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INPUTS ON BASIC INFORMATIONS (e-liquidation-tolitz2022-revised) - FOR GOODS/SERVICES
A. H E A D I N G - BASIC INFORMATIONS G. TAXES WITHHELD

DECIMAL
1 DEPARTMENT: Deprartment of Education 7 SCHOOL HEAD:(ALLCAPS) ALFIE M. ANGEL 59 BIR FORMS TAX RATE % FORM ATC
2 REGION: Region III 8 DESIGNATION (sCAPS): School Principal I 60 2306 1600 MONTHLY 1 0.01 WB080
3 DIVISION: NUEVA ECIJA 9 LIQUIDATION FOR THE MONTH OF: SEPTEMBER 61 2307 0619-E MONTHLY 1 0.01 WI640
4 DISTRICT: (sCAPS) SDO Cuyapo West District 10 YEAR: (yyyy) 2023 62 REN-REN VARIETY STIRE 3,637.00
TIN NO. OF SCHOOL HEAD: (abc-def-ghi-jkl) 275-596-995-000
VAT or
5 SCHOOL: (ALL CAPS) D.R JOSE ELEMANTARY SCHOOL 11 TIN NO. OF SCHOOL: (abc-def-ghi-jkl) 493-663-892-385 63 2307 0619-EQ QUARTERLY 1 NON-VAT NON-VAT
GOODS or
6 SCHOOL ADDRESS: (sCAPS) Latap, Cuyapo, Nueva Ecija 12 SCHOOL ADDRESS: (ALL CAPS) Latap, Cuyapo, Nueva Ecija 64 2307 1604-E ANNUAL 1 SERVICES GOODS
B. DISBURSEMENT VOUCHER (DV) 65 ABSTRACT OF CANVASS BID: VAT SERVICES
PAYEE/SUPPLIER BUSENESS
13 FUND CLUSTER: 06 21
NAME: (ALL CAPS) REN-REN VARIETY STIRE
66 WITH CANVASS 999 1.12 3,247.32
14 DATE: (mm-dd-yyyy): 09/21/2023 22 ADDRESS: (ALL CAPS) NAMPICUAN, NUEVA ECIJA WITH CANVASS TRUE
TIN NO./EMPLOYEE NO.OF
15 DV NO.(yyyy-mm): 2023-09-008 23
PAYEE/SUPPLIER: (abc-def-ghi-jkl) 424-094-620-00001
PAYMENT FOR THE PURCHASE OF
16 OR/Invoice No.: 2446 24 PARTICULARS: (sCAPS)
SOLAR LIGHT(DRRM)
67 SUMMARY
17 GROSS AMOUNT (from INPUT-PO): 3,637.00 25 SCHOOL TREASURER (ALL CAPS): GROSS (1) 3,637.00 1 or 1.12 1 3637.00
MARIZA R. ALFONSO 68
TOTAL TAX
18 CHECK NO.: 26 SCHOOL INSPECTION (ALL CAPS): 2306 2307
JOYCE ANN C. PASCUAL 69 TOTAL CHECK 3,564.26
WITHHELD
19 PO NO.-PR NO.-IAR NO.: 2023-09-002 27 SCHOOL PROPERTY (ALL CAPS): RONNEL D. DAGDAG 70 36.37 36.37 72.74
20 BANK AND ACCT. NO. (ALL CAPS): LANDBANK OF THE PHILIPPINES 28 NAME OF SUPPLIER (ALL CAPS): FERDINAND F. SANGALANG
C. INSPECTION AND ACCEPTANCE (ADDITIONAL INFORMATIONS) H. OTHER INFO: (BIR FORMS 2306 - 2307)
29 DATE INSPECTED (mm-dd-yyyy): 09-21-2023 30 DATE RECEIVED (mm-dd-yyyy): 09-21-2023 71 FROM: 04-01-2023
AMOUNT OF TAXES FOR THE PERIOD
D. PURCHASE ORDER (ADDITIONAL INFORMATIONS) 72 TO: 04-30-2023
ZIP CODE ZIP CODE
31 DATE OF DELIVERY (mm-dd-yyyy): 09/21/2023 34 DELIVERY TERM (ALL CAPS): COD 73 (PAYEE/SUPPLIER): 3117 (PAYOR/SCHOOL): 3117
32 MODE OF PROCUREMENT (ALL CAPS): GOODS 35 PAYMENT TERM (ALL CAPS): CHECK
AMOUNT IN WORDS
33 FUNDS AVAILABLE: MOOE 36
(CHECK AMT.) (lowercase): THREE THOUSAND FOUR HUNDRED e.MAIL ADDRESS OF SCHOOL HEAD: (lowercase)
NINETY ONE AND 52/100
E. PURCHASE REQUEST (ADDITIONAL INFORMATIONS)
PURPOSE (sCAPS): DRRM AMOUNT IN WORDS

