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PURCHASE REQUEST

Llorente, Eastern Samar


LGU
Department: Llorente Technical PR No. Date:
Institute SAI No. Date:
Section: PLUMBING NC II
TOOLS ALOBS No. Date:
Estimated Unit
Item No. Quantity Unit of Issue Item Description Estimated Cost
Cost
1.) 2 pcs. Straight Pipe wrench ( sizes 10”) heavy duty 635.70 1,271.40
2.) 2 pcs. Straight Pipe wrench (sizes12” ) heavy duty 659.70 1,319.40
3.) 2 pcs. Staright Pipe wrench (sizes ,14”) heavy duty 875.70 1,751.40
4.) 5 pcs. Pressure gauges (3” dia. X ¼” dia. 0-300 psi) 276.00 1,380.00
5.) 25 pcs. Steel Tape (5m) 347.70 8,692.50
6.) 25 pcs. Hacksaw with Blade 395.70 9,892.50
7.) 5 pcs. Spirit level bar 24” length 659.70 3,298.50
8.) 5 units Pipe Reamer(1"-2" cap.) 12,000.00 60,000.00
9.) 2 units Pipe Vise 1” – 4” (2 Yoke vise ) Ridgid 16,602.00 33,204.00

10.) 2 units 19,374.00 38,748.00


Pipe Vise 1” – 4” ( 2 chain vise) Top Screw Bench)
11.) 5 pcs. Pipe Cutter ½” – 2” 600.00 3,000.00
12.) 25 pcs. Ballpeen Hammer (12 oz) 419.70 10,492.50
13.) 25 pcs. Pointed Cold Chisel (various length 10” -12”) 316.80 7,920.00
14.) 5 pcs. Electrical Plier 8" 431.70 2,158.50
15.) 5 pcs. Plumb Bob (Std. size) 84.00 420.00
16.) 5 pcs. Mechanical Plier 8" 371.70 1,858.50
17.) 3 pcs. Adjustable wrench (3each 10”) 479.70 1,439.10
18.) 3 pcs. Adjustable wrench (3each 12”) 611.70 1,835.10
19.) 5 pcs. Flat Screw Driver 10” 149.70 748.50
20.) 5 pcs. Philip Screw Driver 10” 149.70 748.50
21.) 25 pcs. Cold Chisel (var. lengths 8”-12” dia. 5/8”) 165.60 4,140.00
SUB-TOTAL 194,318.40

Purpose : Purchase of Plumbing NC II Tools, Charged to : LTI Fund.

Requested By: Cash Availability: Approved:

Signature:
Printed Name MARISSA B. BORMATE JESSE D. CONTADO HON. DANIEL C. BOCO
Designation Vocational School Administrator Municipal Treasurer Municipal Mayor
PURCHASE REQUEST
Llorente, Eastern Samar
LGU
Department: Llorente Technical PR No. Date:
Institute SAI No. Date:
Section: ALOBS No. Date:

Estimated Unit
Item No. Quantity Unit of Issue Item Description Estimated Cost
Cost
OFFICE SUPPLIES
1.) 10 rms Bond Paper, Long (subs 20) 300.00 3,000.00
2.) 4 doz Ballpen Blue 100.00 400.00
3.) 4 doz Ballpen Black 100.00 400.00
4.) 12 pcs Correction Tape 35.00 420.00
5.) Bond Paper, A4 (subs 20) 276.00 8,280.00
30 rms
Ink SET (Brother BT5000C; BT5000M; 2,000.00
6.) 8,000.00
4 SET BT5000Y; BT6000BK )
7.) 5 pads DTR 115.00 575.00
8.) 24 pcs Pencil Mongol 2 10.00 240.00
9.) 48 pcs Folder Ordinary Long 9.00 432.00
10.) 4 pcs. Stapler heavy duty, standard 150.00 600.00
11.) 4 rms Brown Envelope Long 90.00 360.00
12.) 4 rms Brown Envelope Short 80.00 320.00
13.) 2 doz Sliding Folder Long (CLEAR COVER) 350.00 700.00
14.) 2 pcs Pencil Sharpener ,single cutter head 210.00 420.00
parchment paper(short;pack of 10-20pcs) for 70.00
15.) 7,000.00
100 pack diploma

