8/11/2019 Month of September
1/28
Department: Division of Davao City PR No.: Date:
Office: SAI No.: Date:
Purpose:
REQUESTED BY: APPROVED BY:
End User Head of Procuring Entit
PURCHASE REQUESTDepartment of Education
QuantityUnit ofIssue
Item Description Stock No. EstimatedUnit Cost
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- - - - - -
- - - - - - - - - - - - - - -
y
EstimatedCost
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Wireless Elem. School Project Reference Numb er Name of the Project
Loca t iong o f the Pro jec t
Standard Form Number: SF-GOOD-60
RevisedStandard Form Title: Request for Quotaiton
Quotation No.Company Name
Please quote your lowest price on the item/s listed below, subject to the General Conditions on the
page, stating the shortest time of delivery and submit your quotation duly signed by your representative not later
than SEPT 19,2014 in the return envelope attached herewith.
NOTE: 1 ALL ENTRIES MUST BE TYPEWRITTEN2 DELIVERY PERIOD WIHTIN _____________CALENDAR DAYS3 WARRANTY SHALL BE FOR A PERIOD OF SIX 960 MONTHS FOR SUPPLIES &
MATERIALS, ONE (1) YEAR FOR EQUIPMENT, FROM DATE OF ACCEPTANCE
BY THE PROCURING ENTITY4 PRICE VALIDITY SHALL BE FOR A PERIOD OF ______________CALENDAR DAYS5 G-EPS REGISTRATION CERTIFICATE SHALL BE ATTACHED UPON SUBMISSION
OF THE QUOTATION6 BIDDERS SHALL SUBMIT ORIGINAL BROCHURES SHOWING CERTIFICATIONS
OF THE PRODUCT BEING OFFERED.ITEMNO. QTY UNIT PRICE
1 25 kg2 21 kg3 14kg4 4 bot5 2gal
6 3tray7 7kg8 5kg9 5 kg10 5kg11 2kg12 3kg13 10kg14 1kg15 1L16 2L17 2kg18 1kg
19 5kg20 5.5kg21 15kg22 2kg23 1kg
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
tomato sauce
BeansEggplants
SayoteTomatoes
Vinegar
AmpalayaChicken Liver
SoysauceSalt/Seasoning
Onion Bulb
FlourBihon
Canton
Tuna fishChicken
ITEM & DESCRIPTION
Name of the Procuring Entry
Date:
Address
MELANIE M. CABRERASchool Canvasser
Beef
PotatoesCarrots
Oil
MongoEggs
squash
8/11/2019 Month of September
6/28
Item
LILIA JUYO LORDEL LACSON CHYTCHY DALDE VISMINDA BALOLOTBAC Member BAC Member BAC Member BAC Member
ASUNCION S. INFIESTO
ESP-2
APPROVED/DISAPPROVED:
We hereby certify to the correctness of the quotation of prices.
