New PR Form

Republic of the Philippines
Province of Palawan
Municipality of Aborlan
PURCHASE REQUEST
Local Government Unit of Aborlan

Fund:____________________
PR No.:__________________ Date: _________
Section: Mun. Engineering Office FPP: _____________________
Item Unit Total
Unit Item Description Quantity
No. Cost Cost
1 unit 15 tons wheeled excavator 1
2 unit 10 tons boom truck with kangjim KS2700 crane 1

x x x x *mob*x x x x
Php 35,188.00
Purpose: for meo use.
Requested by: Cash Availability: Approved by:

Signature:
______________
___________________
MARIBETH O. BELGICA EDDIE A.
Printed Name: CELSA B. ADIER
AA-1 MAPA
Municipal Mayor
Acting Municipal Treasurer
Designation:
Date: ____________________ ______________________
Province of Palawan
PURCHASE REQUEST

Fund:____________________
PR No.:__________________ Date: _________
Item Unit Total
No. Cost Cost
Dump truck 1 & 2
1 pail engine oil # 40 2 5,100.00 10,200.00
2 pcs oil filter 2 2,500.00 5,000.00
3 tank freon gas RA 134 1 8,500.00 8,500.00
4 sets service kit aircon 2 3,000.00 6,000.00
Apache Loader
5 pc oil seal 1 1,500.00 1,500.00
6 pc O-ring 1 350.00 350.00
7 set service kit aircon 1 3,000.00 3,000.00
Php 34,550.00

Signature:
______________
___________________
AA-1 MAPA
Municipal Mayor
Designation:
Date: ____________________ ______________________
Province of Palawan
PURCHASE REQUEST

Fund:____________________
PR No.:__________________ Date: _________
Item Unit Total
No. Cost Cost
XGMA ROLLER
1 pail hydraulic oil # 10 1 4,692.00 4,692.00
APACHE LOADER
3 pail engine oil # 40 1 4,970.00 4,970.00
XGMA EXCAVATOR
4 assy solenoid coil 1 28,750.00 28,750.00
5 pcs tooth point, bucket 7 2,850.00 19,950.00
6 pcs lock set, tooth point 7 685.00 4,795.00
Php 67,849.00

Signature:
______________
___________________
AA-1 MAPA
Municipal Mayor
Designation:
Date: ____________________ ______________________
Province of Palawan
PURCHASE REQUEST

Fund:____________________
PR No.:__________________ Date: _________
Item Unit Total
No. Cost Cost
1 set scaffolding and ladder 1 10,920.00 10,920.00
2 pcs toks screw/rivets (minor rivets 80 7.35 588.00
3 kgs welding rod 2 116.81 233.63
4 kgs oxygen (content only) 2 80.06 160.13
5 kgs acetylene (content only) 2 106.31 212.63
6 pcs 2" x 3" tubings, 6.0m length 3 462.00 1,386.00
7 pcs 50 x 50 x 5mm angular bar 3 1,470.00 4,410.00
8 pcs sander & cutting machine with cutting outfit & welding machine 1 14,175.00 14,175.00
9 pcs pre-painted/ordinary flashing GA 24 (0.701mm x 2.44m) 4 178.50 714.00
10 gals paints (primer) 1 787.50 787.50
11 gals paints (red lead oxide) 1 735.00 735.00
12 pcs 3" wide paint brush 2 210.00 420.00
13 lit roof sealant/vulcaseal 1 651.00 651.00
14 pcs toks screw/rivets (minor rivets) 80 7.35 588.00
Php 35,980.88
Purpose: for Aborlan Water System Management & Operation Enhancement Program.

Signature:
______________
___________________
EFEGENIO V. SIOSE, JR. EDDIE A.
Acting Municipal Engineer MAPA
Municipal Mayor
Designation:
Date: ____________________ ______________________
Province of Palawan
PURCHASE REQUEST

Fund:____________________
PR No.:__________________ Date: _________
Item Unit Total
No. Cost Cost
1 set scaffolding and ladder 1
2 pcs toks screw/rivets (minor rivets 80
3 kgs welding rod 2
4 kgs oxygen (content only) 2
5 kgs acetylene (content only) 2
6 pcs 2" x 3" tubings, 6.0m length 3
7 pcs 50 x 50 x 5mm angular bar 3
8 pcs sander & cutting machine with cutting outfit & welding machine 1
9 pcs pre-painted/ordinary flashing GA 24 (0.701mm x 2.44m) 4
10 gals paints (primer) 1
11 gals paints (red lead oxide) 1
12 pcs 3" wide paint brush 2
13 lit roof sealant/vulcaseal 1
14 pcs toks screw/rivets (minor rivets 80
Php 199,542.00