16.) Folder Ordinary Short 7.00 336.00


48 pcs
17.) 5 box Paper fastener plastic 92.00 460.00
18.) 5 box Paper Clip 60.00 300.00

19.) 1 pc Puncher heavy duty 120.00 120.00

20.) 4 box Staple wire#35 55.00 220.00


21.) 3 roll Scoth Tape (2 inch) 40.00 120.00
22.) 1 pc Calculator Scientific 12 digits 400.00 400.00
23.) 5 pcs White board eraser 100.00 500.00
24.) 5 pcs White board marker (black) 120.00 600.00
25.) 3 doz Sign pen, black 150.00 450.00

26.) USB Flashdrive, 32 GB 575.00 3,450.00


6 pcs
27.) 1 unit Paper trimmer (long bond paper capacity) 3,500.00 3,500.00
28.) 5 pcs Masking tape (3 inch) 75.00 375.00
29.) 30 pcs Expanding Folder, long 30.00 900.00
EDP BINDER, TB, for 11" X 9-1/2" CCF, plastic,
30.) 45.00 2,250.00
50 pcs spring rod type
SUB-TOTAL page 1 45,128.00

EDP BINDER, TB, for 11" X 14-7/8" CCF, plastic,


31.) 48.00 2,400.00
50 pcs spring rod type
32.) 14 pcs office ID (wallet size,pvc, digitized) 200.00 2,800.00
33.) 14 pcs Office ID (laminated, w/ costumized lanyard) 175 2,450.00
34.) 1 unit Dry seal 5,000.00 5,000.00

Ring binding machine (heavy duty can bind letter, A4


35.) 8,000.00 8,000.00
and legal size, with adjustable holes)
1 unit
SUB-TOTAL page 2
20,650.00

SUB-TOTAL page 1 45,128.00

SUB-TOTAL page 2 20,650.00


GRAND TOTAL 65,778.00

Purpose : For office/School use, Charged to LTI Fund MOOE (Office supplies)

Requested By :Approved:

Signature:
Printed Name MARISSA B. BORMATE HON. DANIEL C. BOCO
Vocational School Administrator Municipal Mayor
Designation
PURCHASE REQUEST
Llorente, Eastern Samar
LGU
Department: Llorente Technical PR No. Date:
Institute SAI No. Date:
Section: ALOBS No. Date:

Estimated Unit
Item No. Quantity Unit of Issue Item Description Estimated Cost
Cost
OTHER SUPPLIES
Office ID (4"x3", colored, laminated, with costumized
15 pcs 175.00 2,625.00
lanyard )
15 pcs Office ID (wallet size, pvc type ) 200.00 3,000.00

Tshirt , with collar , blue corner (office uniform),


embroidered with the abbreviated word- LTI ( 3 assorted
36 pcs plain colors, with few diff line color in sleeves/neckline); in 450.00 16,200.00
assorted sizes- xl-3pcs; L-4pcs; M-4pcs; XS- 1pc (12 each
color type)

SUB TOTAL 21,825.00

Purpose : For office/School use, Charged to LTI Fund MOOE (OTHER SUPPLIES AND MATERIALS EXPENSES)

Requested By :Approved:

Signature:
Printed Name MARISSA B. BORMATE HON. DANIEL C. BOCO
Designation Vocational School Administrator Municipal Mayor
PURCHASE REQUEST
Llorente, Eastern Samar
LGU
Department: Llorente Technical PR No. Date:
Institute SAI No. Date:
Section: ALOBS No. Date:

Estimated Unit
Item No. Quantity Unit of Issue Item Description Estimated Cost
Cost
OTHER SUPPLIES
1 3 box Albatross 50.00 150.00
2 2 packs Tissue Paper (12 rolls) 90.00 180.00
3 4 pcs Tamboo 200.00 800.00
4 4 pcs Oil All Purpose 92.00 368.00
5 2 bag Surf Powder Big 150.00 300.00
6 2 liter Hand liquid Soap (scented) 160.00 320.00
7 20 pcs Trash bag (xl) 15.00 300.00
8 6 pcs Toilet Brush with Handle 140.00 840.00
9 3 ltr Toilet Bowl Cleaner (1000ml) 300.00 900.00
10 2 pcs Baygon Spray Big 180.00 360.00
11 2 btls Alcohol 70%, ethyl 42.85 85.70
12 4 pcs Mop Head with Handle, cotton 195.00 780.00
13 2 pcs Scoth Brite double 35.00 70.00
Trash bin (plastic with hood or cover (black); 3 pcs
14 17 units per classroom (EIM,HK,PL,IT room,FBS, and 2 pcs 250.00 4,250.00
for LTI Admin