CARD 300
No. Qty Unit Description BEVERLY CALLEDO TECKPO
Davao City
ABSTRACT OF BIDS/CANVASS Date of Canvass:
Department of Education Date Open:DIVISION OF DAVAO CITY Bid/Canvass No.:
Republic of the Philippines
8/11/2019 Month of September
7/28
H.O.P.E
8/11/2019 Month of September
8/28
TRINIDAD DAYOSBAC Member
300 300
ROYAL YTELCOMNE COM
8/11/2019 Month of September
9/28
8/11/2019 Month of September
10/28
of IRR of RA 9184; WHEREAS ,in response to the requests/ invitations,the bid proposals submitted by the bidder/s were found substantially complying :
14-09-0514 9/6/2014 Groceries14-09-0515 9/6/2014 Groceries
14-09-0512 9/6/2014 Groceries14-09-0513 9/6/2014 Groceries
14-09-0511 9/6/2014 Groceries
GroceriesGroceries
9/6/20149/6/20149/6/201414-09-0509
14-09-0510
Name of Bidder
9/6/2014
GroceriesGroceriesGroceriesGroceriesGroceriesGroceriesGroceriesGroceries
9/6/20149/6/20149/6/2014
Date opened Particulars
9/6/20149/6/20149/6/2014
14-09-050514-09-050614-09-050714-09-0508
14-09-0504
Bid /Canvass
no.14-09-050114-09-050214-09-0503
REPUBLIC OF THE PHILIPPINES
REGION XIDIVISION OF DAVAO CITY
DAVAO CENTRAL DISTRICT
WHEREAS , at least (3) suppliers/contractors of known qualifications were requested /in-vited submit price quotations/proposals for every purchase request as provided in Rule XVI
WIRELESS ELEMENTARY SCHOOL
(Adopted by: University of the Immaculate Conception)Fr. Selga St. Davao City
DEPARTMENT OF EDUCATION
8/11/2019 Month of September
11/28
8/11/2019 Month of September
12/28
8/11/2019 Month of September
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Annex 3. Section 6.1
Supplier: NCCC SUPERMARKET P.O No. 1 Address RAMON MAGSAYSAY AVENUE DAVAO CITY Date: 9/6/2014T.I.N 006-171-689-002 Mode of Procurement SHOPPINGGentlemen,
Place of Delivery: WIRELESS ELEMENTARY SCHOOL Delivery Term: 5 DAYSDate of Delivery: 09-6-14/09-13-14/09-21-14/09-26-14 Payment Term: CASH
Stock No. Unit Item Description Qty. Unit Cost Amount1 Kg. Tuna fish 25 410 10,250.00 2 Kg. Chicken 21 180 3,780.00 3 Kg. Beef 14 250 3,500.00 4 bt tomato sauce 4 45 180.00 5 gal Oil 2 150 300.00 6 tray Eggs 3 155 465.00 7 Kg. Mongo 7 80 560.00 8 Kg. Potatoes 5 75 375.00 9 Kg. Carrots 5 85 425.00
10 Kg. squash 5 15 75.00 11 Kg. Beans 2 50 100.00 12 Kg. Eggplants 3 30 90.00 13 pcs Sayote 10 5 50.00 14 Kg. Tomatoes 1 12 12.00 15 L Vinegar 1 28 28.00 16 L Soysauce 2 45 90.00 17 Kg. Salt/Seasoning 2 15 30.00 18 Kg. Onion Bulb 1 80 80.00 19 Kg. Flour 5 40 200.00
20 Kg. Bihon 5.5 70 385.00 21 Kg. Canton 15 45 675.00 22 Kg. Chicken Liver 2 145 290.00 23 Kg. Ampalaya 1 60 60.00
Total 22,000.00
Total Amount in Words Twenty-two thousand pesos
Conforme: Very truly yours,
RODEL C. PIEROSignature over printed name
Date:
Please furnish this office the following articles subject to the terms and condtions contrained herein
In case of failure to make full delivery within the time specidied above, a penalty of one-tenth (1/10) of one percent for every dayof delay shall be imposed
H.O.P.E
PURCHASE ORDER
Department of EducationRegion XI
Division of DAVAO CITY
ASUNCION S. INFIESTO
8/11/2019 Month of September
14/28
Annex 1, Section 3.1
Date: SEPT.17,2014SAI No.: _____ Date: _________________
Stock No. Unit Item nDescription Qty. Estimated EstimatedUnit Cost Cost (Php)
1 Kg. Tuna fish 25 410 102502 Kg. Chicken 21 180 37803 Kg. Beef 14 250 3500
4 bt tomato sauce 4 45 1805 gal Oil 2 150 3006 tray Eggs 3 155 4657 Kg. Mongo 7 80 5608 Kg. Potatoes 5 75 3759 Kg. Carrots 5 85 425
10 Kg. squash 5 15 7511 Kg. Beans 2 50 10012 Kg. Eggplants 3 30 9013 pcs Sayote 10 5 5014 Kg. Tomatoes 1 12 1215 L Vinegar 1 28 2816 L Soysauce 2 45 90
17 Kg. Salt/Seasoning 2 15 3018 Kg. Onion Bulb 1 80 8019 Kg. Flour 5 40 20020 Kg. Bihon 5.5 70 38521 Kg. Canton 15 45 67522 Kg. Chicken Liver 2 145 29023 Kg. Ampalaya 1 60 60
Total 22000Purpose: To feed 100 beneficiaries in the period of 22 days
Requested by: Approved by:
MELANIE M. CABRERAFeeding Coordinator School Property Custodian
Printed NameDesignation
Signature:RODEL C. PIERO
Section/Unit: FEEDING
PURCHASE REQUEST
DEPARTMENT OF EDUCATIONRegion XI.