Signature:
______________
___________________
Municipal Mayor
Designation:
Date: ____________________ ______________________
Province of Palawan
PURCHASE REQUEST

Fund:____________________
PR No.:__________________ Date: _________
Item Unit Total
No. Cost Cost
1 pcs 75mmø ID x 6.0m uPVC C-100 105 1,985.00 187,425.00
2 pcs Reducer coupling 4" x 3" uPVC 1 1,155.00 1,155.00
3 pcs uPVC elbow 3" x 22.5 deg 3 1,785.00 5,355.00
4 pcs uPVC elbow 3" x 87.5 deg 3 1,785.00 5,355.00
5 kgs Installation lubricants 2 126.00 252.00
Php 199,542.00

Signature:
______________
___________________
Municipal Mayor
Designation:
Date: ____________________ ______________________
Province of Palawan
PURCHASE REQUEST

Fund:____________________
PR No.:__________________ Date: _________
Item Unit Total
No. Cost Cost
XGMA GRADER
1 pcs plow bolt, complete set 10 313.00 3,130.00
2 ltrs distilled water 10 68.00 680.00
APACHE LOADER
4 pc cylinder head gasket 1 8,265.00 8,265.00
5 pail grease MP3 1 6,780.00 6,780.00
6 tubes beta-grey gasket cement 2 273.00 546.00
7 pcs hex, bolt, 5/16x1" complete set 20 65.00 1,300.00
8 pcs bolt, rocker arm, 12 x 120mm 2 171.00 342.00
9 meter sand paper # 60 1 370.00 370.00
10 tin grinding compound 1 125.00 125.00
11 pcs sand paper # 400 3 57.00 171.00
XGMA EXCAVATOR
12 pcs main fuel filter 2 2,508.00 5,016.00
13 assy booster cable 400A 1 1,710.00 1,710.00
Php 33,451.00

Signature:
______________
___________________
AA-1 MAPA
Municipal Mayor
Designation:
Date: ____________________ ______________________
Province of Palawan
PURCHASE REQUEST

Fund:____________________
PR No.:__________________ Date: _________
Item Unit Total
No. Cost Cost
HOWO Dump truck 1 & 2
1 pail engine oil # 40 3 5,973.00 17,919.00
2 pcs fuel filter # 5020 2 1,600.00 3,200.00
3 pcs fuel filter # 5030 2 2,478.00 4,956.00
4 pcs oil filter # 5602 2 2,494.00 4,988.00
APACHE LOADER
6 pail gear oil # 90 1 4,959.00 4,959.00
7 pc fuel filter # 1280 1 1,350.00 1,350.00
8 pc fuel filter # 5052 1 1,450.00 1,450.00
9 pc fuel filter # 5327 1 1,550.00 1,550.00
GRADER
10 pc fuel filter # 1280 1 1,350.00 1,350.00
11 pc fuel filter # 5052 1 1,450.00 1,450.00
12 pc fuel filter # 5327 1 1,550.00 1,550.00
XGMA BACKHOE
13 pc fuel filter # FC 208 1 1,280.00 1,280.00
Php 55,402.00

Signature:
______________
___________________
AA-1 MAPA
Municipal Mayor
Designation:
Date: ____________________ ______________________
Province of Palawan
PURCHASE REQUEST

Fund:____________________
PR No.:__________________ Date: _________
Item Unit Total
No. Cost Cost
ROAD GRADER
1 ltrs Diesel 10,000 90.00 900,000.00
2 ltrs Gasoline 500 91.00 45,500.00
3 pail oil 10 5 4,300.00 21,500.00
4 pail oil 40 5 5,200.00 26,000.00
5 pail AD blue 3 3,500.00 7,000.00
Php 1,000,000.00

Signature:
______________
___________________
AA-1 MAPA
Municipal Mayor
Designation:
Date: ____________________ ______________________
Province of Palawan
PURCHASE REQUEST

