date:
TIN : 943-948-900-000 Mode of Procurement: Shopping
Gentlemen:
Please furnish this office the following articles subject to the terms and conditions contained herrein:

Place of Delivery: Rizal Cental School, Rizal, ZN Delivery Term:


Date Of Delivery: Payment Term: Cash
Stock No. Unit Description Quantity Unit Cost Amount
1 rolls PLASTIC COVER #8 4 3250.00 13,000.00
2 box PILOT G-TECH BLACK 1 828.00 828.00
3 box PAPER CLIP JUMBO 2 45.00 90.00
4 bot HIGHLIGHTER SET 13 90.00 1,170.00
5 set EPSON INK 664 4 1380.00 5,520.00
6 bot EPSON INK 664 BLACK 4 350.00 1,400.00
7 ream A4 BONDPAPER 11 220.00 2,420.00
8 pcs CORRECTION TAPE 2 35.00 70.00

24,498.00
(Total Amount in Words)
TWENTY FOUR THOUSAND FOUR HUNDRED NINETY EIGHT PESOS 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 School Principal I


Date
Republic of the Philippines
DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
DIVISION OF CITY SCHOOLS
Dipolog City
Appendix 62
INSPECTION AND ACCEPTANCE REPORT

Entity Name: GALAS ELEMENTARY SCHOOL Fund Cluster: 011


Supplier: JCC Enterprises IAR No. : 2020-08-001
PO No. /Date: 2020-08-001 / August 24, 2020 Date: 3-Sep-20
Requisitioning Office/Department: Galas Elementary School Invoice No.:

Responsibility Center Code: Date: 3-Sep-20

Stock/Property No. Description Unit Quantity

1 US bondpaper Long reams 80


2 Ink black for DX2430 pcs 12
3 Master for DX2430 pcs 4
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Nothing Follows………………………………….

INSPECTION ACCEPTANCE
Date Inspected: 21-May-18 21-May-18
Date Inspected: September 3, 2020 Date Received: September 3, 2020
Inspected,
/ Inspected, verifiedverified andinfound
and found orderin order as
asto Complete
Complete
quantity and specifications. /
/ to quantity and specifications.
Partial (pls. specify)
Partial (pls. specify)

FAY ANN T. GOOC EVELYN L. MARANE


Inspection Officer/Inspection Committee Supply and/ Property Custodian
ADONIS B. ABELLANOSA
Inspection Officer/Inspection Committee
Date Received: September 3, 2020
Complete

Partial (pls. specify)

EVELYN L. MARANE
Supply and/ Property Custodian
Republic of the Philippines
DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
DIVISION OF CITY SCHOOLS
Dipolog City
Appendix 63
REQUISITION AND ISSUE SLIP

Entity Name: GALAS ELEMENTARY SCHOOL Fund Cluster: 11


Division: Responsibility Center Code:
Dipolog City
Office: RIS No. : 1
REQUISITION Stock Available? ISSUE
Stock No. Unit Description Quantity Yes No Quantity Remarks
1 reams US bondpaper Long 80 yes 80 complete
2 pcs Ink black for DX2430 12 yes 12 complete
3 pcs Master for DX2430 4 yes 4 complete

Purpose: For Printing and Reproduction of Modules


Requested
Requested by: by: Approved by: Approved by:
Issued by: Issued by: Received by:Received by:
Signature:
Printed Name: CRISPINA P. PAIRAT GEORGINA G. CIELO ROGELIO E. ANDAPAT CRISPINA P. PAIRAT
Signature:
Position:  Master Teacher I School Principal III Teacher III Master Teacher I
Date: Name:
Printed 08-03-2020
IAN T. DAEL 08-03-2020 09-03-2020 IAN T. DAEL
09-03 -2020MARIA JANICE C. BANAGUA
KENT M. ADOLFO
Position: Teacher I School Principal II Property Custodian Teacher I
Date: 15-Apr-18 15-Apr-18 21-Apr-18 21-Apr-18
DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
DIVISION OF CITY SCHOOLS
Dipolog City
Appendix 63
REQUISITION AND ISSUE SLIP