Division of Davao Central
Dep't./Division:Dep.Ed/ Davao City PR No: 1
8/11/2019 Month of September
15/28
Annex 3. Section 6.1
Supplier: NCCC SUPERMARKET P.O No. 1 Address RAMON MAGSAYSAY AVENUE DAVAO Date: 9/6/2014T.I.N 006-171-689-002 Mode of Procurement SHOPPINGGentlemen,
Place of Delivery: WIRELESS ELEMENTDelivery Term: 5 DAYSDate of Delivery: 09-6-14/09-13-14/09-21 Payment Term: CASH
Stock No. Unit Item Description Qty. Unit Cost Amount1 Kg. Tuna fish 25 410 10,250.00 2 Kg. Chicken 21 180 3,780.00 3 Kg. Beef 14 250 3,500.00 4 bt tomato sauce 4 45 180.00 5 gal Oil 2 150 300.00 6 tray Eggs 3 155 465.00 7 Kg. Mongo 7 80 560.00 8 Kg. Potatoes 5 75 375.00 9 Kg. Carrots 5 85 425.00 10 Kg. squash 5 15 75.00 11 Kg. Beans 2 50 100.00 12 Kg. Eggplants 3 30 90.00 13 pcs Sayote 10 5 50.00 14 Kg. Tomatoes 1 12 12.00 15 L Vinegar 1 28 28.00 16 L Soysauce 2 45 90.00 17 Kg. Salt/Seasoning 2 15 30.00 18 Kg. Onion Bulb 1 80 80.00 19 Kg. Flour 5 40 200.00
20 Kg. Bihon 5.5 70 385.00 21 Kg. Canton 15 45 675.00 22 Kg. Chicken Liver 2 145 290.00 23 Kg. Ampalaya 1 60 60.00
Total 22,000.00
Total Amount in Words Twenty-two thousand pesos
Conforme: Very truly yours,
RODEL C. PIEROSignature over printed name
Date:
PURCHASE ORDER
Department of EducationRegion XI
Division of DAVAO CITY
Please furnish this office the following articles subject to the terms and condtions contrainedherein
In case of failure to make full delivery within the time specidied above, a penalty of one-tenth (1/10) of onepercent for every day of delay shall be imposed
ASUNCION S. INFIESTOH.O.P.E
8/11/2019 Month of September
16/28
Annex 1, Section 3.1
Date: SEPT.17,2014SAI No.: _____ Date: _________________
Stock No. Unit Item nDescription Qty. Estimated EstimatedUnit Cost Cost (Php)
1 Kg. Tuna fish 25 410 102502 Kg. Chicken 21 180 37803 Kg. Beef 14 250 3500
4 bt tomato sauce 4 45 1805 gal Oil 2 150 3006 tray Eggs 3 155 4657 Kg. Mongo 7 80 5608 Kg. Potatoes 5 75 3759 Kg. Carrots 5 85 42510 Kg. squash 5 15 7511 Kg. Beans 2 50 10012 Kg. Eggplants 3 30 9013 pcs Sayote 10 5 5014 Kg. Tomatoes 1 12 1215 L Vinegar 1 28 2816 L Soysauce 2 45 90
17 Kg. Salt/Seasoning 2 15 3018 Kg. Onion Bulb 1 80 8019 Kg. Flour 5 40 20020 Kg. Bihon 5.5 70 38521 Kg. Canton 15 45 67522 Kg. Chicken Liver 2 145 29023 Kg. Ampalaya 1 60 60
Total 22000Purpose: To feed 100 beneficiaries in the period of 22 days
Requested by: Approved by:
ELANIE M. CABRERAFeeding Coordinator School Property Custodian
PURCHASE REQUEST
DEPARTMENT OF EDUCATIONRegion XI.
