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LIQUIDATION REPORT
Date: May 10, 2011
LAKE SEBU NATIONAL HIGH SCHOOL Responsibility Center Code
Particulars Amount
CERTIFICATION
I hereby certify that this Cash Disbursement Register in _____ Sheet/s is full, true and correct statements made by me and that this is in liquidation of the cash advance
granted last ____________ in the amount of Php _____________ per Check No. _________________ dated ___________________
RAMON V. GLORIA
Republic of the Philippines
Department of Education
Region XII
DIVISION OF SOUTH COTABATO
TUPI CENTRAL SCHOOL
( name of school)
TUPI NORTH DISTRICT
( address/ district)
For the Period covered___________
CASH DISBURSEMENT REGISTER
Type of Working Fund: SPED FUND
CASH ADVANCE BREAKDOWN OF PAYMENT
REFERENCE OFFICE REPAIRS AND OTHE ACCOUNTS
DATE (OR/RER/ PAYEE/ PARTICULARS TRAVEL TRAINING
AMOUNT BALANCE SUPPLIES MAINTENANCE
Check #) PAYMENT EXPENSES EXPENSES ACCOUNT
RECEIVE (6=4-5) EXPENSES OF SCH. BLDG ACCOUNT CODE AMOUNT
5020101000 5020201000 NAME
5020201000 50213040022
[1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] [13]
Disbursing Officer/School Head/District Supervisor
Date: _______________
Republic of the Philippines
Department of Education
Region XII
DIVISION OF SOUTH COTABATO
TUPI CENTRAL SCHOOL
( name of school)
TUPI NORTH DISTRICT
( address/ district)
For the Period covered___________
CASH DISBURSEMENT REGISTER
Type of Working Fund: SPED FUND
CASH ADVANCE BREAKDOWN OF PAYMENT
REFERENCE OFFICE REPAIRS AND OTHE ACCOUNTS
DATE (OR/RER/ PAYEE/ PARTICULARS TRAVEL TRAINING
AMOUNT BALANCE SUPPLIES MAINTENANCE
Check #) PAYMENT EXPENSES EXPENSES ACCOUNT
RECEIVE (6=4-5) EXPENSES OF SCH. BLDG ACCOUNT CODE AMOUNT
5020101000 5020201000 NAME
5020201000 50213040022
[1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] [13]
CERTIFICATION
I hereby certify that this Cash Disbursement Register in _____ Sheet/s is full, true and correct statements made by me and that this is in liquidation of the cash advance
granted last ____________ in the amount of Php _____________ per Check No. _________________ dated ___________________
RAMON V. GLORIA
Disbursing Officer/School Head/District Supervisor
Republic of the Philippines
Department of Education
Region XII
DIVISION OF SOUTH COTABATO
TUPI CENTRAL SCHOOL
( name of school)
TUPI NORTH DISTRICT
( address/ district)
For the Period covered___________
CASH DISBURSEMENT REGISTER
Type of Working Fund: SPED FUND
CASH ADVANCE BREAKDOWN OF PAYMENT
REFERENCE OFFICE REPAIRS AND OTHE ACCOUNTS
DATE (OR/RER/ PAYEE/ PARTICULARS TRAVEL TRAINING
AMOUNT BALANCE SUPPLIES MAINTENANCE
Check #) PAYMENT EXPENSES EXPENSES ACCOUNT
RECEIVE (6=4-5) EXPENSES OF SCH. BLDG ACCOUNT CODE AMOUNT
5020101000 5020201000 NAME
5020201000 50213040022
[1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] [13]
Date: _______________
