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PURCHASE REQUEST

Isulan, Sultan Kudarat


LGU
Department MO
Section
Stock
Unit Item Description Qty Unit Cost Total Cost
No.
I lot Excavation/Demolition 1 30,000.00 30,000.00
II cu.m. Construction & Installation of Pre-Fabricated Steel Tank 16 cu.m
a. Steel Works 16 25,000.00 400,000.00
b. Masonry Works
bags Portland Cement 9 290.00 2,610.00
cu.m. Washed Sand 5 300.00 1,500.00
cu.m. Selected Washed Gravel 2"dia max. 5 700.00 3,500.00
pcs Plate Connector 8"x8"x12mm 4 900.00 3,600.00
pcs Bolt w/ knot&washer 5/8x6" 16 70.00 1,120.00
Material Cost 2,260.00 12,330.00
Labor Cost 4,315.50
Sub Total 16,645.50
III lot Drilling and well Development 1 450,000.00 450,000.00
200 ft w/ 6"dia Casing including Georisistivity survey
IV Power/Pump House
1. Structural Concrete
pcs 4" CHB 250 8.00 2,000.00
bags Portland Cement 30 290.00 8,700.00
cu.m. Washed Sand 2 300.00 600.00
cu.m. Selected Washed Gravel 2"dia max. 2 700.00 1,400.00
lenghts 10mmdia x 6.0m RSB STD Def. 30 175.00 5,250.00
kilos No. 16 Tie wire 5 80.00 400.00
pcs 30-2"x2"x12' coco form lumber 20 80.00 1,600.00
sheets 5mmx1.20m x 2.40m marine plywood 8 325.00 2,600.00
set Door knob ( quickset) 1 980.00 980.00
box 2 x 4 hinges ( stanley ) 3 85.00 255.00
kilos Common wire Nail 4" 3 80.00 240.00
kilos Common wire Nail 3" 3 80.00 240.00
kilos Common wire Nail 1-1/2" 1 80.00 80.00
pcs Hacksaw Blade 18TPI 2 80.00 1,616.00
Material Cost 25,961.00
Labor Cost 9,086.35
Sub Total 35,047.35
2. Roofing Work
sheets GA.26 Corr. G.I Sheet 6 feet 10 350.00 3,500.00
sheets GA.26 Plain. G.I Sheet 8 feet 1 280.00 280.00
pcs Tekscrew # 3" 98 2.00 196.00
qrt Vulca seal 1 380.00 380.00
lenghts 1.20MM X 2 X 3 Cee Purlins 15 460.00 6,900.00
kilos MT12 Welding Rod 7 70.00 490.00
Material Cost 11,746.00
Labor Cost 4,111.10
Sub Total 15,857.10
3. Painting Work
pcs Paint Brush # 4" 3" 2 70.00 140.00
###
btl Laquer thinner 2 380.00 760.00
###
gal Flat Latex 1 680.00 680.00
###
gal Gloss Latex 1 680.00 680.00
gal Flat enamel 1 680.00 680.00
###
gal Quick dry enamel 1 680.00 680.00
###
set Roller w/ pan 7" 1 120.00 120.00
qrt Thalo blue 1 70.00 70.00
Material Cost 3,810.00
###
Labor Cost 1,333.50
Sub Total 5,143.50
V Water Treatment Facility
lot a. Supply & Installation of Chlorination Equipments 1 30,000.00 30,000.00
VI Pump, Electrical & Motor Controls
unit 1. 5 HP,220V Submersible Pump (Franklin Brand) 1 120,000.00 120,000.00
mtrs 2. Royal Cord 5.5mm 4 in 1 50 160.00 8,000.00
set 3. Magnetic Contactor w/ overload relay 1 5,000.00 5,000.00
pc 4. Ammeter 1 950.00 950.00
pc 5. Voltmeter 1 950.00 950.00
pc 6. Current Transformer 1 2,500.00 2,500.00
pc 7. Push botton Switch N/O (Green) 1 600.00 600.00
pc 8. Push botton Switch N/O (Red) 1 600.00 600.00
pc 9. Enclosure 20"x30"x10" for motor controller 1 5,000.00 5,000.00
pc 10. Pilot Lamp (Red) 1 150.00 150.00
pc 11. Pilot Lamp (Green) 1 150.00 150.00
mtrs 12. 22mm sq. THW 50 120.00 6,000.00
lenghts 13. RSC Pipe 25" dia 1 180.00 180.00
pcs 14. PVC Pipe (orange) 25 mm 3 90.00 270.00
pc 15. 25 mm service entrance 1 45.00 45.00
pcs 16. Straight connector 25 mm 2 30.00 60.00
pcs 17. PVC long elbow 25 mm 3 25.00 75.00
can 18. PVC Solvent Cement 100cc 1 48.00 48.00
pc 19. Panel Board, Bolt on TQD Center 1 5,000.00 5,000.00
pc 20. ckt. Breaker 100 Amp TQD 1 3,500.00 3,500.00
pc 21. ckt. Breaker 50 Amp TQD 1 350.00 350.00
pc 22. ckt. Breaker 20 Amp TQD 1 350.00 350.00
pc 23. ckt. Breaker 15 Amp TQD 1 350.00 350.00
lenghts 24. PVC Pipe 1/2 dia 3 70.00 210.00
pcs 25. Utility box 3 28.00 84.00
pcs 26. Junction Box 3 35.00 105.00
set 27. Switch 2 gang 1 180.00 180.00
set 28. Convenience outlet, 2 gang, weather proof 1 180.00 180.00
pcs 29. Bulb receptacle 2 45.00 90.00
pcs 30. CFL Spiral, 23 watts 2 250.00 500.00
pcs 31. Electrical tape 2 35.00 70.00
set 32. Metering Assembly 1 4,000.00 4,000.00
unit 33. 10 KVA, 1 dia, 220V dist. Transformer 1 48,000.00 48,000.00
set 34. Cut out & arrester combination 1 5,500.00 5,500.00
pc 35. Fuse Link 1 165.00 165.00
pc 36. Electric Post 1 12,000.00 12,000.00
Material Cost 246,636.00 231,212.00
lot Banking (SUKELCO) 1 40,000.00
Labor Cost 80,924.20
Sub Total

