Appendix 49

PURCHASE ORDER

Supplier: P.O. No. :

Address : Date :
___________________________________________________ Mode of Procurement : SMALL VALUE PROCUREMENT
TIN : PR No./s
Gentlemen:
Please furnish this Office the following articles subject to the terms and conditions contained herein:

Place of Delivery : Delivery Term : FOB-Shipping Point

Date of Delivery : within 7 days Payment Term : w/in 10 days UPON COMPLETION OF DELIVERY

Stock/
Unit Description Quantity Unit Cost Amount
Property No.

0 0 0

0 0 0
0 0 0
0

(Total Amount in Words) -

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
___________________________ _____________________________
Date Designation

(In case of Negotiated Purchase pursuant to Section 369 (a) of RA 7160, this portion must be accomplished.)

Approved per Sanggunian Resolution No.: _____________________________________________________

Certified Correct:
_____________________________ __________
Secretary to the Sanggunian Date