DepED PS Form - GOODS - 61 Project Reference No.

Revised on: May 3, 2005

Republic Of The Philippines
DEPARTMENT OF EDUCATION
Region: VIII Division Of Eastern Samar
Address:
Telephone:

PURCHASE ORDER
San Pedro Elementary School
Agency

Supplier : D. O. No. :
Address : Guiuan, Eastern Samar Date :
E - Mail Address : Mode Of
Telephone No. : Procurement : Cash
TIN :
Gentlemen:
Please furnish this office the following articles subject to the terms and conditions contained herein.

Place of Delivery : Delivery Term :

Date of Delivery : Payment Term :

STOCK NO. UNIT DESCRIPTION QTY. UNIT COST AMOUNT

-
GRAND TOTAL -
(Total Amount in Words)

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

Very truly yours,

ERLINDA A. YODICO
School Head
Conforme:
Signature over printed name of supplier

Date:
Funds Available:
ALOBS No. :
NERISSA V. BADEO Amount :
School Treasurer