Republic of the Philippines
Department of Education
Region XII
DIVISION OF SOUTH COTABATO
TUPI CENTRAL SCHOOL
( name of school)
TUPI NORTH DISTRICT
( address/ district)
For the Period covered___________
CASH DISBURSEMENT REGISTER
Type of Working Fund: SPED FUND
CASH ADVANCE BREAKDOWN OF PAYMENT
REFERENCE OFFICE REPAIRS AND OTHE ACCOUNTS
DATE (OR/RER/ PAYEE/ PARTICULARS TRAVEL TRAINING
AMOUNT BALANCE SUPPLIES MAINTENANCE
Check #) PAYMENT EXPENSES EXPENSES ACCOUNT
RECEIVE (6=4-5) EXPENSES OF SCH. BLDG ACCOUNT CODE AMOUNT
5020101000 5020201000 NAME
5020201000 50213040022
[1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] [13]
AUTHORITY TO TRAVEL
Travel Authority #
Position/Designation: TEACHER - I
Requested by :
Approved:
Approved:
by:
ESTRELLA ABID BABANO, CESO III
SUSAN Y. DIDELES Regional Director
ES-I Home Economics
In-Charge of the Division
by:
ELLA ABID BABANO, CESO III
Regional Director
Approved:
Republika ng Pilipinas
Kagawaran ng Edukasyon
Rehiyon XII
SANGAY NG SOUTH COTABATO
TUPI CENTRAL SCHOOL
Tupi, South Cotabato
AUTHORITY TO TRAVEL
Travel Authority #
Position/Designation: TEACHER - II
Requested by :
EMILYN P. PABLEO
Approved:
Approved:
by:
ESTRELLA ABID BABANO, CESO III
SUSAN Y. DIDELES Regional Director
ES-I Home Economics
In-Charge of the Division
by:
ELLA ABID BABANO, CESO III
Regional Director
Approved:
Republika ng Pilipinas
Kagawaran ng Edukasyon
Rehiyon XII
SANGAY NG SOUTH COTABATO
TUPI CENTRAL SCHOOL
Tupi, South Cotabato
AUTHORITY TO TRAVEL
Travel Authority #
Requested by :
SUZETTE L. BASAN
Approved:
Approved:
by:
ESTRELLA ABID BABANO, CESO III
SUSAN Y. DIDELES Regional Director
ES-I Home Economics
In-Charge of the Division
by:
ELLA ABID BABANO, CESO III
Regional Director
Approved:
APPENDIX : A
Republika ng Pilipinas
Kagawaran ng Edukasyon, Kultura at Isports
Rehiyon XII
SANGAY NG SOUTH COTABATO
Koronadal
ITINERARY OF TRAVEL
NAME : RUBY D. MANLABAO
POSITION; MASTER TEACHER - I
OFFICIAL STATION: TUPI CENTRAL SCHOOL, TUPI NORTH DISTRICT, TUPI,SOUTH COTABATO
TIME
Places to be Visited Means of Allowable Expenses Total
DATE Departure ArrivalTranspor - Tanspor - Per Amount
tation tation Diems Claimed
1/6/2015 Station terminal 6:00 Tricycle 10.00 10.00
Terminal Koronadal Van 30.00 30.00
Koronadal Lake Sebu Van 60.00 60.00
Lake Sebu Koronadal Van 60.00 60.00
Koronadal Tupi 6:00: PM Van 30.00 30.00
1/7/15 Tupi Koronadal 5:30 AM Van 30.00 30.00
Koronadal Lake Sebu Van 60.00 60.00
Lake Sebu Koronadal Van 60.00 60.00
Koronadal Tupi 6.15 PM Van 30.00 30.00
1/8/15 Tupi Koronadal 6:00 AM Van 30.00 30.00
Koronadal Lake Sebu Van 60.00 60.00
Lake Sebu Koronadal Van 60.00 60.00
Koronadal Tupi 6.00 PM Van 30.00 30.00
Prepared by:
I HEREBY CERTIFY THAT : (1) I have
reviewed the foregoing Itinerary (2) That the RUBY D. MANLABAO
travel is necessary to the service (3) That the Master Teacher
expenses claimed are proper.