Entity Name: GALAS ELEMENTARY SCHOOL Fund Cluster: 11

Division: Responsibility Center Code:


Dipolog City
Office: RIS No. : 3
REQUISITION Stock Available? ISSUE
Stock No. Unit Description Quantity Yes No Quantity Remarks
1 sets Epson Ink 10 yes 10 complete
2 reams Assorted Cartolina 3 yes 3 complete
3 reams Long Bond Paper 10 yes 10 complete
4 bot Glue 10 yes 10 complete
5 rolls Scotch Tape

Purpose: For school and office supplies


RequestedRequested
by: by: Approved by: Approved by:
Issued by: Issued by: Received by:Received by:
Signature: LOIDA R. RUBIA GEORGINA G. CIELO
Signature:
Printed Name: ROGELIO E. ANDAPAT LOIDA R. RUBIA
Teacher II School Principal III Teacher III Teacher II
Position: Name:
Printed IAN T. DAEL 05-04-2020 KENT M. ADOLFO MARIA JANICE C. BANAGUA
Date:
05-04-2020 06- -2020 06- -2020 IAN T. DAEL
Position: Teacher I School Principal II Property Custodian Teacher I
Date: 15-Apr-18 15-Apr-18 21-Apr-18 21-Apr-18

Republic of the Philippines


DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
DIVISION OF CITY SCHOOLS
Dipolog City
Appendix 63
REQUISITION AND ISSUE SLIP

Entity Name: GALAS ELEMENTARY SCHOOL Fund Cluster: 11

Division: Responsibility Center Code:


Dipolog City
Office: RIS No. : 4
REQUISITION Stock Available? ISSUE
Stock No. Unit Description Quantity Yes No Quantity Remarks
1 sets Epson Ink 1 yes 1 complete
2 reams Assorted Cartolina 2 yes 2 complete
3 reams Long Bond Paper 12 yes 12 complete
4 bot Glue 12 yes 12 complete
5 rolls Scotch Tape 12 yes 12 complete

Purpose: For school and office supplies.


Requested by:
Requested by: Approved by: Approved by:
Issued by: Issued by: Received by:Received by:
Signature: GEORGINA G. CIELO
Signature:
Printed Name:
FLORITA D. AMISTOSO ROGELIO E. ANDAPAT FLORITA D. AMISTOSO
Teacher II School Principal III Teacher III Teacher II
Position: Name:
Printed IAN T. DAEL 05-04-2020 KENT M. ADOLFO MARIA JANICE C. BANAGUA
05-04-2020 06- -2020 06- -2020 IAN T. DAEL
Date:
Position: Teacher I School Principal II Property Custodian Teacher I
Date: 15-Apr-18 15-Apr-18 21-Apr-18 21-Apr-18
Republic of the Philippines
DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
DIVISION OF CITY SCHOOLS
Dipolog City
Appendix 63
REQUISITION AND ISSUE SLIP

Entity Name: GALAS ELEMENTARY SCHOOL Fund Cluster: 11

Division: Responsibility Center Code:


Dipolog City
Office: RIS No. : 5
REQUISITION Stock Available? ISSUE
Stock No. Unit Description Quantity Yes No Quantity Remarks
1 sets Epson Ink 1 yes 1 complete
2 reams Long Bond Paper 12 yes 12 complete
3 bot Glue 12 yes 12 complete
4 rolls Scotch Tape 12 yes 12 complete

Purpose: For school and office supplies


Requested
Requested by: by: Approved by: Approved by:
Issued by: Issued by: Received by:Received by:
Signature: JOSIE B. CAÑETE GEORGINA G. CIELO ROGELIO E. ANDAPAT JOSIE B. CAÑETE
Signature:
Printed Name: Teacher II School Principal III Teacher III Teacher II
Position: Name:
Printed IAN T. DAEL 05-04-2020
05-04-2020 KENT M. ADOLFO
06- -2020 MARIA JANICE C. BANAGUA
06- -2020 IAN T. DAEL
Date:
Position: Teacher I School Principal II Property Custodian Teacher I
Date: 15-Apr-18 15-Apr-18 21-Apr-18 21-Apr-18

