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Annex 22
ALLOTMENT AND OBLIGATION SLIP No.

MUNICIPALITY OF PORAC
LGU Date:
Payee/Office : Responsibility
Address : Center
Allotment Account
Particulars Class Code
Amou
nt
Requested by: Certified as to existence of Certified as to obligation of

appropriation: allotment:
MA. LUISA I. GOMEZ EDUARDO S. LAPID

Department Head Budget Officer Chief Accountant
Date Date Date
STATUS OF OBLIGATION
Reference AMOUNT Posted
Particulars
Date No. Obligation Payments Balance By:
Annex 24
DV No.:
DISBURSEMENT VOUCHER
MUNICIPALITY OF PORAC Date:
LGU
CLASSIFICATION OF DISBURSEMENT
Cash Advance Reimbursement Other Payments
Name of Claimant: ID No./TIN:
Address: Responsibility
Center:
Particulars Amount
Amount Due P
A Certified: B Completeness and propriety of supporting C Cash available:

Expenses/Cash Advances necessary, lawful documents/previous cash advance
and incurred under my direct supervision. liquidated/existence of funds held in
trust:
EDUARDO S. LAPID BERNADETTE C. DUYA

Signature Over Printed Name/Position Signature Over Printed Name/Position Signature Over Printed Name/Position
(Head Requesting Office) (Municipal Accountant) (Municipal Treasurer)
D Approved For Payment: P_________ E Received Payment:
D
D Payment:
Check No. _______________
Bank Name: _____________
JAIME V. CAPIL Date: ___________________
Signature Over Printed Name/Position Signature Over Printed Name/Position
(Municipal Mayor)
JEV No.__________ Date________
Prepared by;
__________________________
Annex 25
PETTY CASH VOUCHER

MUNICIPALITY OF PORAC No.:
LGU Date:
Payee/Office : Responsibility Center:
Address :
I. To be filled up upon request II. To be filled up upon liquidation

Particulars Amount
Total Amount Granted
Total Amount Paid per

OR No. ____________
Amount Refunded/
(Reimbursed)
A Requested by: C
Received Refund
Name of Requestor Reimbursement Paid
Approved by:
JAIME V. CAPIL
Immediate Supervisor Disbursing Officer
MUNICIPAL MAYOR
B Paid by: D
Liquidation Submitted:
Disbursing Officer Reimbursement Received by:
Cash Received by:
Signature over Printed Name of Payee Signature of Payee
Date: _________________ Date: ___________________

Annex 29
PURCHASE ORDER
LGU
Supplier : P.O. No.:

Date :
Address : Mode of Procurement:
PR No./s
Gentlemen:
Please furnish this office the following articles subject to the terms and conditions contained herein:
Place of Delivery:
Unit Delivery Term:
Date of Delivery: Payment Term:
Item Unit
Quantity Description Amount
No. Cost
P P
(Total Amount in Words) P

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: JAIME V. CAPIL

(Supplier) (Authorized Official)
(Signature over printed name) MUNICIPAL MAYOR
___________________________
(Date)
(In case of Negotiated Purchase pursuant to Section 369 (a) of RA 7160, this portion must be accomplished.)
Approved per Sanggunian Resolution No.:
Certified Correct: Date:

Secretary to the Sanggunian
Annex 30
PURCHASE REQUEST
LGU
Department : PR No.: ____________ Date: _________

SAI No.:_____________ Date: _________
Section : ALOBS No.:__________ Date:_________
Item Unit of Estimated Estimated

Item Description
No. Quantity Issue Unit Cost Cost
Purpose:
Requested by: Cash availability: Approved by:

Signature:
Printed Name: BERNADETTE C. DUYA JAIME V. CAPIL
Designation: MUNICIPAL TREASURER MUNICIPAL MAYOR
Republic of the Philippines
Municipality of Porac
Pampanga
OFFICE OF THE TREASURER