Fund:____________________
PR No.:__________________ Date: _________
Item Unit Total
No. Cost Cost
DUMP TRUCK 1 & 2
1 sets Brake shoe, rear w/ revits/reline 2 8,500.00 17,000.00
2 sets Stud bolt , rear 20 450.00 9,000.00
3 pcs Spring brake, rear 8 225.00 1,800.00
4 set Brake shoe, front w/ revits/reline 1 7,950.00 7,950.00
5 pcs Spring, brake front 2 480.00 960.00
6 pcs Flat screen stainless brake (10x25) 8 190.00 1,520.00
7 pc Allen wrench, hi-tensile 1 250.00 250.00
8 pcs Fuel filter # CX0712A 2 1,887.00 3,774.00
9 pcs Fuel filter # CX0712B 2 2,035.00 4,070.00
10 pc Fuel filter separator 1 2,305.00 2,305.00
BACK HOE/LOADER
11 pc Fuel filter # 208 (backhoe) 1 1,550.00 1,550.00
12 pc Air filter Als (backhoe) 1 2,200.00 2,200.00
13 pc Fuel filter # 5052 (loader) 1 1,600.00 1,600.00
Php 53,979.00
Purpose: for the use of heavy equipment.

Signature:
______________
___________________
RAYMUNDO D. AGBON EDDIE A.
Mechanic 1 MAPA
Municipal Mayor
Designation:
______________________
Date: ____________________ ______________________
___
Province of Palawan
PURCHASE REQUEST

Fund:____________________
PR No.:__________________ Date: _________
Item Unit Total
No. Cost Cost
Dump truck 1 & 2
1 sets tire 11.00x20 w/ tube & flap 6 24,950.00 149,700.00
2 pcs Stud bolt w/ nut rear 30 465.00 13,950.00
3 pcs impact hammer 2 1,110.00 2,220.00
for L-300 service van
4 pail oil 40 2 4,500.00 9,000.00
5 pc oil filter 1 550.00 550.00
6 pcs tire (185/14c) 4 8,400.00 33,600.00
for backhoe
7 pail oil 40 4 4,275.00 17,100.00
8 pcs Wiper ring seal 2 980.00 1,960.00
9 pail Grease 2 4,500.00 9,000.00
Supremo 150
10 pc motor chain (120 L) 1 680.00 680.00
11 pc engine sprocket (15T) 1 210.00 210.00
12 pc camshop 1 3,900.00 3,900.00
13 set rocker arm 1 2,520.00 2,520.00
14 pc battery WPX 7L 1 1,250.00 1,250.00
15 pcs tire with tube (300x18) 3 1,300.00 3,900.00
16 pc sprocket (51T) 1 680.00 680.00
17 pc rear sprocket (15T) 1 460.00 460.00
Php 250,680.00

Signature:
______________
___________________
AA-1 MAPA
Municipal Mayor
Designation:
Date: ____________________ ______________________
Province of Palawan
PURCHASE REQUEST

Fund:____________________
PR No.:__________________ Date: _________
Item Unit Total
No. Cost Cost
TMX 150- Honda Supremo
1 pcs motor chain 120 L (TMX 150) 2
2 pcs Sprocket rear 52T (TMX 150) 2
3 pcs Sprocket engine 15T (TMX 150) 2
4 pc Camshop (TMX 150) 1 3,900.00 3,900.00
5 set rocker arm (TMX 150) 1 2,520.00 2,520.00
6 pc Battery WPX 7L (TMX 150) 1 1,250.00 1,250.00
7 pc tire with tube, 250x17 1 1,112.00 1,112.00
XRM 125
10 motor chain 110 L (XRM 125) 3.00
11 Sprocket rear 36T (XRM 125)
12 Sprocket engine 15T (XRM 125)
13 1 Piston ring .025 700.00
14 2 bulb seal 200.00
15
16
Php

Signature:
______________
___________________
AA-1 MAPA
Municipal Mayor
Designation:
Date: ____________________ ______________________
Province of Palawan
PURCHASE REQUEST

Fund:____________________
PR No.:__________________ Date: _________
Item Unit Total
No. Cost Cost
ROAD GRADER
1 ltrs Diesel 6,000 55.00 330,000.00
2 ltrs Gasoline 841 65.00 54,665.00
3 ltrs 2T oil 20 100.00 2,000.00
4 pail oil 10 10 3,950.00 39,500.00
5 pail oil 40 12 4,900.00 58,800.00
6 pail AD blue 5 3,000.00 15,000.00
(engineering & infrastructure Mgt. Prog.)