15 3 units Floor Mop with handle (cotton)


175.00
525.00

16 62 units Plastic chair (white w/out armrest, heavy duty) 31,000.00


500.00
17 23 pc 3'x4' printed tarp attached in a 1x2 cocolumber frame 550.00 12,650.00

18 5 units 3'x4' printed tarp 360.00 1,800.00

19 8 unit 2'x4' printed tarp 280.00 2,240.00

20 1 unit RFID Door lock security system 5,000.00 5,000.00

21 3 unit toilet bowl &urinal cleaner 900ml 350.00 1,050.00


Padlock(heavy duty, for 12 roll-up doors w/ 2 lock
22 24 unit
each) 150.00
3,600.00

SUB TOTAL 67,568.70

Purpose : For office/School use, Charged to LTI Fund MOOE (OTHER SUPPLIES AND MATERIALS EXPENSES)

Requested By :Approved:

Signature:
Printed Name MARISSA B. BORMATE HON. DANIEL C. BOCO
Designation Vocational School Administrator Municipal Mayor
PURCHASE REQUEST
Llorente, Eastern Samar
LGU
Department: Llorente Technical PR No. Date:
Institute SAI No. Date:
Section: ALOBS No. Date:

Estimated Unit
Item No. Quantity Unit of Issue Item Description Estimated Cost
Cost
FURNITURES AND FIXTURES

2 4-6 seater Wooden Dining Table with dining 18,000.00


1.) set 36,000.00
chairs(square/rectangle)

2.) 2 Unit Office table 6,000.00 12,000.00

3.) 5 Unit Junior Office swivel chair 3,800.00 19,000.00

4.) 1 set eight seater round dining table ( with chairs) 31,000.00 31,000.00

GRAND TOTAL 98,000.00

Purpose : for office/school use, Charged to LTI Fund Property, Furnitures & Fixtures

Requested By :Approved:

Signature:
Printed Name MARISSA B. BORMATE HON. DANIEL C. BOCO

Vocational School Administrator Municipal Mayor


Designation
PURCHASE REQUEST
Llorente, Eastern Samar
LGU
Department: Llorente Technical PR No. Date:
Institute SAI No. Date:
Section: ALOBS No. Date:

Estimated Unit
Item No. Quantity Unit of Issue Item Description Estimated Cost
Cost
MATERIALS AND CONSUMABLE
Meals and snacks (for COURSE
1.) 40 pack registration;ASSESSMENT CENTER reg; one 500.00 20,000.00
(1)Competency Aassessment) Breakfast,lunch,dinner
Lodging or accomodation for 10
2.) 6 days inspectors;assessors;TESDA personnel during course 800.00/head 48,000.00
registration/competency assessment
GRAND TOTAL 68,000.00
Purpose :for training center/assesment center registration: TESDA assesment, Charged to LTI Fund (TRAINING EXPENSES)
Requested By :Approved:

Signature:
Printed Name MARISSA B. BORMATE HON. DANIEL C. BOCO
Designation Vocational School Administrator Municipal Mayor
PURCHASE REQUEST
Llorente, Eastern Samar
LGU
Department: Llorente Technical PR No. Date:
Institute SAI No. Date:
Section: ALOBS No. Date:

Estimated Unit
Item No. Quantity Unit of Issue Item Description Estimated Cost
Cost

1 heavy lunch
Menu - beef steak, fish fillet, ampalaya con carne, fruit
salad, bottled water and unli rice
2 heavy snacks
Menu:
Am snack - spaghetti and sandwich 6 bottled water and
1.) 50 pax 300.00 15,000.00
20pcs c2,
Pm snack - canton, puto cheese and coke sakto 20pcs, 6
bottled water.