VII Tap Stand (36 units)


1. Concrete Works
bags Portland Cement 72 260.00 18,720.00
cu.m Washed Sand 15 300.00 4,500.00
cu.m Selected Washed Gravel 2"dia max. 15 700.00 10,500.00
length 10mmdia x 6.0m RSB STD Def. 72 175.00 12,600.00
sheets 5mmx1.20m x 2.40m marine plywood 10 325.00 3,250.00
pcs 30-2"x2"x12' coco form lumber 36 80.00 2,880.00
Material Cost 52,450.00
Labor Cost 18,357.50
Sub Total 70,807.50
VIII Installation of Billboard
1. Steel Works
pc Tarpaulin (8x4 ft. full color) 1 600.00 600.00
pc 1/4 thk Galvanized sheet 1 1,350.00 1,350.00
pcs G.I pipe Galvanized #2 2 1,280.00 2,560.00
pcs Angle Bar 1x1x1/4 3 450.00 1,350.00
kilos Welding Rod 5 120.00 600.00
2. Masonry Works
bags Cement 2 290.00 580.00
cu.m Washed Sand 1 300.00 300.00
cu.m Gravel 1 700.00 700.00
Material Cost 8,040.00
Labor Cost 2,814.00
Sub Total 10,854.00
IX Pipelines
length 100mm dia PE Pipe SDR11 X 6.0M 40 1,220.00 48,800.00
length 75mm dia PE Pipe SDR 11x 6.0M 50 800.00 40,000.00
rolls 50mm dia PE Pipe SDR 11x60m 10 3,025.00 30,250.00
rolls 32mm dia PE Pipe SDR11 X 60.0M 14 1,170.00 16,380.00
pcs 32mm dia. End cap 3 120.00 360.00
length 1/2 dia. G.I Pipe Schd.40 15 520.00 7,800.00
pcs 1/2 dia. PVC Blue 36 28.00 1,008.00
pcs 4"X1" Saddle Clamp 10 350.00 3,500.00
pcs 3"X1" Saddle Clamp 10 250.00 2,500.00
pcs TEE Reducer 2x1 10 200.00 2,000.00
pcs TEE Reducer 1x1 11 140.00 1,540.00
pcs TEE Reducer 1x1/2 36 92.00 3,312.00
pcs 1/2dia. elbow 36 35.00 1,260.00
pcs 1/2dia. G.I elbow 72 28.00 2,016.00
pcs Solvent Cement 200cc 11 120.00 1,320.00
rolls Teflon tape 6 45.00 270.00
pcs 1 G.I Faucet ( Heavy duty ) 36 220.00 7,920.00
pcs 1 dia. Check valve 36 280.00 10,080.00
units checked meter 36 1,600.00 57,600.00
units 1 dia. float valve 36 380.00 13,680.00
Material Cost 251,596.00
Labor Cost 88,058.60
Sub Total 339,654.60
X End Point Flushing (Blow-Off)
units a. Supply of Materials 2 25,000.00 50,000.00
###

