Annex B of Enclosure to DO No. 022, s.

2019, dated 09/02/2019

Date : October 9, 2023

LOCATOR SLIP Control # :
Region : XIII – CARAGA Division : SURIGAO DEL SUR District : SAN MIGUEL II
School : APUGAN ESLT (Tina CES Ext.)
Date of
October 9, 2023
Filing :
Name of Personnel : BUCARILE, DOHLY V
Last Name First Name M.I.
Permanent Station : APUGAN ESLT
Position / Designation : T III, TIC-designate
Purpose :
To purchase LED Emergency Light and refill Fire Extinguisher as
Requirement of BFP for Fire Safety Certificate of Apugan ESLT Building.
Please check : ⃝ Official Business ⃝ Official Time
Destination
Tandag City, Surigao del Sur
:

Date and Time of Event / October 9, 2023

Transaction / Meeting : Tandag City
Approved :

DOHLY V. BUCARILE LILY-ANN R. MENDERO, EdD

TIC-designate PSDS
Signature of Requesting Official / Head of Office or his / her
Employee Authorized Representative
Date : ___________________ Date : ___________________

CERTIFICATION
This is to certify that the above employee appeared in this Office for the above purpose.

Date :
Signature over printed name Position Control
#:
(Note: This portion shall be filled out by the Official / Authorized personnel of the Office visited)

SAN MIGUEL – DISTRICT II

Tina, San Miguel, Surigao del Sur, 8301
Office Telephone #: 086-214-6039
The accomplished and signed Locator Slip shall serve as the Authority to Travel.