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_____________________________________ Date _______________ Invoice No. __________ Requisitioning Office/Dept. ________________________________________________________________ Item No. 1 Unit cards Description Smart Buddy Prepaid Unit Price 300.00 Total 1,200.00 Qty. 4
INSPECTION Date Inspected: __________________ Inspected, verified and found OK as to quantity and specifications
Standard Form Number: SF-GOOD-59 Revised on: May 24, 2004 Standard Form Title: Purchase Request
PURCHASE REQUEST
LGU - ALORAN Agency / Procuring Entity Department HRMO________________ Section __________________________ STOCK NO. 1 UNIT cards PR No. __________________ Date: ____________________ SAI No. __________________ Date: ____________________ QTY 4 UNIT COST 300.00 TOTAL COST 1,200.00
Purpose / Remarks: Telephone Communication Requested by: Signature: Printed Name: Designation: Date: AILEEN M. DIANGO Administrative Officer IV Approved by: ENGR. JIMMY R. REGALADO Municipal Mayor
Standard Form Number: SF-GOOD-58 Revised on: May 24, 2004 Standard Form Title: Purchase Order
PURCHASE ORDER
LGU - ALORAN Agency / Procuring Entity Supplier : FARMACIA JESSICA P.O. No. : _________________ Address : OROQUIETA CITY Date : _________________ Email Address : __________________________ Mod of : _________________ Telephone No. : __________________________ Procurement : _________________ TIN : __________________________ Gentlemen: Please furnish this office the following articles subject to the terms and conditions contained herein: Place of Delivery : __________________________ Delivery Term : ________________ Date of Delivery : __________________________ Payment Term: ________________ STOCK NO. UNIT DESCRIPTION QTY. UNIT COST AMOUNT 1 cards Smart Buddy Prepaid 4 300.00 1,200.00
(Total Amount in Words) One Thousand Two Hundred Pesos PHP 1,200.00 In case of failure to make the full delivery within the time specified above, a penalty of one-tenth (1/10) of one (1) percent for every day of delay shall be imposed.
Very truly yours, Conforme: ________________________________ Signature over printed name of Supplier _____________________ Date Funds Available: MANOLITA M. ORIO Chief Accountant ALOBS No.: ______________________ Amount: _________________________ ENGR. JIMMY R. REGALADO Authorized Official
Standard Form Number: SF-GOOD-60 Revised on: May 24, 2004 Standard Form Title: Request for Quotation
Company Name _________________________ Address _________________________ Please quote your lowest price on the item/s listed below subject to the General Conditions on the last page, stating the shortest time of delivery and submit your quotation in the return envelope attached herewith.
ITEM NO.
ITEM & DESCRIPTION 1 set of computer Intel CPU Intel CPU 1.8ghz ASROCK 82945G Intel Chipset 2gb memory 150gb hardisk Dvd drive Samsung LCD LG monitor 17 L117WSB 500w power supply ATX casing CIVO HP Deskjet D2560 VIVERA AVR 500w elite With keyboard / mouse optical and mouse pad
QTY. 1
UNIT PRICE
AMOUNT
______________ ______________
: : : :
After having carefully read and accepted your General Conditions, I/We quote you on the item at prices noted above. __________________________ Printed Name / Signature __________________________ Tel. No. / Cellphone No. e-mail address __________________________ Date
Standard Form Number: SF-GOOD-42 Revised on: May 24, 2004 Standard Form Title: Purchase Order Abstract of Bids as Calculated Project Name Project Location : ______________________________________________________ : ______________________________________________________ ______________________________________________________ ______________________________________________________ : ______________________________________________________ : ______________________________________________________ : ______________________________________________________ Sheet Date Time : ____________________ : ____________________ : ____________________
Implementing Office Approved Budget for the Contract Time and Place of Bid Opening NAME OF BIDDERS Total Amount of Bid Form of Bid Security Bank / Company Number Validity Period Bid Security Amount Required Bid Security Sufficient / Insufficient Remarks
__________________________ Representative
After all bids have been received, examined, evaluated and ranked, the BAC shall prepare the corresponding Abstract of Bids as Calculated. All members of the BAC, as well as the Observers present, shall sign the Abstract of Bids as Calculated and attach thereto all the bids with their corresponding Bid Securities and the minutes or proceedings of the bidding.
