Department: Division of Davao City PR No.

: Date:
Office: SAI No.: Date:
Purpose:
REQUESTED BY: APPROVED BY:
End User Head of Procuring Entity
PURCHASE REQUEST
Department of Education
Quantity
Unit of
Issue
Item Description Stock No.
Estimated
Unit Cost
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
Head of Procuring Entity
PURCHASE REQUEST
Department of Education
Estimated
Cost
Wireless Elem. School Project Reference Number
Name of the Project
Locationg of the Project
Standard Form Number: SF-GOOD-60
Revised
Standard 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 TYPEWRITTEN
2 DELIVERY PERIOD WIHTIN _____________CALENDAR DAYS
3 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 ENTITY
4 PRICE VALIDITY SHALL BE FOR A PERIOD OF ______________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
NO. QTY UNIT PRICE
1 25 kg
2 21 kg
3 14kg
4 4 bot
5 2gal
6 3tray
7 7kg
8 5kg
9 5 kg
10 5kg
11 2kg
12 3kg
13 10kg
14 1kg
15 1L
16 2L
17 2kg
18 1kg
19 5kg
20 5.5kg
21 15kg
22 2kg
23 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
Beans
Eggplants
Sayote
Tomatoes
Vinegar
Ampalaya
Chicken Liver
Soysauce
Salt/Seasoning
Onion Bulb
Flour
Bihon
Canton
Tuna fish
Chicken
ITEM & DESCRIPTION
Name of the Procuring Entry
Date:
Address
MELANIE M. CABRERA
School Canvasser
Beef
Potatoes
Carrots
Oil
Mongo
Eggs
squash
Item
LILIA JUYO LORDEL LACSON CHYTCHY DALDE VISMINDA BALOLOT
BAC 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 300 300
No. Qty Unit Description BEVERLY CALLEDO TECKPONE COM
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
H.O.P.E
TRINIDAD DAYOS
BAC Member
We hereby certify to the correctness of the quotation of prices.
300 300
ROYAL YTELCOM TECKPONE COM
Date of Canvass:
Date Open:
Bid/Canvass No.:
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 Groceries
14-09-0515 9/6/2014 Groceries
14-09-0512 9/6/2014 Groceries
14-09-0513 9/6/2014 Groceries
14-09-0511 9/6/2014 Groceries
Groceries
Groceries
9/6/2014
9/6/2014
9/6/2014 14-09-0509
14-09-0510
Name of Bidder
9/6/2014
Groceries
Groceries
Groceries
Groceries
Groceries
Groceries
Groceries
Groceries
9/6/2014
9/6/2014
9/6/2014
Date opened Particulars
9/6/2014
9/6/2014
9/6/2014
14-09-0505
14-09-0506
14-09-0507
14-09-0508
14-09-0504
Bid /Canvass
no.
14-09-0501
14-09-0502
14-09-0503
REPUBLIC OF THE PHILIPPINES
REGION XI
DIVISION 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
Annex 3. Section 6.1
Supplier: NCCC SUPERMARKET P.O No. 1
Address RAMON MAGSAYSAY AVENUE DAVAO CITY Date: 9/6/2014
T.I.N 006-171-689-002 Mode of Procurement SHOPPING
Gentlemen,
Place of Delivery: WIRELESS ELEMENTARY SCHOOL Delivery Term: 5 DAYS
Date 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 Amount
1 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. PIERO
Signature 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 day
of delay shall be imposed
H.O.P.E
PURCHASE ORDER
Department of Education
Region XI
Division of DAVAO CITY
ASUNCION S. INFIESTO
Annex 1, Section 3.1
Date: SEPT.17,2014
SAI No.: _____ Date: _________________
Stock No. Unit Item nDescription Qty. Estimated Estimated
Unit Cost Cost (Php)
1 Kg. Tuna fish 25 410 10250
2 Kg. Chicken 21 180 3780
3 Kg. Beef 14 250 3500
4 bt tomato sauce 4 45 180
5 gal Oil 2 150 300
6 tray Eggs 3 155 465
7 Kg. Mongo 7 80 560
8 Kg. Potatoes 5 75 375
9 Kg. Carrots 5 85 425
10 Kg. squash 5 15 75
11 Kg. Beans 2 50 100
12 Kg. Eggplants 3 30 90
13 pcs Sayote 10 5 50
14 Kg. Tomatoes 1 12 12
15 L Vinegar 1 28 28
16 L Soysauce 2 45 90
17 Kg. Salt/Seasoning 2 15 30
18 Kg. Onion Bulb 1 80 80
19 Kg. Flour 5 40 200
20 Kg. Bihon 5.5 70 385
21 Kg. Canton 15 45 675
22 Kg. Chicken Liver 2 145 290
23 Kg. Ampalaya 1 60 60
Total 22000
Purpose: To feed 100 beneficiaries in the period of 22 days
Requested by: Approved by:
MELANIE M. CABRERA
Feeding Coordinator School Property Custodian
Printed Name
Designation
Signature:
RODEL C. PIERO
Section/Unit: FEEDING
PURCHASE REQUEST
DEPARTMENT OF EDUCATION
Region XI.