(FOL enpenses - SB #1 CY 2021)
Php 499,965.00

Signature:
______________
___________________
AA-1 MAPA
Municipal Mayor
Designation:
Date: ____________________ ______________________
Province of Palawan
PURCHASE REQUEST

Fund:____________________
PR No.:__________________ Date: _________
Item Unit Total
No. Cost Cost
ROAD GRADER
1 pcs Fuel Filter Separator 2 2,310.00 4,620.00
2 pcs Fuel filter # CXO712A 2 1,890.00 3,780.00
3 pcs Fuel filter # CXO712B 2 2,040.00 4,080.00
4 pail Engine oil # 40 1 4,980.00 4,980.00
5 pc Oil filter # 5602 1 2,625.00 2,625.00
6 pcs Fan belt A-36 2 945.00 1,890.00
SELF LOADING & MITSUBISHI L-300 VAN
7 pail Add blue additive 1 2,890.00 2,890.00
8 pc Oil filter 1 400.00 400.00
9 ltrs Engine oil # 40 6 380.00 2,280.00
GRADER, ROAD ROLLER & LOADER
10 pc Oil filter, cummins 2 2,700.00 5,400.00
11 pail Engine oil # 40 1 4,980.00 4,980.00
12 pails Hydraulic oil # 10 3 4,120.00 12,360.00
13 pc Fuel filter separator # 5706 1 2,625.00 2,625.00
14 pc Fuel filter # 7903 1 1,890.00 1,890.00
15 pc Pre filter # H 70WKO2 1 2,625.00 2,625.00
16 pc Air filter element 1 2,040.00 2,040.00
17 pc Drive belt - 8PK-1470 1 3,255.00 3,255.00
Php 62,720.00
Purpose: for the use of heavy equipment.

Signature:
______________
___________________
RAYMUNDO D. AGBON EDDIE A.
Mechanic 1 MAPA
Municipal Mayor
Designation:
______________________
Date: ____________________ ______________________
___
PURCHASE REQUEST
Municipality of Aborlan, Palawan
Department: PR No. Date:
SAI No. Date:
Division: OBRE No. Date:
Estimated Total
Item No. Qty. Unit of Issue Item Description
Unit Cost Cost
OMVM
2 Rms copy paper long 0.00
3 pcs copy paper, short 0.00
4 pcs data file box 0.00
ballpen black, fine
5 pcs 0.00
point
6 pcs correction tape 0.00
7 pcs folder, long 0.00
8 pcs backfold clip, 19 mm 0.00
11 pcs paper clips, small 0.00
12 pcs paper clips, large 0.00
marker, whiteboard,
13 pcs 0.00
black
marker, permanent
14 box 0.00
black
15 pcs DTR 0.00
16 pcs RER 0.00
17 box ballpoint/pen, black 0.00
ballpoint/pen, black,
18 pcs 0.00
fine point
19 pcs sign pen black 0.5 0.00
20 pcs pencil, ordinary 0.00
21 pcs mailing envelope 0.00
computer original ink
23 pcs 0.00
for epson T6641
24 pcs 0.00
for epson T6642
0.00
for epson T6643
0.00
for epson T664
Purpose: 16,908.00
Requested by: Approved by:
Signature
Printed Name JAIME M. ORTEGA
Designation Municipal Mayor

Province of Palawan
PURCHASE REQUEST
Local Government Unit of Aborlan Fund: Supplemental Budget #02-13-040-01 (Repair and Maintenance : Comelec Building)
PR No.:__________________ Date: Dec. 15, 2021

