Republic of the Philippines

Department of Environment and Natural Resources Appendix 60

PROVINCIAL ENVIRONMENT AND NATURAL RESOURCES OFFICE
RXII-4, Alabel, Sarangani Province
Tel No.add:
Email (083) 508-2008 Fax (083) 508-2009
denrpenro_alabel@yahoo.com.ph

PURCHASE REQUEST

Entity Name: DENR RXII-4, Alabel, Sarangani Province Fund Cluster:

Office : DENR - PENRO Alabel PR Number : Date :
Section : MSD Responsibility Center Code :
Stock/ Property
Unit Item Description Quantity Unit Cost Total Cost
No.

_______
_______
_______ TOTAL:
_______
_______
Purpose:
_______
_______
_______
_______ for repear and maintenance.crosswind government vehicle.
_______
_______
_______
_______
_______
_______ Requested by: Approved by:
_______
_______
_______
Signature :
Printed Name : JOY C. OLOGUIN RENATO C. DOMINGO
Designation : PASu - SBPS PENR Officer
 Republic of the Philippines
Department of Environment and Natural Resources
PROVINCIAL ENVIRONMENT AND NATURAL RESOURCES OFFICE
RXII-4, Alabel, Sarangani Province
Tel No. (083) 508-2008 Fax (083) 508-2009
Email add: denrpenro_alabel@yahoo.com.ph

Canvass No. :_______________

Date :_______________________
Region/District :___________
Dealer :_____________________________________________________
Address :_______________________________________

OPEN CANVASS
Please quote your price for each of the following articles below which we may
purchase from you, should your quotation is the most reasonable and advantageous to us:

QTY. UNIT ARTICLES UNIT PRICE TOTAL

Approved:

RENATO C. DOMINGO
PENR Officer
(SIGNATURE OVER Printed Name of Bidder)
Canvassed By:

(Date) ADRIANO R. VIRTUDAZO, JR.

Canvasser
 Republic of the Philippines
Department of Environment and Natural Resources
Appendix 61
PROVINCIAL ENVIRONMENT AND NATURAL RESOURCES OFFICE
RXII-4, Alabel, Sarangani Province
Tel No. (083) 508-2008 Fax (083) 508-2009
Email add: denrpenro_alabel@yahoo.com.ph

PURCHASE ORDER

Supplier : P.O. No. :

Address : Date :
TIN : Mode of Procurement :
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/
Property No. Unit Description Quantity Unit cost Amount
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
TOTAL :
Total Amount in Words :
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 every day of delay shall be imposed.

Conforme: Very truly yours,

(Signature over printed name) RENATO C. DOMINGO

PENR Officer
(Date)

Fund Cluster :
Funds Available : P 0.00 ORS/BURS No. : __________________
Date of the ORS/BURS: ____________
CLARISSA MARCIA A. VILLANUEVA Amount : ________________________
Accountant III
 Republic of the Philippines
Department of Environment and Natural Resources
PROVINCIAL ENVIRONMENT AND NATURAL RESOURCES OFFICE
RXII-4, Alabel, Sarangani Province
Tel No. (083) 508-2008 Fax (083) 508-2009
Email add: denrpenro_alabel@yahoo.com.ph

CERTIFICATE OF EMERGENCY PURCHASE

September 15, 2020

Date

This is to certify that the emergency purchase of supplies/ materials/ services covered under Purchase
Request No. __________ dated ___________ and Voucher No. ___________ dated _________________
were exceptionally urgent or absolutely indispensable to prevent immediate danger to, or loss of life and/or
which cannot delayed without hampering the operation of the Agency or causing detriment to public service.

Brief description of the situation:

To payment for various expense for the official use of PASu-SBPS Alabel, Sarangani in the
amount of P________.

It is further certified that a personal canvass was made of prevailing prices and that the prices paid
were most reasonable and the lowest obtainable at the time of purchase.

JOY C. OLOGUIN
(Purchaser/Requisitioner)

RENATO C. DOMINGO
PENR Officer
 Republic of the Philippines
Department of Environment and Natural Resources
PROVINCIAL ENVIRONMENT AND NATURAL RESOURCES OFFICE
RXII-4, Alabel, Sarangani Province
Tel No. (083) 508-2008 Fax (083) 508-2009
Email add: denrpenro_alabel@yahoo.com.ph

BIDS AND AWARDS COMMITTEE

Date :
Bid No. :
Office : DENR - PENRO Alabel
ABSTRACT OF BID

NOTE: With Asterisk *** Winning Bidder Name of Bidders

*** *** - -

Stock/
Unit Quantity Description
Property No.