Division of Davao Central
Dep't./Division:Dep.Ed/ Davao CitySection/Unit: FEEDING
Signature:Printed Name RODEL C. PIERODesignation
8/11/2019 Month of September
17/28
8/11/2019 Month of September
18/28
8/11/2019 Month of September
19/28
o.
Date:
Responsibility Center
Code:
To liquidate cash advance granted last ____________________ P per chk#_____________.
TOTAL AMOUNT SPENT P -
AMOUNT OF CASH ADVANCE PER DV. NO. DATED P
AMOUNT REFUNDED PER OR NO. P
AMOUNT TO BE REIMBURSED P
A.Certified: Correctness of the above B. Certified: Purpose of travel/ C. Certified: Supporting documents data. cash advance duly accomplished complete and proper.
HELEN D. PAGUICAN, CESO VHead Teacher I/OIC Schools Division Superintendent Accountant II
LIQUIDATION REPORTDepEd, Division Office, Davao City
PARTICULARS
LORADEL L. BARICAUA
8/11/2019 Month of September
20/28
Report No.Sheet No.
Date OR Number Payee Account Code Amount
-
I hereby certify that this Report of Disbursement in 1 sheet(s) is a full, true andcorrect statement of the disbursement made by me and that this is in liquidation of the cashadvance granted last ___________ in the amount of P50,000.00 per check no.___________dated _____________
DatePrincipal
REPORT OF DISBURSEMENTSDEPED - DIVISION OF DAVAO CITY SCHOOLS, DAVAO CITY
C E R T I F I C A T I O N
8/11/2019 Month of September
21/28
TYPE OF WORKING FUND: MOOE
REFERENCE PAYEE/ TRAVEL TRAINING OFFICE RDATE (OR/RER/ PARTICULARS AMOUNT PAYMENTS BALANCE EXPENSES EXPENSES SUPPLIES A
check #) RECEIVED (6=4-5) (751) (753) (755) SCH. BL(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
42,150.00-
8/18/2014 Beverly Galleos 600.00 41,550.00 8/14/2014 Davao Deseret 13,350.00 28,200.00 8/14/2014 Three A Business Center 17,687.00 10,513.00
7/2/2014 Bayantel 1,397.00 9,116.00 7/2/2014 Byantel 1,381.00 7,735.00 9/4/2014 Network Yechnology & bEngrng Corp 4,500.00 3,235.00 9/4/2014 Davao Deseret 3,600.00 (365.00)
- TOTAL - 42,515.00 - - -
CERTIFIED CORRECT CERTIFIED: Supporting Documents and Complete NOTED:
221 Office Equipment 766 Water Expenses 795 General222 Furniture and Fixture 767 Electricity Expenses 796 Janitori751 Travel Expenses - Local 771 Postage and Deliveries 781 Printing753 Training And Seminar Expenses 772 Telephone Expenses - Landline 812 Repair a755 Office Supplies 773 Telephone Expenses - Mobile 821 Repair a765 Other Supplies Expenses 774 Internet Expenses 822 Repair a
DATE:_____________________ DATE:_____________________ DAT
ASUNCION S. INFIESTO LORADEL L. BARICAUAPrincipal II Accountant II Sch
Name of SchoolDivision of Davao City
FOR THE PERIOD _________________________________
CASH DISBURSEMENTS REGISTER
CASH ADVANCEBREAKDOWN OF P
8/11/2019 Month of September
22/28
TYPE OF WORKING FUND: MOOE
REFERENCE PAYEE/ TRAVEL TRAINING OFFICE REPDATE (OR/RER/ PARTICULARS AMOUNT PAYMENTS BALANCE EXPENSES EXPENSES SUPPLIES AI
check #) RECEIVED (6=4-5) (751) (753) (755) SCH. BLDG(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
42,150.00
Name of SchoolDivision of Davao City
FOR THE PERIOD _________________________________
CASH DISBURSEMENTS REGISTER
CASH ADVANCEBREAKDOWN OF PAY
Note: Accounts not identified in column 7,8,9 and 10. Post it to column 11,12 and 13 under other accounts .Please refer to the Account Names and Account Number stated above.
