Project Refence Number: ________________________

Name of the Project Installation of CCTV

Location of the Project Barangay Tubod, Clarin, Bohol

Standard Form Number : SF GOODS-59

Revised on: May 24, 2004
Standard Form Title : PURCHASE REQUEST

PURCHASE REQUEST

Department Tubod, Clarin, Bohol PR NO. ________________ Date _____________

Section _________________________ SAI NO. ________________ Date ____________

UNIT TOTAL
STOCK UNIT ITEM DESCRIPTION QTY. COST COST
NO.

1 Set Specifications 1 49,500.00 49,500.00

2 pcs. Dahua Bullet CCTV Cameras 2mp Full
Color HD
4 pcs. Dahua Dome CCTV Cameras 2mp Full
Color HD
16 channel DVR with mouse
1.5 roll Siamese Cable
20 inches LED HD monitor
1 Terabyte Hard Disk
2 pcs Octopus

Including Installation

49,500.00

Purpose/Remarks: Installation of CCTV

Requested by:

Signature:

Printed Name: ROVIE M. PAYLA LEA E. INFANSO

Designation: Barangay Treasurer Barangay Captain