KI FORM D-120723 DRINKS

BRANCH: ROXAS BRANCH PO REF. #

DATE: Wednesday, June 26, 2024

QUANTITY PARTICULARS PRICE TOTAL REMARKS

1 KIWI FRUIT SYRUP ₱ 590.00 ₱ 590.00
1 PREMIUM MATCHA POWDER ₱ 1,960.00 ₱ 1,960.00
1 BELGIAN CHOCO POWDER ₱ 450.00 ₱ 450.00
1 DARK CHOCO POWDER ₱ 445.00 ₱ 445.00
1 CATCHER SALTED CARAMEL FLAVOURED SAUCE ₱ 830.00 ₱ 830.00
1 COOKIES AND CREAM FRAPPE POWDER ₱ 415.00 ₱ 415.00
1 JAVA CHIP POWDER ₱ 1,920.00 ₱ 1,920.00
1 CHOCOLATE FRUIT PUREE ₱ 555.00 ₱ 555.00
1 CHOCOLATE MINT MOCHA ₱ 1,844.00 ₱ 1,844.00
1 TORANI LAVENDER SYRUP ₱ 530.00 ₱ 530.00
1 STRAWBERRY FRUIT SYRUP 2L ₱ 550.00 ₱ 550.00
2 COFFEE BAG ₱ 150.00 ₱ 300.00
2 FRAPPE BASE POWDER ₱ 350.00 ₱ 700.00

TOTAL AMOUNT: ₱ 11,089.00

PREPARED BY: MONICO L. ILARDE DELIVERED: ( ) YES ( ) NO

NAME & SIGNATURE DELIVERY DATE:
DATE: 6/26/2024

APPROVED BY: ENGR. JERUEL K. RARAMA RECEIVED: ( ) YES ( ) NO

NAME & SIGNATURE DATE:
DATE: 6/26/2024

PAYMENT REMARKS:
MODE OF PAYMENT AMOUNT DATE TRN REFERENCE/CK# RECEIVED BY: DATE:
CASH PAYMENT:
CHECK PAYMENT:
DEPOSIT PAYMENT:
GCASH PAYMENT

NOTED BY: PRINCESS KARLA M. JAO

YOU MAY PROCESS YOUR PAYMENT USING THE ACCOUNT PROVIDED BELOW:
ACCT# 1184-0000-5487
CHINABANK CORPORATION JOHN CEDRICK B. TAN