Purpos
e: Requested by: Approved by:

Signature:
Printed Name: DIOSDADO G. PALLASIGUE DIOSDADO G. PALLASIGUE
Designation: Municipal Mayor Municipal Mayor
Annex A

Republic of the Philippines


Municipality of Isulan
Province of Sultan Kudarat

No.
OBLIGATION REQUEST
Payee ENGR. CEZAR L. FRANCO, ET AL
Office MEO
Address Isulan, Sultan Kudarat
Responsibility Account
Particulars F.P.P. Amount
Center Code

Payment of Year End Bonus & Cash Gift 343,160.00


135,000.00

TOTAL 478,160.00
A. Certified B. Certified

Charges to appropriation, lawful and under Existence of available appropriation


my direct supervision

Supporting documents valid, proper and legal

Signature: Signature:
Printed Printed
Name ENGR. CEZAR L. FRANCO Name LALYN B. FERNANDEZ
Position: Municipal Engineer Position: Municipal Budget Officer
Head, Budget unit/Authorized Representative
Date: Date:
Republic of the Philippines
MUNICIPALITY OF ISULAN
Province of Sultan Kudarat
DISBURSEMENT VOUCHER No.
Mode of Payment Check Cash Others
Payee Obligation Request
SKTSI TIN/Employee No.
Responsibility Center
Address Isulan, S.K Office Unit Project Code

EXPLANATION AMOUNT
Payment of telephone bill at the Office of the Municipal Engineer and Motorpool for the month of
Apr-15 922.88

TOTAL 922.88
A. Certified B. Certified
Funds Available
Allotment obligated for the purpose as indicated above
Supporting documents complete
Signature Signature

Printed Name RUDY B. FERNANDEZ, CPA Date Printed Name MAE L. BARRERA Date
Position Municipal Accountant Position Municipal Treasurer
Head, Accounting Unit/Authorized Representative Treasurer/Authorized Representative

C. Approved for Payment D. Received Payment


Check No. Bank Name Date
Signature
Printed Name Date Signature: Date
DIOSDADO G. PALLASIGUE
SKTSI
Position Municipal Mayor OR/Other Documents JEV No. Date
Agency Head/Authorized Representative

JOURNAL ENTRY VOUCHER H


Isulan, Sultan Kudarat Date
LGU
ACCOUNTING ENTRIES
AMOUNT
Responsibility ACCOUNT
ACCOUNTS AND EXPLANATION PR
Center CODE DEBIT CREDIT

TOTAL
Prepared: Approved:
RUDY B. FERNANDEZ, CPA
Municipal Accountant
PURCHASE ORDER
Isulan, Sultan Kudarat
LGU
Supplier: ISULAN ACCREDITED ELECTRICAL PRACTITIONER ASSN. PO
Address: Isulan, Sultan Kudarat Da
TIN ________________________________________________ Mode of Procur

Gentlemen:
Please furnish this office the following articles subject to the terms & conditions herein:
Place of Delivery : LGU-Isulan Delivery Term : Immediately
Date of Delivery : Payment Term: Upon approval of all
procurement services
Stock No. Unit Description Qty. Unit Cost Amount
unit Repair and cleaning of aircon 1 2,000.00 2,000.00

