PURCHASE ORDER

Barangay: City/Municipality:
Tel. No.: Province:

Supplier: PO No.:
Address: Date:
TIN: Mode Of Procurement:

Bidding Negotiated Over the Counter

Gentlemen:
Please deliver to this office the following articles subject to the terms and conditions contained herein
Place of Delivery: Delivery Term:
Date of Delivery: Payment Term:

Unit Particulars Quantity Unit Cost Amount

(Total Amount In Words)

In case of failure to make full delivery within the time specified above, a penalty of one-tenth (1/10)
of one percent for everyday of delay shall be imposed.

Very truly yours,

Punong Barangay

Conforme: Existence of Available Appropriations of

Signature over Printed Name (Signature over Printed Name)

Supplier Chairman, Committee on Appropriations

Date Date