APPROVED:
WILFREDO S. NOBLEZA
Principal AMRAH M. AGUSTIN
Principal - II/ Principal In Charge
DEPARTMENT OF EDUCATION Control #
Date:
Quotation Number:
__________________________________
(name of company)
___________________________________
(address)
Please quote your lowest price on the item/s listed below, subject to the General Condition on the last page,
stating the shortest time of delivery and submit your quotation duly signed by your representative not later than
JANE B. CABARLO
Principal
Note: 1. ALL ENTRIES MUST BE TYPWIRTTEN OR WRITTEN LEGIBLY.
2. DELIVERY PERIOD WITHIN 5 WORKING DAYS
3. WARANTY SHALL BE FOR THE PERIOD OF SIX (6) MONTHS FOR SUPPLIES AND MATERIALS, ONE
(1) YEAR FOR EQUIPMENT, FROM DATE OF ACCEPTANCE BY THE PROCURING ENTITY
4. PRICE VALIDITY SHALL BE FOR THE PERIOD OF 1 CALENDAR YEAR
5. G-EPS REGISTRATION OF CERTIFICATE SHALL BE ATTACHED UPON SUBMISSION OF THE
QUOTATION.
6. BIDDERS SHALL SUBMIT ORIGINAL BROCHURES SHOWING CERTIFICATIONS OF THE PRODUCT
BEING OFFERED, IF AVAILABLE.
Item Unit of
ITEM AND DESCRIPTION Quantity Unit Price
Number Issue
1 LTC HANZA YELLOW LTS 1
(Agency)
(Address)
After having carefully read and accepted your General Conditions, I/We quote you on the item at
prices noted.
________________________________
Printed Name/Signature of Supplier
Date:
Quotation Number:
__________________________________
(name of company)
___________________________________
(address)
Please quote your lowest price on the item/s listed below, subject to the General Condition on the last page,
stating the shortest time of delivery and submit your quotation duly signed by your representative not later than
JANE B. CABARLO
Principal
Note: 1. ALL ENTRIES MUST BE TYPWIRTTEN OR WRITTEN LEGIBLY.
2. DELIVERY PERIOD WITHIN 5 WORKING DAYS
3. WARANTY SHALL BE FOR THE PERIOD OF SIX (6) MONTHS FOR SUPPLIES AND MATERIALS, ONE
(1) YEAR FOR EQUIPMENT, FROM DATE OF ACCEPTANCE BY THE PROCURING ENTITY
4. PRICE VALIDITY SHALL BE FOR THE PERIOD OF 1 CALENDAR YEAR
5. G-EPS REGISTRATION OF CERTIFICATE SHALL BE ATTACHED UPON SUBMISSION OF THE
QUOTATION.
6. BIDDERS SHALL SUBMIT ORIGINAL BROCHURES SHOWING CERTIFICATIONS OF THE PRODUCT
BEING OFFERED, IF AVAILABLE.
Item Unit of
ITEM AND DESCRIPTION Quantity Unit Price
Number Issue
1 SAND PAPER PCS 3
(Agency)
(Address)
After having carefully read and accepted your General Conditions, I/We quote you on the item at
prices noted.
________________________________
Printed Name/Signature of Supplier
Recommendation of the Items number 1-12 are awarded to MELS PAINT as the lowest bidder.
requisitioner:
JANE B. CABARLO
DAISY M. ORENCIO JANE D. SOLON SHIRLEY B. DELMONTE Requesting Officer
(BAC Committee Member) (BAC Committee Member) (BAC Committee Member)
ABSTRACT OF BID / CANVASS
TUPI CENTRAL SCHOOL
(Name of School)
Recommendation of the Items number 1-15 are awarded to MELS PAINT as the lowest bidder.