Republic of the Philippines


DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
DIVISION OF CITY SCHOOLS
Dipolog City
Appendix 63
REQUISITION AND ISSUE SLIP

Entity Name: GALAS ELEMENTARY SCHOOL Fund Cluster: 11

Division: Responsibility Center Code:


Dipolog City
Office: RIS No. : 6
REQUISITION Stock Available? ISSUE
Stock No. Unit Description Quantity Yes No Quantity Remarks
1 sets Epson Ink 1 yes 1 complete
2 reams Long Bond Paper 12 yes 12 complete
3 bot Glue 12 yes 12 complete
4 rolls Scotch Tape 12 yes 12 complete

Purpose: For school and office supplies.


Requested by:
Requested by: Approved by: Approved by:
Issued by: Issued by: Received by:Received by:
Signature: JUVY B. ZAMORAS GEORGINA G. CIELO ROGELIO E. ANDAPAT JUVY B. ZAMORAS
Signature:
Printed Name: Teacher II School Principal III Teacher III Teacher II
Position: Name:
Printed 05-04-2020 IAN T. DAEL 05-04-2020 KENT M. ADOLFO
06- -2020 MARIA JANICE C. BANAGUA
06- -2020 IAN T. DAEL
Date:
Position: Teacher I School Principal II Property Custodian Teacher I
Signature: JUVY B. ZAMORAS GEORGINA G. CIELO ROGELIO E. ANDAPAT JUVY B. ZAMORAS
Printed Name: Teacher II School Principal III Teacher III Teacher II
Position:  05-04-2020 05-04-2020 06- -2020 06- -2020
Date:
Republic of the Philippines
DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
DIVISION OF CITY SCHOOLS
Dipolog City
Appendix 63
REQUISITION AND ISSUE SLIP

Entity Name: GALAS ELEMENTARY SCHOOL Fund Cluster: 11

Division: Responsibility Center Code:


Dipolog City
Office: RIS No. : 7
REQUISITION Stock Available? ISSUE
Stock No. Unit Description Quantity Yes No Quantity Remarks
1 sets Epson Ink 12 yes 12 complete
2 reams Assorted Cartolina 10 yes 10 complete
3 reams Long Bond Paper 85 yes 85 complete

Purpose: For school and office supplies


RequestedRequested
by: by: Approved by: Approved by:
Issued by: Issued by: Received by:Received by:
Signature: CRISPINA P. PAIRAT GEORGINA G. CIELO ROGELIO E. ANDAPAT CRISPINA P. PAIRAT
Signature:
Printed Name: Master Teacher I School Principal III Teacher III Master Teacher I
Position: Name:
Printed IAN T. DAEL 06-02-2020
06-02-2020 KENT M. ADOLFO
06-30-2020MARIA JANICE C. BANAGUA
06-30-2020 IAN T. DAEL
Date:
Position: Teacher I School Principal II Property Custodian Teacher I
Date: 15-Apr-18 15-Apr-18 21-Apr-18 21-Apr-18

Republic of the Philippines


DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
DIVISION OF CITY SCHOOLS
Dipolog City
Appendix 63
REQUISITION AND ISSUE SLIP

Entity Name: GALAS ELEMENTARY SCHOOL Fund Cluster: 11

Division: Responsibility Center Code:


Dipolog City
Office: RIS No. : 8
REQUISITION Stock Available? ISSUE
Stock No. Unit Description Quantity Yes No Quantity Remarks
1 sets Epson Ink 12 yes 12 complete
2 reams Assorted Cartolina 10 yes 10 complete
3 reams Long Bond Paper 85 yes 85 complete

Purpose: For school and office supplies.


