Annex 15

PURCHASE ORDER
SK of Barangay: City/Municipality:
Tel. No.: Province:
Supplier: ___________________________________________ PO No.: ____________________________
Address: __________________________________________ Date: ______________________________
Tel. No.:____________________TIN: ___________________ Mode of Procurement: _________________

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 of
Item No. Item Description Quantity Unit Cost Amount
Measurement

(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 every day of delay shall be
imposed on the undelivered item/s.
Conforme: Very truly yours,

____________________________________ ___________________________________________
Signature over Printed Name of Supplier Signature over Printed Name of SK Chairperson

__________________ ____________________
Date Date
Availability of the budget or funds received for specific purpose:

_________________________________________________________ ____________________
Signature over Printed Name of Budget Monitoring Officer Date