requisitioner:
JANE B. CABARLO
DAISY M. ORENCIO JANE D. SOLON SHIRLEY B. DELMONTE Requesting Officer
(BAC Committee Member) (BAC Committee Member) (BAC Committee Member)
PURCHASE REQUEST
1 LTS
LTC HANZA YELLOW 1 160.00 160.00
2 LTS LTC GLOSS VIOLET 1 160.00 160.00
3 LTS LTC THALO BLUE 1 160.00 160.00
4 LTS
LTC THALO GREEN 1 160.00 160.00
5 ROLL
MASKING TAPE #3/4 2
15.00 30.00
6 ROLL
MASKING TAPE #1/2 2
20.00 40.00
7 GAL
MEYER GLOSS WHITE 1
440.00 440.00
8 PNT
LTC RAW SIENNA 2
50.00 100.00
9 PCS
ROLLER #4 3
45.00 135.00
10 PCS
BRUSH#1 3
30.00 90.00
11 BOTTLE
LAC THINNER 2
45.00 90.00
12 GAL
GLOSS LATEX RAW SIENNA 1
580.00 580.00
13 -
14 -
15 -
16 -
17
Signature
Printed Name: CRISTIE LOU M. CARILLO JANE B. CABARLO
Designation TEACHER-I PRINCIPAL - I
*Prepare in 2 copies
PURCHASE REQUEST
1 PCS
SAND PAPER 3 14.00 42.00
2 GAL FLATWALL ENAMEL WHITE 1 460.00 460.00
3 GAL GLOSS ENAMEL WHITE 1 520.00 520.00
4 PNT
QTC RAW SIENNA 2
50.00 100.00
5 PNT
LTE RAW SIENNA 2
50.00 100.00
6 GAL
GLOSS LATEX 2
270.00 540.00
7 GAL
PALMERA GREEN LATEX 2
620.00 1,240.00
8 GAL
SUNNY YELLOW LATEX 3
640.00 1,920.00
9 GAL
POWER ROOF GREEN 1
620.00 620.00
10 GAL
GLOSS LATEX 1
440.00 440.00
11 GAL
POPULAR QDE WHITE 1
450.00 450.00
12 PCS
PAINT BRUSH #2 5
45.00 225.00
13 PCS
Paint brush#1 1
30.00 30.00
14 GAL
MEYER PAINT (LATEX WHITE) 2
330.00 660.00
15 GAL
QDE PALMERA GREEN 1
640.00 640.00
16 -
17
Signature
Printed Name: CRISTIE LOU M. CARILLO JANE B. CABARLO
Designation TEACHER-I PRINCIPAL - I
*Prepare in 2 copies
ABSTRACT OF BID / CANVASS
TUPI CENTRAL SCHOOL
(Name of School)
Recommendation of the Item number 1 is awarded to Marbel Computer Center as the lowest bidder.
requisitioner:
JANE B. CABARLO
DAISY M. ORENCIO JANE D. SOLON SHIRLEY B. DELMONTE Requesting Officer
(BAC Committee Member) (BAC Committee Member) (BAC Committee Member)
ABSTRACT OF BID / CANVASS
TUPI CENTRAL SCHOOL
(Name of School)
Recommendation of the Items number 1-6 are awarded to EEH HARDWARE as the lowest bidder.
requisitioner:
JANE B. CABARLO
DAISY M. ORENCIO JANE D. SOLON SHIRLEY B. DELMONTE Requesting Officer
(BAC Committee Member) (BAC Committee Member) (BAC Committee Member)
ABSTRACT OF BID / CANVASS
TUPI CENTRAL SCHOOL
(Name of School)
Recommendation of the Items number 1-8 are awarded to NJC Gen. Merch as the lowest bidder.