(GROSS AMT.) (lowercase): THREE THOUSAND SIX HUNDRED
37
THIRTY SEVEN
F. REQUEST FOR QUOTATIONS - (ALL CAPS)
WITH CANVASS REN-REN VARIETY STIRE
38
QUOTATION-SUPPLIER 01 41 NAME OF SUPPLIER: FERDINAND F. SANGALANG
REN-REN VARIETY STORE 42 DESIGNATION: PROPRIETOR
43 COMPANY/BUSENESS NAME: REN-REN VARIETY STORE
44 BUSENESS ADDRESS: NAMPICUAN, NUEVA ECIJA

45 CP NUMBER: N/A
46 e-MAIL ADDRESS: N/A
39
QUOTATION-SUPPLIER 02 47 NAME OF SUPPLIER: AUGUSTO LADON
LADON'S COPY CENTER & GEN. MDSE 48 DESIGNATION: PROPRIETOR
49 COMPANY/BUSENESS NAME:
LADON'S COPY CENTER & GEN.
MDSE
50 BUSENESS ADDRESS: CUYAPO, NUEVA ECIJA
51 CP NUMBER: N/A

40
QUOTATION-SUPPLIER 03 53 NAME OF SUPPLIER: ELMER C. GARCIA
MERMER GEN. MDSE. 54 DESIGNATION: PROPRIETOR
55 COMPANY/BUSENESS NAME: MERMER GEN. MDSE.
56 BUSENESS ADDRESS: CUYAPO, NUEVA ECIJA
57 CP NUMBER: N/A

Page 1 of 12
Deprartment of Education
Region III
NUEVA ECIJA
SDO Cuyapo West District
D.R JOSE ELEMANTARY SCHOOL
Latap, Cuyapo, Nueva Ecija
Fund Cluster
Original Copy/Photocopy: 06
CHECK: PAYMENT FOR THE PURCHASE OF SOLAR LIGHT(DRRM)
LIQUIDATION REPORT FOR THE MONTH OF:

SEPTEMBER 2023 Check No. 0
REN-REN VARIETY STIRE

NAMPICUAN, NUEVA ECIJA
Page 2 of 12
Region III
NUEVA ECIJA
Fund Cluster : 06
DISBURSEMENT VOUCHER Date: 09/21/2023
DV No. 2023-09-008
Mode of / MDS Check Commercial Check ADA Others (Please specify)

Payment
_________________
TIN/Employee No.: ORS/BURS No.:
Payee REN-REN VARIETY STIRE
424-094-620-00001 2446
Address NAMPICUAN, NUEVA ECIJA
Particulars Responsibility Center MFO/PAP Amount

PAYMENT FOR THE PURCHASE OF SOLAR LIGHT(DRRM)
GROSS AMOUNT Php. 3,637.00
TAX WITHHELD
NON-VAT 1 % 36.37 1600 WB080 72.74
GOODS 1 % 36.37 0619-E WI640
Amount Due Php. 3,564.26
A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.
ALFIE M. ANGEL
School Principal I
B. Accounting Entry:
Account Title UACS Code Debit Credit
C. Certified: D. Approved for Payment