GRAND TOTAL 15,000.00


Purpose :for LTI Site Inspection/Registration , Charged to LTI Fund (TRAINING EXPENSES)
Requested By :Approved:

Signature:
Printed Name MARISSA B. BORMATE HON. DANIEL C. BOCO
Designation Vocational School Administrator Municipal Mayor
REQUISITION AND ISSUE SLIP
Llorente, Eastern Samar
LGU

Division : Responsib
: RIS No. : Date:
Office :LTI Code : SAI No. : Date:

Requisition Issuance
Stock No. Unit Description Quantity Remarks/Amount

Computer desktop (specs: i3 processor, HDD


memory: 1000 GB, RAM: 8 GB
,mouse,keyboard, OS(windows 10) and
microsoft office applications,15” WXGA +
1440x900 w/LED, 4 USB ports, HD graphics,
with UPS) with 1 computer table and 1
1 units ups(specs : 220 volt input 120v required, 5
power output connector 4x power nemaa ups
abd surge 4x power nema 5-15 surge, output
voltage AC 115 8 percent - 50/60hz power
capacity 300 watts/500VA, with
surgesuppression, 365 joules energy rating,
300W power provided

Purpose: Purchase of ICT Equipment, Charge to Capital Outlay (PPE)


Requested By: Approved: Issued by:
Signature

Print Name MARISSA B. BORMATE MARIPAZ B. HUGO JUAN B. GUARINO


Designation VSA Mun. Accountant MGSO
PURCHASE REQUEST
Llorente, Eastern Samar
LGU
Department: Llorente Technical PR No. Date:
Institute SAI No. Date:
Section: ALOBS No. Date:

Estimated Unit
Item No. Quantity Unit of Issue Item Description Estimated Cost
Cost

Computer desktop (specs: i3 processor, HDD


memory: 1000 GB, RAM: 8 GB ,mouse,keyboard,
OS(windows 10) and microsoft office applications,15”
WXGA + 1440x900 w/LED, 4 USB ports, HD
graphics, with UPS) with 1 computer table and 1
1.) 5 unit ups(specs : 220 volt input 120v required, power 25,000.00 125,000.00
output connector 4x power nemaa ups abd surge 4x
power nema 5-15 surge, output voltage AC 115 8
percent - 50/60hz power capacity 300 watts/500VA,
with surgesuppression, 365 joules energy rating,
300W power provided

GRAND TOTAL 125,000.00


Purpose : Purchase of ICT Equipment, Charge to Capital Outlay (PPE)

Signature:
Printed Name MARISSA B. BORMATE HON. DANIEL C. BOCO
Designation Vocational School Administrator Municipal Mayor
REQUISITION AND ISSUE SLIP
Llorente, Eastern Samar
LGU

Division : Responsib
: RIS No. : Date:
Office :LTI Code : SAI No. : Date:

Requisition Issuance
Stock No. Unit Description Quantity Remarks/Amount
1 Bond Paper, Long (subs 20)
rms 10
2 Ballpen Blue
doz 4
3 Ballpen Black
doz 4
4 Correction Tape
pcs 12
5 Bond Paper, A4 (subs 20)
rms 30
Ink SET (Brother BT5000C; BT5000M;
6
SET BT5000Y; BT6000BK ) 4
7 DTR
pads 5
8 Pencil Mongol 2
pcs 24
9 Folder Ordinary Long
pcs 48
10 Stapler heavy duty, standard
pcs. 4
11 Brown Envelope Long
rms 4
12 Brown Envelope Short
rms 4
13 Sliding Folder Long (CLEAR COVER)
doz 2
14 Pencil Sharpener ,single cutter head
pcs 2
parchment paper(short;pack of 10-20pcs) for
15
pack diploma 100
16 Folder Ordinary Short
pcs 48
17 Paper fastener plastic
box 5
18 Paper Clip
box 5
19 Puncher heavy duty
pc 1
20 Staple wire#35
box 4
21 Scoth Tape (2 inch)
roll 3
22 Calculator Scientific 12 digits
pc 1
23 White board eraser
pcs 5
24 White board marker (black)
pcs 5
25 Sign pen, black
doz 3
26 USB Flashdrive, 32 GB
pcs 6
27 Paper trimmer (long bond paper capacity)
unit 1
28 Masking tape (3 inch)
pcs 5
29 Expanding Folder, long
pcs 30
EDP BINDER, TB, for 11" X 9-1/2" CCF,
30
pcs plastic, spring rod type 50
EDP BINDER, TB, for 11" X 14-7/8" CCF,
31
pcs plastic, spring rod type 50
32 office ID (wallet size,pvc, digitized)
pcs 14
33 pcs Office ID (laminated, w/ costumized lanyard) 14