8/11/2019 Month of September
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Date Reference/ Name of Payee Nature of Payment AmountPayroll No.
DV No.
- - - - - - - - - - - - - - - - -
TOTAL -
Principal
STATEMENT / SUMMARY OF EXPENSES
Republika ng PilipinasKAGAWARAN NG EDUKASYON
Rehiyon XISANGAY NG LUNGSOD NG DABAW
MALABOG NATIONAL HIGH SCHOOL
8/11/2019 Month of September
24/28
Supplier:IAR No: _________ P.O. NO _________ Date: _____________ Invoice No.___________ Date: ________Requisitioning Office/Dept.: ______________________________________________________
StockNo.
Unit Quantity
card 1
card 1pc 1,300sets 210pc 210pc 350pc 675pc 525bill 2tube 3
sets 72
CHYTCHY DALDESchool Inspector
JUYO
Division Inspector
Description
INSPECTION & ACCEPTANCE REPORTDepartment of Education
Sch ID Cards
smart cellcardSun cellcard
RODEL C. PINEROSupplyOfficer/Property Custodian
INSPECTION ACCEPTANCE
Date Inspected: _______________________
As to quantity & specifications.
Date Received: __________________
English act shts
Aral Pan 3 Act ShtsECCD Checklist
THERESE ROCABERTESchool Inspector
F138 1 &IIF138 IIIF138 5 &6Bayantel billToner
Complete
Partial (Pls. Specify qty)
Inspected, verify & found in order
/
8/11/2019 Month of September
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Revised January, 1992
Date
the amount
(P )
In payment for
Address: Address:
Residence Cert. No. Residence Cert. No.Date of Issue: Date of Issue:Place of Issue: Place of Issue:
(Signed by inspecto r)
( Signature) ( Signature)
(Printed Name) (Printed Name)
( In Figure ) ( In Figure )
( payment for substance, services, rental or transportation should show )
( Inclusive dates, purpose, distance, inclusive points of travel, etc. )
PAYEE WITNESS
(Official Designation) In Words
REIMBURSEMENT OF EXPENSES RECEIPTS
Received from ASUNCION S. INFIESTOName
8/11/2019 Month of September
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Name of SchoolAttendance SheetSchool Feeding ProgramFor the Period ________________
Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7 Day 8 Day 9
Name of Beneficiary
Aug.____
2014
Aug.____
2014
Aug.____
2014
Aug.____
2014
Aug.____
2014
GradeLevel
Aug.____
2014
Aug.____
2014
Aug.____
2014
Aug.____
2014
8/11/2019 Month of September
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Day 10Aug.____
2014
8/11/2019 Month of September
28/28
LIST OF DOCUMENTS ATTACHED TO LIQUIDATION REPORTS
1. Purchase Request
2. BAC Resolution (Mode of Procurement)3. Canvass4. Abstract of Bids5. BAC Resolution (Award of Contract/PO)6. Purchase Order7. Liquidation Report8. Report of Disbursment9. Cash Disbursement Register
10. Summary of Expenses11. Inspection and Acceptance Report12. Attendance Sheet13. Menu on the Scheduled Date14. Official Receipts/RER