/ Cash available
Subject to Authority to Debit Account (when applicable)
THREE THOUSAND FOUR HUNDRED NINETY ONE AND 52/100
Su
proper
Signature Signature
Printed MARIZA R. ALFONSO ALFIE M. ANGEL
Printed Name
Name
Position Disbursing Officer/Treasurer Position School Principal I
Date 09/21/2023 Date 09/21/2023
E. Receipt of Payment JEV No.

Check/
ADA Date : Bank Name & Account Number:
0 09/21/2023 LANDBANK OF THE PHILIPPINES
No. :
Date : Printed Name: Date 09/21/2023
Signature :
09/21/2023 MARIA
FERDINANDCARMELITA G. RAMOS
F. SANGALANG
Page 2 of 12
Official Receipt No. & Date/Other 2446 09/21/2023

Documents
Page 3 of 12
Region III
NUEVA ECIJA
Date
09/21/2023
Original Copy/Photocopy:
OR/INVOICE RECEIPT: PAYMENT FOR THE PURCHASE OF SOLAR LIGHT(DRRM)

SEPTEMBER 2023 OR/SI No. 2446

NAMPICUAN, NUEVA ECIJA
Page 4 of 12
Region III
NUEVA ECIJA
Original Copy/Photocopy:
PICTURE: PAYMENT FOR THE PURCHASE OF SOLAR LIGHT(DRRM)

SEPTEMBER 2023
3
1
4
2
Page 5 of 12
Region III
NUEVA ECIJA
INSPECTION AND ACCEPTANCE REPORT
Fund Cluster : 06
Supplier : REN-REN VARIETY STIRE IAR No. : 2023-09-002

PO No./Date : 2023-09-002 09/21/2023 Date : 09/21/2023
Requisitioning Office/Dept. : _______________________________ Invoice No. 2446
Responsibility Center Code : _______________________________ Date : 09/21/2023
Stock/
Description Unit Quantity
Property No.
1 SOLAR LIGHT (150 WATT) SET 1
INSPECTION ACCEPTANCE
Date Inspected : 09-21-2023 Date Received : 09-21-2023
Inspected, verified and found in Complete

order as to quantity and
specifications
Partial (pls. specify quantity)
Team Leader: AURORA S. PASCUA

RONNEL D. DAGDAG
Regular Member SINAMAR C. CONCEPCION Supply and/or Property Custodian
Provisional Member: JOYCE ANN C. PASCUAL

Page 7 of 12
Region III
NUEVA ECIJA
ABSTRACT OF CANVASS BID
FOR THE PURCHASE OF DRRM SUPPLIES
Held on Tuesday, September 19, 2023
REN-REN VARIETY STORE LADON'S COPY CENTER & GEN. MDSE MERMER GEN. MDSE.
QTY UNIT ARTICLES
UNIT PRICE TOTAL UNIT PRICE TOTAL UNIT PRICE TOTAL
1 SET SOLAR LIGHT (150 WATT) 3,637.00 3,637.00 3,750.00 3,750.00 4,000.00 4,000.00
TOTAL 3,637.00 3,750.00 4,000.00
Recommending award to REN-REN VARIETY STORE

Prices considered just and reasonable and does not exceed the prices prevailing in the locality.
MARIZA R. ALFONSO RONNEL D. DAGDAG ALFIE M. ANGEL

School Treasurer School Property Custodian School Head
Page 11 of 12
PURCHASE REQUEST
Entity Name: Department of Education Fund Cluster: 06
Office/Section PR. NO. 2023-09-002 Date: 09/19/2023

D.R JOSE ELEMANTARY
SCHOOL Responsibility Center Code:
Stock/ Property No. Unit Item Description Qty Unit Cost Total Cost
1 SET SOLAR LIGHT (150 WATT) 1 3637.00 3,637.00