34 unit Dry seal 1


Ring binding machine (heavy duty can bind
35 letter, A4 and legal size, with adjustable
unit holes) 1
Purpose: For office/School use, Charged to LTI Fund MOOE (Office supplies)
Requested By: Approved: Issued by:
Signature

Print Name MARISSA B. BORMATE MARIPAZ B. HUGO JUAN B. GUARINO


Designation VSA Mun. Accountant MGSO
REQUISITION AND ISSUE SLIP
Llorente, Eastern Samar
LGU

Division : Responsib
: RIS No. : Date:
Office :LTI Code : SAI No. : Date:

Requisition Issuance
Stock No. Unit Description Quantity Remarks/Amount

Office ID (4"x3", colored, laminated, with


1 pcs 15
costumized lanyard )

2 pcs Office ID (wallet size, pvc type ) 15

Tshirt , with collar , blue corner (office uniform),


embroidered with the abbreviated word- LTI ( 3
3 pcs assorted plain colors, with few diff line color in 36
sleeves/neckline); in assorted sizes- xl-3pcs; L-
4pcs; M-4pcs; XS- 1pc (12 each color type)

Purpose: For office/School use, Charged to LTI Fund MOOE (OTHER SUPPLIES AND MATERIALS EXPENSES)
Requested By: Approved: Issued by:
Signature

Print Name MARISSA B. BORMATE MARIPAZ B. HUGO JUAN B. GUARINO


Designation VSA Mun. Accountant MGSO
REQUISITION AND ISSUE SLIP
Llorente, Eastern Samar
LGU

Division : Responsib
: RIS No. : Date:
Office :LTI Code : SAI No. : Date:

Requisition Issuance
Stock No. Unit Description Quantity Remarks/Amount
1 box Albatross 3

2 packs Tissue Paper (12 rolls) 2

3 pcs Tamboo 4

4 pcs Oil All Purpose 4

5 bag Surf Powder Big 2

6 liter Hand liquid Soap (scented) 2

7 pcs Trash bag (xl) 20

8 pcs Toilet Brush with Handle 6

9 ltr Toilet Bowl Cleaner (1000ml) 3

10 pcs Baygon Spray Big 2

11 btls Alcohol 70%, ethyl 2

12 pcs Mop Head with Handle, cotton 4

13 pcs Scoth Brite double 2


Trash bin (plastic with hood or cover (black);
14 units 3 pcs per classroom (EIM,HK,PL,IT 17
room,FBS, and 2 pcs for LTI Admin
15 units Floor Mop with handle (cotton) 3
Plastic chair (white w/out armrest, heavy
16 units 62
duty)
3'x4' printed tarp attached in a 1x2
17 pc 23
cocolumber frame

18 units 3'x4' printed tarp 5

19 unit 2'x4' printed tarp 8

20 unit RFID Door lock security system 1

21 unit toilet bowl &urinal cleaner 900ml 3


Padlock(heavy duty, for 12 roll-up doors w/ 2
22 unit 24
lock each)

Purpose: For office/School use, Charged to LTI Fund MOOE (OTHER SUPPLIES AND MATERIALS EXPENSES)
Requested By: Approved: Issued by:
Signature

Print Name MARISSA B. BORMATE MARIPAZ B. HUGO JUAN B. GUARINO


Designation VSA Mun. Accountant MGSO
REQUISITION AND ISSUE SLIP
Llorente, Eastern Samar
LGU

Division : Responsib
: RIS No. : Date:
Office :LTI Code : SAI No. : Date:

Requisition Issuance
Stock No. Unit Description Quantity Remarks/Amount
4-6 seater Wooden Dining Table with dining 2
1 set
chairs(square/rectangle)

2 Unit Office table 2

3 Unit Junior Office swivel chair 5

4 set eight seater round dining table ( with chairs) 1

Purpose: for office/school use, Charged to LTI Fund Property, Furnitures & Fixtures
Requested By: Approved: Issued by:
Signature