Unit Total
Item No. Unit Item Description Quantity
Cost Cost
1 pcs 75mmØ x 10' PVC Drain Pipe 1 558.680 558.68
2 pcs 75mmØ PVC 87.5deg Bend 2 108.825 217.65
3 pcs Solvent Cement 1 57.280 57.28
4 pcs Prepainted Metal Sheets (Corrugated, Short Span, Below 0.4mm thk.) 4 1102.500 4,410.00
5 pcs Tek screw J-bolt with washer 90 3.3326 299.93
6 Lit Vulcaseal 1 494.350 494.35
7 pcs 6mm Ordinary Plywood on Wooden Frame Ceiling 4 706.125 2,824.50
8 bd.ft. Good Lumber 84 44.100 3,704.40
9 kgs Assorted Nails 2 105.000 210.00
10 gals Glazing Putty 1 651.420 651.42
11 gals Flat Wall Enamel 1 701.740 701.74
12 gals Enamel Quick Dry Paint 1 787.500 787.50
13 liters Paint Thinner 3 335.360 1,006.08
14 pt Tinting Color 1 192.910 192.91
15 ln.m. Preformed Pre-painted G.I. Gutter, GA 24 (0.701mmx 2.44m) 24.4 394.370 9,622.62
16 pcs 12" x 1" Plain G.I. Strap 25 52.500 1,312.50
17 pcs Blind Rivets 391 3.150 1,231.65
28,283.21

Signature: ______________ ___________________
Printed Name: EFEGENIO V. SIOSE, JR. EDDIE A. MAPA CELSA B.
Acting Municipal Engineer Acting Municipal Treasurer ADIER
Designation: Municipal Mayor
Date: ____________________ ______________________
Province of Palawan
PURCHASE REQUEST
Local Government Unit of Aborlan Fund: Supplemental Budget #01 CY 2021 (Construction of RCPC Head Wall Brgy.
Isaub)
PR No.:__________________ Date: _________

Item Unit Total
No. Cost Cost
1 bags Cement 130.00 342.56 44,533.125
2 cu.m. Sand 11.75 1,512.53 17,772.17
3 cu.m. Gravel Fill 1.00 1,355.03 1,355.03
4 ln.m. Weep Holes (PVC) 12.00 107.10 1,285.20
5 sq.m. Filter Cloth 1.00 374.85 374.85
6 cu.m. Boulders 40.00 1,553.16 62,126.40
7 pcs RC Pipes 14.00 3,056.29 42,788.08
170,234.85
170,234.86

Signature: ___________________
______________
EFEGENIO V. SIOSE, JR.
Printed Name: Acting Municipal Engineer EDDIE A. MAPA CELSA B. ADIER
Designation: Municipal Mayor
Date:

New PR Form

Uploaded by

Copyright:

Available Formats

You might also like

New PR Form

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

New PR Form

Uploaded by

Copyright:

Available Formats

Republic of the Philippines

Local Government Unit of Aborlan

2 unit 10 tons boom truck with kangjim KS2700 crane 1

Purpose: for meo use.

Requested by: Cash Availability: Approved by:

Local Government Unit of Aborlan

Purpose: for meo use.

Requested by: Cash Availability: Approved by:

Local Government Unit of Aborlan

Purpose: for meo use.

Requested by: Cash Availability: Approved by:

Local Government Unit of Aborlan

Requested by: Cash Availability: Approved by:

Local Government Unit of Aborlan

Requested by: Cash Availability: Approved by:

Local Government Unit of Aborlan

Requested by: Cash Availability: Approved by:

Local Government Unit of Aborlan

Purpose: for meo use.

Requested by: Cash Availability: Approved by:

Local Government Unit of Aborlan

Purpose: for meo use.

Requested by: Cash Availability: Approved by:

Local Government Unit of Aborlan

Purpose: for meo use.

Requested by: Cash Availability: Approved by:

Local Government Unit of Aborlan

Purpose: for the use of heavy equipment.

Requested by: Cash Availability: Approved by:

Local Government Unit of Aborlan

Purpose: for meo use.

Requested by: Cash Availability: Approved by:

Local Government Unit of Aborlan

Purpose: for meo use.

Requested by: Cash Availability: Approved by:

Local Government Unit of Aborlan

(engineering & infrastructure Mgt. Prog.)

Purpose: for meo use.

Requested by: Cash Availability: Approved by:

Local Government Unit of Aborlan

Purpose: for the use of heavy equipment.

Requested by: Cash Availability: Approved by:

Designation Municipal Mayor

PR No.:__________________ Date: Dec. 15, 2021

Section: Mun. Engineering Office FPP: _____________________

Purpose: for meo use.

Requested by: Cash Availability: Approved by:

PR No.:__________________ Date: _________

Requested by: Cash Availability: Approved by:

You might also like

PR No.:__________ Date: _