-
-
-
-
-
-
TOTAL Php. 3,637.00

Purpose:
DRRM
#REF!
Requested by: Approved by:
Signature :
Printed Name : RONNEL D. DAGDAG ALFIE M. ANGEL

Designation : Property Custodian School Principal I
Page 8 of 12
Region III
NUEVA ECIJA
REQUEST FOR QUOTATION

Date: 09/21/2023
Quotation Reference Number: 2023-09-004
Sir/Madam:
Please quote your lowest price on the item/s listed below, stating the shortest time of delivery and submit your
quotation thru email at alfie.angel01@deped.gov.ph not later than 09/21/2023
JOYCE ANN C. PASCUAL ALFIE M. ANGEL

Canvasser Division Head
PROCUREMENT TERMS AND CONDITIONS
1. The Approved Budget for the Contract is PhP 3,637.00
2. Price quoted are subject to deduction of 5% VAT & 1% EWT (for goods) or 5%VAT & 2%EWT (for services)
3. Goods, supplies, equipment or work done are subject to inspection/acceptance, DepED reserves the right to cancel
reject or rebid the items which do not conform with the specifications.
4. Complete technical specifications, brand & model must be indicated in the price quotation for evaluation purposes.
5. Delivery period shall be indicated in the quotation. A liquidated damages equivalent to 1/10 of 1% per day
of delay for the value of undelivered items shall be imposed.
6. All bids in excess of the ABC will be rejected.
7. Supplier warrants that he/she has not given nor promised to give any money or gift to any DepEd employee to
secure this offer and to obtain an award.
Item No. Quantity Unit Item and Description Unit Price Total Amount
-
-
-
-
-
-
*************** Php. -
Delivery Period: SEPTEMBER 19 - 21, 2023
Warranty: 1 month after delivery
Price Validity: one month
Delivery Term: deliver
Payment Term: check payment/payment upon delivery
After having carefully read and accept your Procurement Terms & Conditions, I/We quote you on the item at prices
noted above.
FERDINAND F. SANGALANG
PRINTED NAME/SIGNATURE
Designation: PROPRIETOR
Company Name: REN-REN VARIETY STORE

Business Address: NAMPICUAN, NUEVA ECIJA
Telephone Number/CP number: N/A
Email Address: N/A
Page 6 of 12
Region III
NUEVA ECIJA
PURCHASE ORDER
Supplier : REN-REN VARIETY STIRE P.O. No. : 2023-09-002

Address : NAMPICUAN, NUEVA ECIJA Date : 09/21/2023
TIN: 424-094-620-00001 Mode of Procurement : GOODS
Gentlemen:
Please furnish this Office the following articles subject to the terms and conditions contained herein:
Place of Delivery :
D.R JOSE ELEMANTARY SCHOOL Delivery Term : COD
Date of Delivery : 09/21/2023 Payment Term : CHECK

Stock/
Description Quantity Unit Cost Amount
Property No.
1 SET SOLAR LIGHT (150 WATT) 1 3637.00 3,637.00
-
-
-
(Total Amount in Words) THREE THOUSAND SIX HUNDRED THIRTY SEVEN Php. 3,637.00
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,
FERDINAND F. SANGALANG ALFIE M. ANGEL

Signature over Printed Name of Supplier Signature over Printed Name of School
Principal/Teacher-in-Charge
09/21/2023 School Principal I
Date Designation
Fund Cluster : 06 ORS/BURS No. 2446

Funds Available : MOOE Date of the ORS/BURS: 09/21/2023
MARIZA R. ALFONSO Amount : Php. 3,637.00

Signature over Printed Name of Disbursing
officer/School Treasurer
Page 9 of 12
Region III
NUEVA ECIJA

Date: 09/21/2023
Sir/Madam:

