ANNEX A

DEPARTMENT OF EDUCATION
SCHOOL: STO.TOMAS ELEMENTARY SCHOOL

CERTIFICATE OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated June 19, 2017

Name of IMELDA C. GARCIA Employee 0030291

Employee Number
Office/School STO.TOMAS ES
Division QUIRINO
Particulars Amount
SNACKS - MORNING - BUKO JUICE 10.00
PUTO WITH KUTSINTA 75.00
LUNCH - PORK-ADOBO 70.00
RICE 10.00

SNACKS - AFTERNOON – BUKO JUICE 10.00

PANCIT WITH LUMPIANG GULAY 75.00

Total 250.00
Purpose: NLC Meal Allowance

I hereby certify that the above expenses are incurred as they are necessary for the above
cited purpose, that above goods and services were acquired from parties not issuing receipts. And
that I am fully aware that willful falsification of statements is punishable by law.
Certified Correct: Noted by
Signature

Printed Name IMELDA C. GARCIA NELIA D. MIGUEL

Name of Employee School Heads
Date: JULY 1, 2024 Date: JULY 1, 2024

Noted by: Noted by:

SONIA C. PAGBILAO Ph D WHILMAR M. VILLANUEVA

Public Schools District Supervisor Education Program Supervisor-Mathematics
National Learning Camp Division Coordinator