PURCHASE ORDER

SK of Barangay: City/Municipality:
Telephone No.: Province:
Supplier: P.O. 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 Qty. 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.

Very Truly Yours,

Conforme:
(printed name)
SK Chairperson
(printed name)
Signature over Printed Name of Date
Supplier's Authorized Representative

Date

Availability of the Budget or Funds Received for Specific Purpose:

(printed name)
(Signature over Printed Name) Date
Budget Monitoring Officer
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