requisitioner:
JANE B. CABARLO
DAISY M. ORENCIO JANE D. SOLON SHIRLEY B. DELMONTE Requesting Officer
(BAC Committee Member) (BAC Committee Member) (BAC Committee Member)
5 BOX THHN 1 3,100.00 3,100.00
6 PC TW#10 20 45.00 900.00
7 PC FLUSH TYPE 1 90.00 90.00
8 PC OUTET 1 85.00 85.00
9 -
10 -
11 -
12 -
13 -
14 -
15 -
16 -
17
Signature
Printed Name: CRISTIE LOU M. CARILLO JANE B. CABARLO
Designation TEACHER-I PRINCIPAL - I
*Prepare in 2 copies
Appendix 64
9 PCS ROLLER #4 3
10 PCS BRUSH#1 3
13
14
15
INSPECTION ACCEPTANCE
INSPECTION ACCEPTANCE
Signature
Printed Name: CRISTIE LOU M. CARILLO JANE B. CABARLO
Designation TEACHER-I PRINCIPAL - I
*Prepare in 2 copies
PURCHASE ORDER
DIVISION OF SOUTH COTABATO
Koronadal City
10
TOTAL 54,170.25
Total amount in words: FIFTY FOUR THOUSAND ONE HUNDRED SEVENTY AND TWENTY FIVE CENTAVOS ONLY
In case of failure to make the full delivery within the time specified above, a penalty of one-tenth (1/10) of one percent for everyday of delay
shall be imposed.
TOTAL 21,635.00
Total amount in words: TWENTY ONE THOUSAND SIX HUNDRED THIRTY-FIVE PESOS ONLY
In case of failure to make the full delivery within the time specified above, a penalty of one-tenth (1/10) of one percent for everyday of delay
shall be imposed.
Address: Date:
TOTAL -
Total amount in words: NINETY ONE THOUSAND EIGHT HUNDRED SEVENTY FIVE PESOS ONLY
In case of failure to make the full delivery within the time specified above, a penalty of one-tenth (1/10) of one percent for everyday of delay
shall be imposed.
(Supplier)
Schools Division Superintendent
__________________
Date:
Funds AvaIlable ALOBS No.
INSPECTION ACCEPTANCE
*Prepare in 2 copies
REPORT OF DISBURSEMENT
__________________________________________________________
Agency
Responsibility
Date DV/Payroll No. Center Code Payee Nature of Payment Amount
CERTIFICATION
I hereby that this Report of Disbursement in ____ sheets is a full, true and correct statement of the
disbursements made by me and that this liquidation of the cash advance granted last ____________ in
the amount of Php ______________ per Check No. _______________ dated _________________.
________________________________ ___________________
Disbursing Officer Date
JOB ORDER
LAKE SEBU NATIONAL HIGH SCHOOL
(Name of School)
Address: Date:
-
-
-
-
-
-
-
-
-
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 for everyday of
delay shall be imposed.
ALOBs No.
Funds Available:
Amount:
______________________________
Administrative Assistant III
REIMBURSEMENT EXPENSE RECEIPT
Date No.
____________________________________________________________
rental or transportation should show inclusive dates,
____________________________________________________________
purpose, distance, inclusive points of travel, etc.)