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

Signature: GEORGINA G. CIELO GEORGINA G. CIELO ROGELIO E. ANDAPAT GEORGINA G. CIELO


Signature:
Printed Name: School Principal III School Principal III Teacher III School Principal III
Position: Name:
Printed 06-02-2020 IAN T. DAEL 06-02-2020 KENT M. ADOLFO
06-30-2020 MARIA JANICE C. BANAGUA
06-30-2020 IAN T. DAEL
Date:
Requested by: Approved by: Issued by: Received by:
Signature: GEORGINA G. CIELO GEORGINA G. CIELO ROGELIO E. ANDAPAT GEORGINA G. CIELO
Printed Name: School Principal III School Principal III Teacher III School Principal III
Position:  06-02-2020 06-02-2020 06-30-2020 06-30-2020
Date:
Position: Teacher I School Principal II Property Custodian Teacher I
Republic of the Philippines

DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
DIVISION OF CITY SCHOOLS
Dipolog City
Appendix 63
REQUISITION AND ISSUE SLIP

Entity Name: GALAS ELEMENTARY SCHOOL Fund Cluster: 11

Division: Responsibility Center Code:


Dipolog City
Office: RIS No. : 9
REQUISITION Stock Available? ISSUE
Stock No. Unit Description Quantity Yes No Quantity Remarks
1 sets Epson Ink 12 yes 12 complete
2 reams Assorted Cartolina 10 yes 10 complete
3 reams Long Bond Paper 85 yes 85 complete

Purpose: For school and office supplies


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

Signature: ADONIS B. ABELLANOSA GEORGINA G. CIELO ROGELIO E. ANDAPAT ADONIS B. ABELLANOSA


Signature:
Printed Name: Teacher III School Principal III Teacher III Teacher III
Position: Name:
Printed IAN T. DAEL 06-02-2020 KENT M. ADOLFO MARIA JANICE C. BANAGUA
06-02-2020 06-30-2020 06-30-2020 IAN T. DAEL
Date:
Position: Teacher I School Principal II Property Custodian Teacher I
Date: 15-Apr-18 15-Apr-18 21-Apr-18 21-Apr-18
Republic of the Philippines
DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
DIVISION OF CITY SCHOOLS
Dipolog City
Appendix 63
REQUISITION AND ISSUE SLIP

Entity Name: GALAS ELEMENTARY SCHOOL Fund Cluster: 11

Division: Responsibility Center Code:


Dipolog City
Office: RIS No. : 4
REQUISITION Stock Available? ISSUE
Stock No. Unit Description Quantity Yes No Quantity Remarks
1 sets Epson Ink yes complete
2 reams Assorted Cartolina yes complete
3 reams Long Bond Paper yes complete
4 bot Glue yes complete
5 rolls Scotch Tape yes complete

Purpose: For school and office supplies.


Requested by:
Requested by: Approved by: Approved by:
Issued by: Issued by: Received by:Received by:
Signature: MARY E. CARDEÑO GEORGINA G. CIELO ROGELIO E. ANDAPAT MARY E. CARDEÑO
Signature:
Printed Name: Master Teacher II School Principal III Teacher III Master Teacher II
Position: Name:
Printed IAN T. DAEL KENT M. ADOLFO MARIA JANICE C. BANAGUA
05-04-2020 05-04-2020 06- -2020 06- -2020 IAN T. DAEL
Date:
Position: Teacher I School Principal II Property Custodian Teacher I
Republic of the Philippines
Received by:

CRISPINA P. PAIRAT
Master Teacher I
09-03-2020
Received by:

LOIDA R. RUBIA
Teacher II
06- -2020

Received by:

FLORITA D. AMISTOSO
Teacher II
06- -2020
Received by:

JOSIE B. CAÑETE
Teacher II
06- -2020

Received by:

JUVY B. ZAMORAS
Teacher II
06- -2020
JUVY B. ZAMORAS
Teacher II
06- -2020

Received by:

CRISPINA P. PAIRAT
Master Teacher I
06-30-2020

Received by:

GEORGINA G. CIELO
School Principal III
06-30-2020
Received by:

GEORGINA G. CIELO
School Principal III
06-30-2020

Received by:

ADONIS B. ABELLANOSA
Teacher III
06-30-2020
Received by:

MARY E. CARDEÑO
Master Teacher II
06- -2020

You might also like