Appendix 62

INSPECTION AND ACCEPTANCE REPORT

Procuring Entity Name: Barangay San Roque Fund Cluster:

Supplier: R JARABO CONSTRUCTION AND SUPPLIES IAR No.:_________________________
PO No./Date: _________________ Date: __________________________
Requisitioning Office/Dept: Invoice No.:______________________
Responsibility Center Code:___________________________ Date:___________________________
STOCK/PROPERTY
DESCRIPTION UNIT QUANTITY
NUMBER
1 20 - 2" x 3" x 10' Coco Lumber bd.ft 100
2 Nylon #0.80 Rolls 1
3 Portland Cement bags 164
4 Washed Sand cu.m 12
5 peasize gravel cu.m 14
6 Plastic pail (medium size) pcs 10
7 Plastic Container (20 ltrs capacity) pcs 1
8 Concrete Mixer(Operated with FOL) day/s 1
9 10mm Ø x 6.0m RSB pcs. 307
10 16mm Ø x 6.0m RSB pcs. 96
11 #16 G.I. Tie Wire(2% of total RSB) kgs. 45
12 Cut-off Disc pc 1
13 Cut-off Machine day/s 6
14 500- 2" x 3" x 12' Coco Lumber bd.ft 3024
15 1/4" thk. Ordinary Plywood shts. 35
16 4" CWN kgs. 26
17 3" CWN kgs. 28
18 2" CWN kgs. 10
19 1" CWN kgs. 6
20 4" x 8" x 16" CHB pcs. 380
D- 1 (0.8m x 2.1m) swing glass door on aluminum frame with
21 1/4 thk glass and lockset, hinges set 1
W-1 (1.20m x 1.20m) awning type window with 1/4 thk glass
22 on aluminum frame set 4
23 3" Ø x 3.0m PVC Pipe pcs. 1
24 3" Ø x 3" PVC Elbow pcs. 2
25 3" Ø x 3" PVC Wye pcs. 1
26 3" Ø x 3" Ø PVC Tee pc 1
27 3" Ø PVC Clean Out Plug pcs. 1
28 1/2" ø PN-25 PPR gate valve set 1
29 1/2" ø x 4m PN-16 PPR pipe pcs. 2
30 1/2" ø x 90⁰ PN-25 PPR elbow pcs. 4
31 1/2" ø PN-25 PPR tee pcs. 2
32 1/2" ø PN-25 PPR union patente pcs. 1
33 1/2" ø PN-25 PPR coupling pcs. 6
34 1/2" ø PN-25 PPR plug pcs. 2
35 PVC solvent cement can 2
36 1/2" Ø Female Threaded Adaptor pcs. 2
37 1/2" Ø Faucet pcs. 2
38 200 liters PVC Drum pcs. 2
39 Teflon Tape pcs. 3
40 2" x 4" Utility Boxes PVC pcs. 6
41 4" x 4" Junction Boxes PVC pcs. 8
42 Flexible Hose 1/2' dia. m 150
43 3/4" Ø Entrance cap pc 1
44 Screw Insulator pc. 1
45 #14 THHN copper wire boxes 1
46 #12 THHN copper wire boxes 1
47 1 gang switch pcs. 2
48 3 gang switch pcs. 1
49 Convenience outlet (flush type) pcs. 4
50 Bulb receptacle pcs. 9
51 LED Bulb 9w pcs. 9
52 Electrical Tape pcs. 4

53 4 Branch Panel Board with circuit breaker set 1

54 Hand Gloves pair 15

55 Safety Boots pair 1
56 Hard Hat pcs 2
57 Shovel ( Pointed ) pcs 2
58 Tarpaulin 4' x 8' sq.ft. 32
INSPECTION ACCEPTANCE
Date Inspected:_______________________________ Date Received:_______________________
Inspected, verified and found
in order as to quality and COMPLETE
specifications.
PARTIAL(Pls. specify quantity)

Inspection Officer/Inspection Committee Supply and/or Property Custodian

 Appendix 62

INSPECTION AND ACCEPTANCE REPORT

Entity Name:_______________________________________ Fund Cluster:

Supplier: JIGZ ENTERPRISES IAR No.:
PO No.: Date:
Requisitioning Office/ Dept.:MO______ Invoice No.:
Responsibility Center Code:___________________________ Date:
STOCK/PROPERTY
DESCRIPTION UNIT QUANTITY
NUMBER
1 Projector with White Screen Unit 1
2 Office Chair Pcs 2

3in1 Printer
•Print, scan, copy with ADF
•Print speeds up to 17ipm for black and
9.5ipm for color
3 •Auto-Duplex printing Unit 2
•Wi-Fi & Wi-Fi Direct
¤Draft, A4 (black/color): Up to 37.0 ppm/ 23.o ppm*2
•ISO 24734, A4 Simple (black/ Color): Up to 17.0 ipm / 9.5
ipm*2
•ISO 24734, A4 Duplex (black/ color); Up to 7.5 ipm / 5.0
ipm*2
•First page out time from ready mode (black/ color); Simplex;
Up to 7.0 sec/ 11 sec *2

Laptop
•Windows 11 Pro
•11th Gen Intel® Core™ i5-11400H
(2.7GHz ̴4.5GHz)
4 •Intel® UHD Graphics Unit 1
NVIDIA® GeForce RTX™3060 Laptop GPU 6GB GDDR6
•15.6'' Thin Bezel FHD 1920x1080 IPS-level Anti-glare Display
LCD (144Hz Refresh Rate)
•16GB of Ram
•512GB PCIe SSD
o 1x2.5'' HDD/SSD slot (Only support 7mm or thinner)
2x M.2 SSD slotr ( Type 2280, supports 1x NVMe PCIe Gen3 &
SATA/ 1x NVMe PCIe Gen4)
•Support 3 Storage System

Desktop Computer
5 •Windows 10 or 11 Pro Unit 1
•Core i5 or i7
•8 GB DDR4-2666 SDRAM (1x8 GB)
•1 TB NVMe™ M.2 SSD with HDD Expansion Slot
•NVIDIA® GeFore® GTX 1030
6 Heavy
HEAVYDuty
DUTYUPS
UPS Unit 3
 INSPECTION ACCEPTANCE

Date Inspected: _____________________________ Date Received: _______________________

Inspected, verified and found Complete

in order as to quality and Partial(Pls. specify quantity)
specifications. _____________________________

NOMIE F. GALLANOSA JOSEPH D. GABITAN

Inspection Officer/Inspection Committee Supply and/or Property Custodian