________________________ Representative
_________________________ Head Reviewed by: JOVITO P. APARTE Mun. Budget Officer Department: Accnt. Title: Approp./Allot. Bal.: Less Expenses: Balance:
__________________________ Head Reviewed by: JOVITO P. APARTE Mun. Budget Officer Department: Accnt. Title: Approp./Allot. Bal.: Less Expenses: Balance:
__________________________ Head Reviewed by: JOVITO P. APARTE Mun. Budget Officer Department: Accnt. Title: Approp./Allot. Bal.: Less Expenses: Balance:
___________________________ Head Reviewed by: JOVITO P. APARTE Mun. Budget Officer Department: Accnt. Title: Approp./Allot. Bal.: Less Expenses: Balance:
___________________________ Head Reviewed by: JOVITO P. APARTE Mun. Budget Officer Department: Accnt. Title: Approp./Allot. Bal.: Less Expenses: Balance:
___________________________ Head Reviewed by: JOVITO P. APARTE Mun. Budget Officer Department: Accnt. Title: Approp./Allot. Bal.: Less Expenses: Balance:
___________________________ Head Reviewed by: JOVITO P. APARTE Mun. Budget Officer Department: Accnt. Title: Approp./Allot. Bal.: Less Expenses: Balance:
___________________________ Head Reviewed by: JOVITO P. APARTE Mun. Budget Officer Department: Accnt. Title: Approp./Allot. Bal.: Less Expenses: Balance:
__________________________ Head Reviewed by: JOVITO P. APARTE Mun. Budget Officer Department: Accnt. Title: Approp./Allot. Bal.: Less Expenses: Balance:
___________________________ Head Reviewed by: JOVITO P. APARTE Mun. Budget Officer Department: Accnt. Title: Approp./Allot. Bal.: Less Expenses: Balance:
__________________________ Head Reviewed by: JOVITO P. APARTE Mun. Budget Officer Department: Accnt. Title: Approp./Allot. Bal.: Less Expenses: Balance:
___________________________ Head Reviewed by: JOVITO P. APARTE Mun. Budget Officer Department: Accnt. Title: Approp./Allot. Bal.: Less Expenses: Balance:
___________________ Head
____________________ Head
___________________ Head
____________________ Head
____________________ Head
APPENDIX "A" AMENDED ITINERARY OF TRAVEL Name: Position: Purpose of travel: See attached Travel Order DATE
12/16/09
PLACES TO BE TAKEN
Oroq. City - Ozamiz City Mucas - Iligan City Iligan City - CDO
TOTAL
860.00 28.00 80.00 100.00 150.00 800.00 800.00 150.00 500.00 80.00 28.00 60.00 3,636.00
Still in CDO Still in CDO CDO - Iligan City Iligan City - Mucas Ozamiz City - Oroq. City Taxi Bus Bus Barge Bus 150.00 100.00 80.00 28.00 60.00
1. I hereby certify (1) that I have received the foregoing itinerary (2) The travel is necessary to the service (3) The period covered is reasonable (4) The expenses are proper. Prepared by:
Official Employee
ENGR. JIMMY R. REGALADO Head or Chief of Office Republic of the Philippines PROVINCE OF MISAMIS OCCIDENTAL
Municipality of Aloran
Date
I certify that I have completed the travel authorized in Itinerary of Travel No. __________, dated ______________ made conditions indicated below. Strictly in accordance with the approved itinerary. Cut short as explained below excess payment in the amount of ___________________ was refunded on O.R. _________________ dated __________________. Expended as explained below, additional itinerary was submitted. Other deviation as explained below. Explanations or justifications: See attached Travel Order
Travel Order
Respectfully Submitted:
Official Employee
On the evidence and information of which I have acknowledge, the travel was actually undertaken.
Republic of the Philippines Province of Misamis Occidental Municipality of Aloran ACKNOWLEDGEMENT RECEIPT FOR EQUIPMENT Qty. 1 Unit set Description 1 set of computer Intel CPU Intel CPU 1.8ghz ASROCK 82945G Intel Chipset 2gb memory 150gb hardisk Dvd drive Samsung LCD LG monitor 17 L117WSB 500w power supply ATX casing CIVO HP Deskjet D2560 VIVERA AVR 500w elite With keyboard / mouse optical and mouse pad Unit Price 32,500.00 Total Value 32,500.00 Property No.
Received from:
Received by:
Annex B
DISBURSEMENT VOUCHER
Mode of Payment Payee Address Check VER MATEO R. SARIGUMBA ET.AL. ALORAN, MIS. OCC. Cash Others
TIN/Employee No.
No.
EXPLANATION
To payment of wages for Casual Employees for the period of of September 16-30, 2009 in the amount of --------------------------------------
AMOUNT
PHP
44,470.42
AMOUNT DUE
A. Certified
Allotment obligated for the purpose as indicated above Supporting documents complete
PHP
44,470.42
Date
Date
Head, Accounting Unit/Authorized Representative C. Approved for Payment Signature Printed Name
Treasurer/Authorized Representative D. Received Payment Check No. Bank Name Date Signature Printed Date VER MATEO R. SARIGUMBA ET.AL. Name OR/Other Documents JEV No. Date
Date
Position
I. To be filled upon request PARTICULARS To payment of travelling expenses as per supporting papers hereto attached in the amount of --------------------------------
II. To be filled up upon liquidation Amount Total Amount Granted Total Amount paid per OR No. _____________ P
PHP
120.00
Requested by
Approved by:
Date: _______________________
NAME
For the month of ________________________________________________ Office hours of arrival Regular days_________________________________ and departure Saturdays___________________________________
NAME
For the month of ________________________________________________ Office hours of arrival Regular days_________________________________ and departure Saturdays___________________________________
NAME
For the month of ________________________________________________ Office hours of arrival Regular days_________________________________ and departure Saturdays___________________________________
D A Y 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Morning IN OUT
Afternoon IN OUT
D A Y 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Morning IN OUT
Afternoon IN OUT
D A Y 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Morning IN OUT
Afternoon IN OUT
TOTAL ____________________________________ I certify on my honor that the above is true and correct report of the hours of work performed, record of which was made daily at the time of arrival and departure from office.
TOTAL ____________________________________ I certify on my honor that the above is true and correct report of the hours of work performed, record of which was made daily at the time of arrival and departure from office.
TOTAL ____________________________________ I certify on my honor that the above is true and correct report of the hours of work performed, record of which was made daily at the time of arrival and departure from office.
In-Charge
In-Charge
In-Charge