*************** Php.
Delivery Period: SEPTEMBER 19 - 21, 2023
Warranty: 1 month after delivery
noted above.
AUGUSTO LADON
LADON'S COPY CENTER & GEN. MDSE

Company Name:
Business Address: CUYAPO, NUEVA ECIJA
Telephone Number/CP number: n/a
Email Address: N/A
Page 10 of 12
Region III
NUEVA ECIJA

Date: 09/21/2023
Sir/Madam:

*************** Php.
Delivery Period: SEPTEMBER 19-21, 2023
Warranty:
noted above.
ELMER C. GARCIA
MERMER GEN. MDSE.

Company Name:
Business Address: CUYAPO, NUEVA ECIJA
Telephone Number/CP number: n/a
Email Address: N/A
Republic of the Philippines
For BIR BCS/ Department of Finance
Use Only Item: Bureau of Internal Revenue
BIR Form No.
Certificate of Creditable Tax
2307
January 2018 (ENCS)
Withheld at Source 2307 01/18ENCS
Fill in all applicable spaces. Mark all appropriate boxes with an "X".
1 For the Period From 04-01-2023 (MM/DD/YYYY) To 04-30-2023 (MM/DD/YYYY)
Part I – Payee Information
2 Taxpayer Identification Number (TIN) 424-094-620-00001

3 Payee’s Name (Last Name, First Name, Middle Name for Individual OR Registered Name for Non-Individual)
4 Registered Address 4A ZIP Code
NAMPICUAN, NUEVA ECIJA 3117

5 Foreign Address, if applicable
Part II – Payor Information

6 Taxpayer Identification Number (TIN) 493-663-892-385
7 Payor’s Name (Last Name, First Name, Middle Name for Individual OR Registered Name for Non-Individual)
8 Registered Address 8A ZIP Code
Latap, Cuyapo, Nueva Ecija 3117

Part III – Details of Monthly Income Payments and Taxes Withheld
AMOUNT OF INCOME PAYMENTS
Income Payments Subject to Expanded Tax Withheld for
ATC 1st Month of the 2nd Month of the 3rd Month of the
Withholding Tax Total the Quarter
Quarter Quarter Quarter
PAYMENT FOR THE PURCHASE OF WB080 3,637.00 36.37
SOLAR LIGHT(DRRM) 1 %
MONTHLY
0.01
Total
Money Payments Subject to Withholding
of Business Tax (Government & Private)
PAYMENT FOR THE PURCHASE OF WI640 3,637.00 36.37
SOLAR LIGHT(DRRM) 1 %
MONTHLY
0.01
Total Php. 72.74

We declare under the penalties of perjury that this certificate has been made in good faith, verified by us, and to the best of our knowledge and belief, is true and
correct, pursuant to the provisions of the National Internal Revenue Code, as amended, and the regulations issued under authority thereof. Further, we give our
consent to the processing of our information as contemplated under the *Data Privacy Act of 2012 (R.A. No. 10173) for legitimate and lawful purposes.
Date Signed (MM/DD/YYYY)

09/21/2023
275-596-995-000 ALFIE M. ANGEL
Signature over Printed Name of Payor/Payor’s Authorized Representative/Tax Agent
(Indicate Title/Designation and TIN)
Tax Agent Accreditation No./ Date of Issue Date of Expiry
Attorney’s Roll No. (if applicable) (MM/DD/YYYY) (MM/DD/YYYY)
CONFORME:
Date Signed (MM/DD/YYYY)
09/21/2023
424-094-620-00001 FERDINAND F. SANGALANG
Signature over Printed Name of Payee/Payee’s Authorized Representative/Tax Agent
(Indicate Title/Designation and TIN)
Tax Agent Accreditation No./ Date of Issue Date of Expiry
Attorney’s Roll No. (if applicable) (MM/DD/YYYY) (MM/DD/YYYY)
*NOTE: The BIR Data Privacy is in the BIR website (www.bir.gov.ph)