(Total Amount in Words) 2,000.00


In case of failure to make the full delivery within the time specified above, a penalty of one-tenth
(1/10) of one percent (1%) for everyday or delay shall be imposed.
Very truly yours,
Conforme:
DIOSDADO G. PALLASIGUE
ISULAN ACCREDITED ELECTRICAL PRACTITIONER ASSN. (Authorized Official)
(Signature Over Printed Name of Supplier)
________________________
Date
INSPECTION AND ACCEPTANCE REPORT

Isulan, Sultan Kudarat


LGU
Supplier: ISULAN ACCREDITED ELECTRICAL PRACTITIONER ASSN. IAR No.
PO No. _________________________ Date: _________________ Invoice No. ____________________ Date: ____
Requisitioning Office/Department MEO
Stock No. Unit Description Qty
unit Repair and cleaning of aircon 1

INSPECTION ACCEPTANCE
Date Inspected: Date Received:

Inspected, verified and found in order as to Complete


quantity and specifications Partial (pls. specify quantity)

RICHARD P. LAGDAMIN DARRYLL E. BANICO


Inspection Office/ Committee GSO-Designate
REQUISITION AND ISSUE SLIP

Isulan, Sultan Kudarat


LGU

Division Responsibility Center RIS No. Date 4/14/2015


Office MEO Code

REQUISITION ISSUANCE
Stock No. Unit Description Qty. Unit Cost Remarks
JOB ORDER:
1 pc. Vulcate of tire of Mini DT 1 150.00 issued
2 pc. Vulcate of tire of Dump Truck 05 1 150.00 issued
3 pcs. Vulcate of tires of Dump Truck 07 3 150.00 issued
4 pcs. Vulcate of tires of Dump Truck 09 3 150.00 issued
5 pcs. Vulcate of tiresa of Dump Truck 10 2 150.00 issued
6 pc. Vulcate of tires of Payloader 1 500.00 issued
7 pcs. Change tube and check up of tires of Dump Truck 10 4 162.50 issued

Purpose: vulcate of tires, change tube and check up of tires of various equipment

Requested by: Approved by: Issued by: Received by:

Signature
Printed Name ENGR. CEZAR L. FRANCO DARRYLL E. BANICO DARRYLL E. BANICO ALAN K. PUBLICO
Designation Municipal Engineer GSO-Designate GSO-Designate Motor Pool In-Charge
Date
Republic of the Philippines
Province of Sultan Kudarat
MUNICIPALITY OF ISULAN

CANVASS

QUOTATION NO.:
_____________________________________ PURCHASE NO.:

_____________________________________ REMARKS:

TEL NO.: _____________________________ DATE: 4-Sep-15

Gentlemen:

Please quote your lowest government price for the following items specified below:

ITEM QTY. UNIT


ITEM & DESCRIPTION UNIT PRICE TOTAL PRICE
NO.
1 500 liters Diesoline
2 235 liters Gasoline
xxx

Deadline of submission: ___________________________ TOTAL:

Important:
1 Prices should be valid for 45 days.
2 DELIVERY PERIOD: 7 WORKING DAYS upon receipt of P.O. (Pls. state no. of days of delivery if beyond the required 7 working days;
3 Term of payment:
4 Total price quoted above, subject to withholding tax and payable check;
5 For NON-ACCREDITED suppliers, please call 9295960 regarding accreditation requirements.

_________________________________ FOR THE BIDS AND AWARDS COMMITTEE:


Supplier's Representative (Print Name)

ATTY. MARIBLITHE CARTUJANO-GARINGO


_________________________________ Municipal Administrator
Signature / Date BAC Chairperson

Canvassed by: __________________________________


Date: __________________________________
Republic of the Philippines
Province of Sultan Kudarat
Municipality of Isulan
BIDS AND AWARDS COMMITTEE (BAC)

ABSTRACT OF QUOTATION: __________________________


PROJECT TITLE : ____________________________________
SUPPLIERS
DIGAN
APPROVED BUDGET ISULAN ACCREDITED REFRIGERATION
Item No. Item of Work QTY. UNIT CONTRACT FABALE
ELECTICAL &
PRACTITIONER ASSN. AIRCONDITIONIN AIRCONDITIONING

UNIT COST TOTAL UNIT COST UNITGCOST UNIT COST


1 Repair & cleaning of aircon 1 unit 2,000.00 2,000.00 2,000.00 2,400.00 2,500.00
Awarded to ISULAN ACCREDITED
ELECTRICAL PRACTITIONER
ASSN.

