PURCHASE REQUEST

Republic of the Philippines

Department of Education
Caraga Administrative Region
Division of Butuan City

District: Southeast Butuan District II PR No. 10-003-23 Date 3/10/2023

Division: Butuan City Division SAI No. Date

Stock No. Unit Item Description Quantity Unit Cost Total Cost
1 3 3 3 3.00 9.00

GRAND TOTAL 9.00

Purpose:

Requested by: Approved by:

Signature
Printed Name: ROMEO M. GIDUCOS APRIL ANN G. BERNABE
Designation: School Head District In - Charge - SE II
 Republic of the Philippines
DEPARTMENT OF EDUCATION
Caraga Administrative Region
Division of Butuan City

QUOTATION

BUTUAN CITY

Gentlemen:

Please quote price in the following listed articles which BILAY NATIONAL HIGH SCHOOL of DepEd,
Butuan City division to buy advantageous to the government for your protection. You are request to return this quotation
in duly sealed envelope which will be opened by a duly authorized representative.

Very truly yours,

ROMEO M. GIDUCOS, Ed.D

School Head

Item No. Unit Item and Description Quantity Unit Price Total Amount

Signature of Dealer or Bidder or His Authorized Representative

Date:

Signature Over Printed

Name of Canvasser JADE N. SULTAN
Position BAC Canvasser
Date of Canvass
School BILAY NATIONAL HIGH SCHOOL
 Republic of the Philippines
DEPARTMENT OF EDUCATION
Caraga Administrative Region
Division of Butuan City

QUOTATION
1
BUTUAN CITY

Gentlemen:

Please quote price in the following listed articles which BILAY NATIONAL HIGH SCHOOL of DepEd,
Butuan City division to buy advantageous to the government for your protection. You are request to return this quotation
in duly sealed envelope which will be opened by a duly authorized representative.

Very truly yours,

ROMEO M. GIDUCOS, Ed.D

School Head

Item No. Unit Item and Description Quantity Unit Price Total Amount
1 3 3 3

Signature of Dealer or Bidder or His Authorized Representative

Date:

Signature Over Printed

Name of Canvasser JUNNEL D. BALLADOS
Position BAC Canvasser
Date of Canvass
School BILAY NATIONAL HIGH SCHOOL
 Republic of the Philippines
DEPARTMENT OF EDUCATION
Caraga Administrative Region
Division of Butuan City

QUOTATION
2
BUTUAN CITY

Gentlemen:

Please quote price in the following listed articles which BILAY NATIONAL HIGH SCHOOL of DepEd,
Butuan City division to buy advantageous to the government for your protection. You are request to return this quotation
in duly sealed envelope which will be opened by a duly authorized representative.

Very truly yours,

ROMEO M. GIDUCOS, Ed.D

School Head

Item No. Unit Item and Description Quantity Unit Price Total Amount
1 3 3 3

Signature of Dealer or Bidder or His Authorized Representative

Date:

Signature Over Printed

Name of Canvasser JUNNEL D. BALLADOS
Position BAC Canvasser
Date of Canvass
School BILAY NATIONAL HIGH SCHOOL
 Republic of the Philippines
Department of Education
CARAGA Administrative Region
Division of Butuan City
Southeast Butuan District II
BILAY NATIONAL HIGH SCHOOL
P-7 Bilay, Butuan City

ABSTRACT OF SEALED CANVASS

Office/End-user: Bilay National High School Purchase Request No. 10-003-23

Date/Place
Package

NAME OF BIDERS
ITEM 0 1 2
QUANTITY ITEM DESCRIPTION
NUMBER
1 3 3 1.00 2.00 3.00
2
3

BEVERLY MAE C. PELIGRO JADE N. SULTAN DARIOUS PABIA RAMIL MICARANDAYO MERLIE ARO
BAC CHAIRMAN BAC MEMBER BAC MEMBER BAC MEMBER BAC MEMBER
 PURCHASE ORDER
Republic of the Philippines
Department of Education
Caraga Administrative Region
Division of Butuan City

Supplier: J PO No.: 10-001-23

Address: Butuan City Date: 2/10/2023
Tel./ FaxNo.:_________________________________________ Mode of Procurement: ________________________
TIN:
Gentlemen:
Please furnish this Office the following articles subject to the terms and conditions contained herein:

Place of Delivery: Bilay National HIgh School Delivery Term:

Date of Delivery: Payment Term:

Stock No. Unit Item Description Quantity Unit Cost Total Cost
1 3 3 3 0.00

TOTAL AMOUNT -
SEVEN THOUSAND FIVE HUNDRED SIXTY FIVE PESOS ONLY

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 everyday of
delay shall be imposed.

Conforme:

___________________________________ APRIL ANN G. BERNABE

Signature over Printed Name of Supplier District In-Charge - SE II

Date: ________________

Funds Available:
BUR NO./ObR No.:
ROMEO M. GIDUCOS, Ed.D Date:
Principal III Amount:
 Fund Cluster: School MOOE
BILAY NATIONAL HIGH SCHOOL
Entity Name

Date: 2/10/2023
DISBURSEMENT VOUCHER DV No.: 10 - 001 - 23

Mode of MDS Check Commercial Check ADA Others (Please specify) ______________
Payment
TIN/ Employee No. ORS/BURS No.
Payee J
Address BUTUAN CITY Responsibility
Particulars Center MFO/PAP Amount

PAYMENT FOR SCHOOL SUPPLIES AND

MATERIALS

-
A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

ROMEO M. GIDUCOS, Ed.D

Printed Name, Designation and Signature of Superior

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)
Supporting documents complete and amount
claimed proper

Signature Signature

Printed ROMEO M. GIDUCOS, Ed.D Printed Name APRIL ANN G. BERNABE

Name
Principal III District In- Charge - SE II
Position Position
Head, Accounting Unit/ Authorized Representative Agency Head/Authorized Representative

Date Date

E. Receipt of Payment JEV No.

Date: Bank Name & Account Number:
Check/ ADA
No.

Date: Printed Name: Date

Signature

Official Receipt No. & Date / Other Documents:

 INSPECTION AND ACCEPTANCE REPORT
Republic of the Philipines
Department of Education
Caraga Administrative Region
Division of Butuan City

Supplier: J IAR No. 10-001-23

P. O No. 10-001-23 Inv. DR No.

OFFICIAL
DATE ITEM DESCRIPTION AMOUNT REMARKS
RECEIPT
2/10/2023 3 0 COMPLETE

Date Inspected: Date Inspected:

Inspected, verified and found in order as

to quantity and specifications Complete

BEVERLY MAE C. PELIGRO Partial (please specify quantity

INSPECTION CHAIRMAN

DARIOUS PABIA
MEMBER JADE N. SULTAN
School Property Custodian
RAMIL MICARANDAYO
MEMBER

MERLIE ARO
MEMBER

Requisting Office/School: BILAY NATIONAL HIGH SCHOOL