Print Name MARISSA B. BORMATE MARIPAZ B. HUGO JUAN B. GUARINO


Designation VSA Mun. Accountant MGSO
REQUISITION AND ISSUE SLIP
Llorente, Eastern Samar
LGU

Division : Responsib
: RIS No. : Date:
Office :LTI Code : SAI No. : Date:

Requisition Issuance
Stock No. Unit Description Quantity Remarks/Amount

1 heavy lunch
Menu - beef steak, fish fillet, ampalaya con
carne, fruit salad, bottled water and unli rice
2 heavy snacks
Menu:
1 pax Am snack - spaghetti and sandwich 6 bottled
50
water and 20pcs c2,
Pm snack - canton, puto cheese and coke
sakto 20pcs, 6 bottled water.

Purpose: for LTI Site Inspection/Registration , Charged to LTI Fund (TRAINING EXPENSES))
Requested By: Approved: Issued by:
Signature

Print Name MARISSA B. BORMATE MARIPAZ B. HUGO JUAN B. GUARINO


Designation VSA Mun. Accountant MGSO
PURCHASE REQUEST
Llorente, Eastern Samar
LGU
Department: Llorente Technical PR No. Date:
Institute SAI No. Date:
Section: SMAW NC II ALOBS No. Date:
MATERIALS & CON-
SUMABLES
Estimated Unit
Item No. Quantity Unit of Issue Item Description Estimated Cost
Cost
CONSUMABLES
1.) 6 pcs. Electrode 3.2mm E6011 3,125.00 18,750.00
2.) 3 pcs. Electrode 3.2mm E6013 2,375.00 7,125.00
3.) 6 pcs. Electrode 3.2mm E7018 3,250.00 19,500.00
4.) 20 pcs. Mild steel plate (flat bar) (1/2" x 2") 2,400.00 48,000.00
5.) 20 pcs. Mild steel plate (flat bar) (1/4" x 2") 1,031.25 20,625.00
6.) 20 pcs. Filter lens (Welding) 25.00 500.00
7.) 20 pcs. Lens clear glass (for welding mask) 15.00 300.00
8.) 50 pcs. Cut off disc for metal (4") 75.00 3,750.00
9.) 50 pcs. Grinding disc for metal (4") 75.00 3,750.00
10.) 25 pcs. Grinding disc for metal (7") 150.00 3,750.00
11.) 25 pcs. Cut off disc for metal (7") 175.00 4,375.00
12.) 0 pcs. Power saw blade (T4x1x10T) 593.75 -
13.) 0 pcs. Metal chalk (CHALK STONE) 750.00 -
CARBON STEEL PIPE, Schedule 40 diameter 6" x 15,000.00
14.) 2 pcs. 30,000.00
3m
LGU Llorente Project Reference Number
Name of the Project
Location of the Project
Standard Form Number: SF-GOOD-60
Revised on: May 24, 2004
Standard Form Title: Request for Quotation
Date:
Quotation No.:

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 duly signed by your representative not later than _______________________ in
the return envelope attached herewith.

MR. JESSE D. CONTADO


Procurement Officer
NOTE: 1. ALL ENTRIES MUST BE TYPEWRITTEN
2. DELIVERY PERIOD WITHIN 15 CALENDAR DAYS
3. WARRANTY SHALL BE FOR A PERIOD OF SIX (6) MONTHS FOR SUPPLIES & MATERIALS, ONE (1) YEAR FOR EQUIPMENT, FROM DATE
OFPRICE
4. ACCEPTANCE
VALIDITYBY THE PROCURING
SHALL ENTITY.
BE FOR A PERIOD OF 30 CALENDAR DAYS
5. G-EPS REGISTRATION CERTIFICATE SHALL BE ATTACHED UPON SUBMISSION OF THE QUOTATION
6. BIDDERS SHALL SUBMIT ORIGINAL BROCHURES SHOWING CERTIFICATIONS OF THE PRODUCT BEING OFFERED.