2,000.00

RECOMMENDATIONS: Awarded to the lowest and responsive bidder.


OPENED AND RECOMMENDED BY THE BAC:
FOR THE BAC:
ATTY. MARIBLITHE CARTUJANO-GARINGO
Municipal Administrator
BAC Chairperson
Republic of the Philippines
Province of Sultan Kudarat
MUNICIPALITY OF ISULAN

PRE INSPECTION REPORT

Items to be repaired

4 pcs. Change tube and check up of tires of Dump Truck 10

Action/Recommendation:

ALAN K. PUBLICO
Motorpool-In-Charge Driver/Operator

APPROVED:

ENGR. CEZAR L. FRANCO


Municipal Engineer

INSPECTED BY:

RICHARD P. LAGDAMIN
Inspection Office/ Committee
Republic of the Philippines
Province of Sultan Kudarat
MUNICIPALITY OF ISULAN

POST INSPECTION REPORT

Items purchased

4 pcs. Change tube and check up of tire of Dump Truck 10

SEE ATTACHED WASTE MATERIALS

Driver

APPROVED:

ENGR. CEZAR L. FRANCO


Municipal Engineer

INSPECTED BY:

RICHARD LAGDAMIN
Inspection Office/ Committee
WASTE MATERIALS REPORT

Isulan, Sultan Kudarat


LGU

Place of Storage: Date:

ITEMS FOR DISPOSAL


Record of Sales
ITEM Qty Unit Description O.R. No. Amount
1 5 tablets Aluminum Magnesium (Maalox)
2 6 tablets Levofloxacin 750 mg
3 5 tablets NAC (Exflem) 600mg
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

Certified Correct: Disposal Approved:

DARRYLL E. BANICO CEZAR L. FRANCO


GSO-Designate Municipal Engineer

CERTIFICATE OF INSPECTION
I hereby certify that the property enumerated below was disposed of as of follows:

Item Destroyed
Item Sold at private sale
Item Sold at public auction
Item Transferred without cost to ______________________________

Property Inspector: Witness to disposition:

RICHARD LAGDAMIN ALAN K. PUBLICO


(Name and Signature) Motorpool-In-Charge
Republic of the Philippines
Province of Sultan Kudarat
Municipality of Isulan
BIDS AND AWARDS COMMITTEE (BAC)

ABSTRACT OF QUOTATION: __________________________


PROJECT TITLE : ____________________________________
SUPPLIERS
APPROVED BUDGET Cyber Exchange
A & C Computer & JM Computer
Item No. Item of Work QTY. UNIT CONTRACT Computer's & Gen.
Mdse. Supply sales & services Awarded to
UNIT COST TOTAL UNIT COST UNIT COST UNIT COST
1 Computer Reformat 1 Unit 600.00 600.00 600.00 700.00 750.00 Cyber Exchange Computer's &
Gen. Mdse.

RECOMMENDATIONS: Awarded to the lowest and responsive bidder.


OPENED AND RECOMMENDED BY THE BAC:

FOR THE BAC:

ATTY. MARIBLITHE CARTUJANO-GARINGO


Municipal Administrator
BAC Chairperson
PURCHASE REQUEST

Isulan, Sultan Kudarat


LGU
Department MO Date June 21,2016
Section

Stock
Unit Item Description Qty Unit Cost Total Cost
No.

LABOR & MATERIALS FOR THE


I LOT 5,000,000.00
CONCRTETING OF MUNICIPAL ROADS

5,000,000.00
Purpose: for concreting of Municipal Roads at D. Lotilla Street.

Requested by: Approved by:


Signature:
Printed Name: DIOSDADO G. PALLASIGUE DIOSDADO G. PALLASIGUE
Designation: Municipal Mayor Municipal Mayor

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