Date :
PLEASE QUOTE YOUR PRICES FOR THE FOLLOWING :
QTY. UNIT DESCRIPTION OF ARTICLES UNIT PRICE AMOUNT
TOTAL -
Approved: Canvasser:
JAIME V. CAPIL BENEDICTO TUAZON

Municipal Mayor Supply Officer
Business Name
Address
Signature over printed name of Bidder
Pampanga

Date :
TOTAL -

Business Name
Address
Pampanga

Date :
TOTAL -

Business Name
Address
Province of Pampanga
Date :
ABSTRACT OF QUOTATION
SUPPLIER 1 SUPPLIER 2 SUPPLIER 3
QTY. UNIT DESCRIPTION OF ARTICLES
TOTAL COST:
Canvasser: Approved:
BENEDICTO R. TUAZON JAIME V. CAPIL
Supply Officer Municipal Mayor
PROVINCE OF PAMPANGA
NOTICE OF AWARDS
TO: _______________________
Sir / Madam:
In connection to the abstract of quotation presented to us, your company / office has been approved by this committee
as the most advantageous. Consequently, the contract for furnishing to this office is hereby awarded to you.
You are therefore requested to deliver to the office/site of the Municipality of Porac, within 5 days from receipt
hereof that said articles at the approved prices set to cash item wit:
QTY. UNIT articles price total
TOTAL:
Respectfully,
______________ JAIME V. CAPIL BERNADETTE C. DUYA
Req. Officer Municipal Mayor Municipal Treasurer
Annex 31
ACCEPTANCE & INSPECTION REPORT
LGU
Supplier : _______________________________________ AIR No. ___________

PO No.: __________ Date: _________ Invoice No.: _______ Date: ____________
Requisitioning Office/Department:_______________________________________
Item No. Unit Description Quantity
ACCEPTANCE INSPECTION
Date Received: _________________ Date Inspected: __________________
Complete Inspected, verified and found OK

as to quantity and specifications
Partial
BENEDICTO R. TUAZON
Property Officer Inspection Officer/Committee
REPUBLIC OF THE PHILIPPINES
PAMPANGA
OFFICE OF THE ________________
CERTIFICATION
This is to certify that the atached voucher payable to

amounting to (P )
as payment for ____________________________________office.
Issued this day of 20__
________________
Department Head

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Annex 22

ALLOTMENT AND OBLIGATION SLIP No.

Requested by: Certified as to existence of Certified as to obligation of

MA. LUISA I. GOMEZ EDUARDO S. LAPID

Date Date Date

A Certified: B Completeness and propriety of supporting C Cash available:

EDUARDO S. LAPID BERNADETTE C. DUYA

JEV No.__________ Date________

PETTY CASH VOUCHER

I. To be filled up upon request II. To be filled up upon liquidation

Total Amount Paid per

Name of Requestor Reimbursement Paid

Disbursing Officer Reimbursement Received by:

Cash Received by:

Signature over Printed Name of Payee Signature of Payee

Date: _________________ Date: ___________________

Supplier : P.O. No.:

(Total Amount in Words) P

Conforme: JAIME V. CAPIL

Approved per Sanggunian Resolution No.:

Certified Correct: Date:

Department : PR No.: ____________ Date: _________

Item Unit of Estimated Estimated

Requested by: Cash availability: Approved by:

OFFICE OF THE TREASURER

JAIME V. CAPIL BENEDICTO TUAZON

OFFICE OF THE TREASURER

JAIME V. CAPIL BENEDICTO TUAZON

OFFICE OF THE TREASURER

JAIME V. CAPIL BENEDICTO TUAZON

ACCEPTANCE & INSPECTION REPORT

Supplier : _______________________________________ AIR No. ___________

Item No. Unit Description Quantity

Date Received: _________________ Date Inspected: __________________

Complete Inspected, verified and found OK

OFFICE OF THE ________________

This is to certify that the atached voucher payable to

Issued this day of 20__

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JEV No.__ Date

Date: _ Date: ___

Department : PR No.: ____ Date: _

Supplier : _____________________________ AIR No. _

Date Received: _ Date Inspected: __