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INPUTS ON BASIC INFORMATIONS (e-liquidation-tolitz2022-revised) - FOR GOODS/SERVICES

A. H E A D I N G - BASIC INFORMATIONS G. TAXES WITHHELD

B. DISBURSEMENT VOUCHER (DV) 65 ABSTRACT OF CANVASS BID: VAT SERVICES

PURPOSE (sCAPS): DRRM AMOUNT IN WORDS

REN-REN VARIETY STORE 42 DESIGNATION: PROPRIETOR

43 COMPANY/BUSENESS NAME: REN-REN VARIETY STORE

44 BUSENESS ADDRESS: NAMPICUAN, NUEVA ECIJA

LADON'S COPY CENTER & GEN. MDSE 48 DESIGNATION: PROPRIETOR

50 BUSENESS ADDRESS: CUYAPO, NUEVA ECIJA

52 e-MAIL ADDRESS: N/A

MERMER GEN. MDSE. 54 DESIGNATION: PROPRIETOR

55 COMPANY/BUSENESS NAME: MERMER GEN. MDSE.

56 BUSENESS ADDRESS: CUYAPO, NUEVA ECIJA

58 e-MAIL ADDRESS: N/A

CHECK: PAYMENT FOR THE PURCHASE OF SOLAR LIGHT(DRRM)

LIQUIDATION REPORT FOR THE MONTH OF:

REN-REN VARIETY STIRE

Mode of / MDS Check Commercial Check ADA Others (Please specify)

Particulars Responsibility Center MFO/PAP Amount

REN-REN VARIETY STIRE

GROSS AMOUNT Php. 3,637.00

C. Certified: D. Approved for Payment

Date 09/21/2023 Date 09/21/2023

E. Receipt of Payment JEV No.

Official Receipt No. & Date/Other 2446 09/21/2023

LIQUIDATION REPORT FOR THE MONTH OF:

REN-REN VARIETY STIRE

LIQUIDATION REPORT FOR THE MONTH OF:

INSPECTION AND ACCEPTANCE REPORT

Supplier : REN-REN VARIETY STIRE IAR No. : 2023-09-002

Inspected, verified and found in Complete

Team Leader: AURORA S. PASCUA

Provisional Member: JOYCE ANN C. PASCUAL

TOTAL 3,637.00 3,750.00 4,000.00

Recommending award to REN-REN VARIETY STORE

MARIZA R. ALFONSO RONNEL D. DAGDAG ALFIE M. ANGEL

Entity Name: Department of Education Fund Cluster: 06

Office/Section PR. NO. 2023-09-002 Date: 09/19/2023

1 SET SOLAR LIGHT (150 WATT) 1 3637.00 3,637.00

TOTAL Php. 3,637.00

Requested by: Approved by:

Printed Name : RONNEL D. DAGDAG ALFIE M. ANGEL

REQUEST FOR QUOTATION

JOYCE ANN C. PASCUAL ALFIE M. ANGEL

Company Name: REN-REN VARIETY STORE

Supplier : REN-REN VARIETY STIRE P.O. No. : 2023-09-002

Date of Delivery : 09/21/2023 Payment Term : CHECK

Conforme: Very truly yours,

FERDINAND F. SANGALANG ALFIE M. ANGEL

Fund Cluster : 06 ORS/BURS No. 2446

MARIZA R. ALFONSO Amount : Php. 3,637.00

REQUEST FOR QUOTATION

JOYCE ANN C. PASCUAL ALFIE M. ANGEL

LADON'S COPY CENTER & GEN. MDSE

REQUEST FOR QUOTATION

JOYCE ANN C. PASCUAL ALFIE M. ANGEL

MERMER GEN. MDSE.

Part I – Payee Information

2 Taxpayer Identification Number (TIN) 424-094-620-00001

NAMPICUAN, NUEVA ECIJA 3117

Part II – Payor Information

Latap, Cuyapo, Nueva Ecija 3117

Total Php. 72.74