ITEM
ITEM & DESCRIPTION QTY. UNIT PRICE AMOUNT
NO.
1.) Err:509 Err:509 Err:509
2.) Err:509 Err:509 Err:509
3.) Err:509 Err:509 Err:509
4.) Err:509 Err:509 Err:509
5.) Err:509 Err:509 Err:509
6.) Err:509 Err:509 Err:509
7.) Err:509 Err:509 Err:509
8.) Err:509 Err:509 Err:509
9.) Err:509 Err:509 Err:509

TOTAL

Purpose : Purchase of Rescue Equipments, Charged to : MDRRM Fund.

Brand and Model


Delivery Period
Warranty
Price Validity

_____________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:
Republic of the Philippines
Province of Eastern Samar
Municipality of Llorente

ABSTRACT OF QUOTATION

Date Prepared:
Name of Sup
Item No. Quantity Unit Description

1.) Err:509 Err:509 Meals

2.) Err:509 Err:509 Snacks

We hereby certify to the correctness of the foregoing abstract of canvass and recommend the same for approval and award

ROMMEL C. BOCO JOEY A. TAN RONALDO A. CONTADO ASUNCION


Requisitioning Officer Member Member Mem

JESSE D. CONTADO ROMMEL C. BOCO


Chairman Vice-Chairman
Republic of the Philippines
Province of Eastern Samar
Municipality of Llorente

BSTRACT OF QUOTATION

Name of Supplier
Awarded To

s and recommend the same for approval and award.

RONALDO A. CONTADO ASUNCION PAULINE DAYAG MAYROSE B. ENCIO


Member Member Member

TADO ROMMEL C. BOCO


Vice-Chairman
PURCHASE ORDER
Llorente, Eastern Samar
L G U

Supplier : O.R. NO. :


Address : Date :
Mode of Procurement :
PR No. :
Gentlemen:
Please furnish this office the following articles subject to the terms and conditions contained herein:

Place of Delivery : LGU Llorente Eastern Samar Delivery term : As specified in delivery date
Date of Delivery : Payment Term : Check

Item No. Unit Quantity Description Unit Cost Amount

1.)

TOTAL
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 every day of
delay shall be imposed.
Very truly yours,

Conforme: HON. TITO CODOY JR.


__________________________________________ Municipal Mayor
SIGNATURE OVER PRINTED NAME
Date:
(In case of Negotiated Procurement pursuant to Section 53 of RA 9184, this portion must be accomplished).

Funds Available
Amount
ALB Request No.

JUAN B. GUARINO MARIPAZ B. HUGO, CPA


Supply Officer Municipal Accountant
ACCEPTANCE AND INSPECTION REPORT

Municipality of Llorente

Supplier : Eastern Samar Electric Cooperative IAR No. :


P.O. No. : Date : Invoice No: Date :
REQUISITIONING OFFICE/DEPARTMENT : Municipal disaster Risk Reduction & Mgt. Office
Item No. Unit Description Quantity

1.)

ACCEPTANCE: INSPECTION
Date Received:____________ Date Inspected:_____________

/ / COMPLETE / / INSPECTED VERIFIED AND FOUND


OK AS TO QUANTITY AND SPECIFICATIONS.
/ / PARTIAL

JESSE D. CONTADO
Member, Inspection Committee

JUAN B. GUARINO
Property Officer JONIE BORJA
Member, Inspection Committee

ROMMEL C. BOCO
Requesitioning Officer//Representative
SUPPLIES AVAILABILITY INQUIRY
LGU

DIVISION : RESPONSIBILITY CENTER:___________ No.:_______


Office : Mun. Engineering CODE : Date: 10-3-2005

Item No: DESCRIPTION Unit Quantity Status of Stock

Purpose:

INQUIRED BY: STATUS PROVIDED BY:

Signature :
Printed Name: ROMMEL C. BOCO
Designation : Assistant Municipal Engineer Bookkeeper
Republic of the Philippines
Province of Eastern Samar
Municipality of Llorente

ACKNOWLEDGEMENT RECEIPT FOR EQUIPMENT

ARE No.

DATE
QTY UNIT DESCRIPTION UNIT VALUE TOTAL VALUE
ACQUIRED PROPERTYNO.

1 IF NECESSARY ONLY

Received from: Received by:

MR. JUAN B. GUARINO MR. ANTONIO ENCIO


Property Officer Name

Electrician
Position

Date Date

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