Note:

TOTAL: - -

The undersigned members of the Bids and Awards Committee (BAC) after reviewing and evaluating the submitted bids/canvass/proposals listed above find and offer of the price and terms of NVC ENTERPRISES
as most advantageous to the government and therefore recommend to the PENR Officer the approval of the purchase of the described items.

CLARISSA MARCIA A. VILLANUEVA JOY C. OLOGUIN FREDAM P. UNABIA JOSEPHINE J. FIDEL

ACCOUNTANT III SvEMS FORESTER II DMO II
BAC Chairman Member Member Member
 Republic of the Philippines
Department of Environment and Natural Resources
PROVINCIAL ENVIRONMENT AND NATURAL RESOURCES OFFICE
RXII-4, Alabel, Sarangani Province
Tel No. (083) 508-2008 Fax (083) 508-2009
Email add: denrpenro_alabel@yahoo.com.ph

Appendix 62
INSPECTION AND ACCEPTANCE REPORT

Entity Name : DENR RXII-4, Alabel, Sarangani Province Fund Cluster :

Supplier : IAR No. : ______________

PO No. : Date : Date : _________________
Requisitioning Office: DENR - PENRO Alabel Dept. : MSD Invoice No. : ____________
Responsibility Center Code : _______________________________ Date : _________________

Stock/
Description Unit Quantity
Property No.

INSPECTION ACCEPTANCE

Date Inspected : ________________________ Date Received : _____________________

Inspected, verified and found in order as to Complete

quantity and specifications
Partial (pls. specify quantity)

MA. KAREN S. CARIGA LORNA M. TADIAMAN

Inspection Officer/Inspection Committee AO I
 Republic of the Philippines
Department of Environment and Natural Resources
PROVINCIAL ENVIRONMENT AND NATURAL RESOURCES OFFICE
RXII-4, Alabel, Sarangani Province
Tel No. (083) 508-2008 Fax (083) 508-2009
Email add: denrpenro_alabel@yahoo.com.ph

Appendix 62
PRE-INSPECTION AND PRE-ACCEPTANCE REPORT

Entity Name : DENR RXII-4, Alabel, Sarangani Province Fund Cluster :

Supplier : IAR No. : ______________

PO No. : Date : Date : _________________
Requisitioning Office: DENR - PENRO Alabel Dept. : PASu-SBPS Invoice No. : ____________
Responsibility Center Code : _______________________________ Date : _________________

Stock/
Description Unit Quantity
Property No.

INSPECTION ACCEPTANCE

Date Inspected : ________________________ Date Received : _____________________

Inspected, verified and found in order as to Complete

quantity and specifications
Partial (pls. specify quantity)

MA. KAREN S. CARIGA EMILY A. ESCOBAR

Inspection Officer/Inspection Committee Planning Officer I
 Republic of the Philippines
Department of Environment and Natural Resources
PROVINCIAL ENVIRONMENT AND NATURAL RESOURCES OFFICE Appendix 32
RXII-4, Alabel, Sarangani Province
Tel No. (083) 508-2008 Fax (083) 508-2009
Email add: denrpenro_alabel@yahoo.com.ph

Fund Cluster :

Date :
DISBURSEMENT VOUCHER DV No. :

Mode of
Payment MDS Check Commercial Check ADA Others (Please specify)
_____________________________
TIN/Employee No.: ORS/BURS No.:
Payee

Address

Particulars Responsibility Center MFO/PAP Amount

To payment for ____________ Alabel, Sarangani in the amount

of... . . . . . . . . . . . . .. PENRO ₱ -

Amount Due ₱ -
A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

FOR. JESUS S. BOJA

DMO V - CHIEF TSD
Printed Name, Designation and Signature of Supervisor

B. Accounting Entry:
Account Title UACS Code Debit Credit

C. Certified: D. Approved for Payment

Cash available
Subject to Authority to Debit Account (when applicable)
Supporting documents complete and amount claimed
proper