PAYEE
Name/Signature ________________________________________________________
Address ______________________________________________________________
Residence Cert. No. ____________________________________________________
Date of Issue __________________________________________________________
Place of Issue _________________________________________________________
WITNESS
Name/Signature ________________________________________________________
Address ______________________________________________________________
Residence Cert. No. ____________________________________________________
Date of Issue __________________________________________________________
Place of Issue _________________________________________________________
Republic of the Philippines
Department of Education
Region XII
TUPI CENTRAL SCHOOL
Name of School
LABOR PAYROLL
Date :______________________
Total 800.00
Noted:
JANE B. CABARLO
Principal I
Republic of the Philippines
Department of Education
Region XII
Division of South Cotabato
TUPI CENTRAL SCHOOL
Tupi, South Cotabato
Requisition Issuance
Purpose:
Signature
Printed Name DANNY D. PEREZ ROSALYN E. MONTES DANNY D. PEREZ
Designation Admin. Asst II Supply Officer Admin. Asst III
Date 6/13/2011 6/13/2011 6/13/2011
ACKNOWLEDGEMENT RECEIPT OF EQUIPMENT
Agency: TUPI CENTRAL SCHOOL SPED CENTER
Tupi North District, Division of South Cotabato
Date Date
*ddp
Station Code - Secondary
IMPLEMENTING UNIT
501 BANGA
519 STO. NIÑO
*ddp
Station Code - Elementary
095 INSULAR
001 BANGA SOUTH 239-1148
008 BANGA NORTH 239-1145
014 BANGA EAST
017 NORALA 234-1128
018 STO. NIÑO 235-1107
019 LAKE SEBU EAST
020 LAKE SEBU WEST 0921-2887682 - REYNITA MARCELINO
023 TUPI NORTH 226-2829
024 TAMPAKAN 234-1007
025 TUPI SOUTH 238-7206
029 SURALLAH NORTH 238-3991
030 SURALLAH SOUTH 238-6177
031 SURALLAH CENTRAL 238-6154
032 TBOLI WEST 238-8047
033 TBOLI EAST
037 TANTANGAN 229-2711
038 POLOMOLOK WEST 225-2658
039 POLOMOLOK EAST 225-3016
*ddp
Republic of the Philippines Republic of the Philippines
Department of Education Department of Education
Region XII Region XII
DIVISION OF SOUTH COTABATO DIVISION OF SOUTH COTABATO
LAKE SEBU NATIONAL HIGH SCHOOL LAKE SEBU NATIONAL HIGH SCHOOL
Lake Sebu, South Cotabato Lake Sebu, South Cotabato
ITINERARY OF TRAVEL
Name: JOY M. LIM
Positio Senior Bookkeeper
Official Station: Maltana National High School
Purpose of TraveReport to Division Office-Accounting Section
Time Expenses
Mode of
Date Place to be Visited Transportation Registration
Departure Arrival Fare Per Diem Total
Fee
TOTAL - - - -
I certify that: (1) I have reviewed the forgoing itinerary, (2) Prepared by:
the travel is necessary to the service, (3) the covered period is
reasonabe and (4) the exoenses claimed are proper JOY M. LIM
CARLO P. DIVEDOR, CPA Senior Bookkeeper
APPENDIX - B
DATE
I certify that I have completed the travel authorized in itrenary No. ______________________
dated , under my conditions indicated below.
On evidence and information of which I have knowledge the travel was actually undertaken.
Principal/TIC
Republic of the Philippines
Department of Education
Region XII
DIVISION OF SOUTH COTABATO
LAKE SEBU NATIONAL HIGH SCHOOL
Lake Sebu, South Cotabato
January 3, 2012
Date
TRAVEL ORDER
No. ______ S. 2010
January 3, 2012
Date
TRAVEL ORDER
No. ______ S. 2010
AUTHORITY TO TRAVEL
Name :
Position/Designation:
Official Station :
Destination :
Purpose :
Inclusive Dates :
Chargeable Against :
0
0 School Principal I
Recommending Approval:
APPROVED:
AUTHORITY TO TRAVEL
Travel Authority #
Position/Designation: Accountant ll
APPROVED:
I HEREBY request inspection, and disposition I CERTIFY that I have inspected each and every article I CERTIFY that I hav
pursuant to Section 79 of PD 1445, of the property enumerated in this report and that the dispositon made thereof articles enumerated on th
enumerated above. was, in my judgement the best for public interest.
DAVID C. GALLARDO
Requested by: Request for Inspection Approved By: ES I - Pilipino ABRAHA
St
Official REMARS
Amount
Receipt No.
[15] [16]
ABRAHAM G. CASTAÑEROS
State Auditor IV
Date
DRIVER'S TRIP TICKET
Purpose:
APPROVED:
Principal
TOTAL Liters
0
Driver