Signature Signature

Printed Name Printed Name

CLARISSA MARCIA A. VILLANUEVA RENATO C. DOMINGO
Accountant III PENR Officer
Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative
Date Date
E. Receipt of Payment JEV No.
Check/ ADA Date : Bank Name & Account Number:
No. :
Date : Printed Name: Date
Signature :

Official Receipt No. & Date/Other Documents

 Republic of the Philippines
Department of Environment and Natural Resources
PROVINCIAL ENVIRONMENT AND NATURAL RESOURCES OFFICE
RXII-4, Alabel, Sarangani Province
Tel No. (083) 508-2008 Fax (083) 508-2009
Email add: denrpenro_alabel@yahoo.com.ph

Appendix 11
OBLIGATION REQUEST AND STATUS Serial No. : _____________________

DENR RXII-4, Alabel, Sarangani Province Date : _________________________

Entity Name Fund Cluster :

Payee

Office

Address

UACS Object
Responsibility Center Particulars MFO/PAP Amount
Code

PENRO
₱ -
To obligate payment for _______________
Alabel, Sarangani in the amount of... . . . . . . .
. . . . . ..

Total ₱ -
A. Certified: Charges to appropriation/alloment are B. Certified: Allotment available and obligated
necessary, lawful and under my direct supervision;and for the purpose/adjustment necessary as
supporting documents valid, proper and legal indicated above

Signature : Signature :

Printed Name: FOR. JESUS S. BOJA Printed Name: CINDY J. CUICO, MPA
Position : DMO V - CHIEF TSD Position : Administrative Officer IV/Budget Officer

Head, Requesting Office/Authorized Representative Head, Budget Division/Unit/Authorized

Representative
Date : ___________________________________ Date : ____________________________

C. STATUS OF OBLIGATION
Reference Amount
Balance
ORS/JEV/Check/ Obligation Payable Payment Due and
Date Particulars Not Yet Due
ADA/TRA No. Demandable
(a) (b) (c) (a-b) (b-c)
 Appendix 14

BUDGET UTILIZATION REQUEST AND STATUS Serial No. : ___________________

_____________________________________ Date : _______________________
Entity Name Fund Cluster :_________________

Payee

Office

Address
0
UACS Object
Responsibility
Particulars MFO/PAP Code/ Amount
Center
Expenditures
To obligate payment for _______________
Alabel, Sarangani in the amount of... . . . . . . .
. . . . . ..
-

Total -
A. Certified: Charges to appropriation/budget necessary, B. Certified: Budget available and utilized for
lawful and under my direct supervision; and supporting the purpose/adjustment necessary as
documents valid, proper and legal indicated above

Signature : ____________________________________ Signature : _________________________________

Printed Name: JOY C. OLOGUIN Printed Name: CINDY J. CUICO, MPA

Position : PASu-SBPS Position : Admin Officer IV/ Budget Officer

Head, Requesting Office/Authorized Representative Head, Budget Division/Unit/Authorized
Representative
Date : _______________________________ Date : ____________________________

C. STATUS OF UTILIZATION
Reference Amount
Balance
BURS/JEV/RCI/ Utilization Payable Payment Due and
Date Particulars Not Yet Due
RADAI/RTRAI No. Demandable
(a) (b) (c) (a-b) (b-c)

48
 DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
PENRO ALABEL, SARANGANI

EXPENSE MONITORING FORM

Control No: Unit: DateReleased :

ORS No: PENRO/CENRO: PENRO ALABEL Date of Check/LDDAP-ADA:
Payee:

Program, Activity, Project(PAP)

Sub-PAP Allotment Amount Amount Actual Amount

Class Obligated
Code Description Code Description Requested Disbursed

Regular Fund-101

To obligate payment for the

______________ Alabel, Sarangani
in the amount of ... . . . . . . . . . . . . ..

-
-

TOTAL - - -
.

Prepared by: Checked by: Approved by:

KAMILLE GRACE J. GUTIERREZ JOY C. OLOGUIN RENATO C, DOMINGO

PASU-STAFF PASu-SBPS PENR Officer

Service/Division:

Date Received by Action Taken/Remarks by Received/Released by:

CINDY J. CUICO, MPA

Adm. Officert IV/ Budget Officer

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