Division of Davao Central
Dep't./Division:Dep.Ed/ Davao City PR No: 1
Annex 3. Section 6.1
Supplier: NCCC SUPERMARKET P.O No. 1
Address RAMON MAGSAYSAY AVENUE DAVAO CITY Date: 9/6/2014
T.I.N 006-171-689-002 Mode of Procurement SHOPPING
Gentlemen,
Place of Delivery: WIRELESS ELEMENTARY SCHOOL Delivery Term: 5 DAYS
Date 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 Amount
1 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. PIERO
Signature over printed name
Date:
PURCHASE ORDER
Department of Education
Region XI
Division of DAVAO CITY
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 day of delay shall be imposed
ASUNCION S. INFIESTO
H.O.P.E
Annex 1, Section 3.1
Date: SEPT.17,2014
SAI No.: _____ Date: _________________
Stock No. Unit Item nDescription Qty. Estimated Estimated
Unit Cost Cost (Php)
1 Kg. Tuna fish 25 410 10250
2 Kg. Chicken 21 180 3780
3 Kg. Beef 14 250 3500
4 bt tomato sauce 4 45 180
5 gal Oil 2 150 300
6 tray Eggs 3 155 465
7 Kg. Mongo 7 80 560
8 Kg. Potatoes 5 75 375
9 Kg. Carrots 5 85 425
10 Kg. squash 5 15 75
11 Kg. Beans 2 50 100
12 Kg. Eggplants 3 30 90
13 pcs Sayote 10 5 50
14 Kg. Tomatoes 1 12 12
15 L Vinegar 1 28 28
16 L Soysauce 2 45 90
17 Kg. Salt/Seasoning 2 15 30
18 Kg. Onion Bulb 1 80 80
19 Kg. Flour 5 40 200
20 Kg. Bihon 5.5 70 385
21 Kg. Canton 15 45 675
22 Kg. Chicken Liver 2 145 290
23 Kg. Ampalaya 1 60 60
Total 22000
Purpose: To feed 100 beneficiaries in the period of 22 days
Requested by: Approved by:
MELANIE M. CABRERA
Feeding Coordinator School Property Custodian
PURCHASE REQUEST
DEPARTMENT OF EDUCATION
Region XI.
Division of Davao Central
Dep't./Division:Dep.Ed/ Davao City PR No: 1
Section/Unit: FEEDING
Signature:
Printed Name RODEL C. PIERO
Designation
No.
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 V
Head Teacher I/OIC Schools Division Superintendent Accountant II
LIQUIDATION REPORT
DepEd, Division Office, Davao City
PARTICULARS
LORADEL L. BARICAUA
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 and
correct statement of the disbursement made by me and that this is in liquidation of the cash
advance granted last ___________ in the amount of P50,000.00 per check no.___________
dated _____________
Date Principal
REPORT OF DISBURSEMENTS
DEPED - DIVISION OF DAVAO CITY SCHOOLS, DAVAO CITY
C E R T I F I C A T I O N
TYPE OF WORKING FUND: MOOE
REFERENCE PAYEE/ TRAVEL TRAINING OFFICE REPAIRS &
DATE (OR/RER/ PARTICULARS AMOUNT PAYMENTS BALANCE EXPENSES EXPENSES SUPPLIES MAINTENANCE ACCOUNT ACCOUNT AMOUNT
check #) RECEIVED (6=4-5) (751) (753) (755) OF SCH. BLDG.(812) NAME CODE
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13)
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 General Services
222 Furniture and Fixture 767 Electricity Expenses 796 Janitorial Services
751 Travel Expenses - Local 771 Postage and Deliveries 781 Printing and Binding Expense
753 Training And Seminar Expenses 772 Telephone Expenses - Landline 812 Repair and Maintenance - School Building
755 Office Supplies 773 Telephone Expenses - Mobile 821 Repair and Maintenance - Office Equipment
765 Other Supplies Expenses 774 Internet Expenses 822 Repair and Maintenance - Furniture and Fixture
DATE:_____________________ DATE:_____________________ DATE:_____________________
ASUNCION S. INFIESTO LORADEL L. BARICAUA HELEN D. PAGUICAN, Ph.D.
Principal II Accountant II Schools Division Superintendent
Name of School
Division of Davao City
FOR THE PERIOD _________________________________
CASH DISBURSEMENTS REGISTER
CASH ADVANCE
BREAKDOWN OF PAYMENTS
OTHER ACCOUNTS
TYPE OF WORKING FUND: MOOE
REFERENCE PAYEE/ TRAVEL TRAINING OFFICE REPAIRS &
DATE (OR/RER/ PARTICULARS AMOUNT PAYMENTS BALANCE EXPENSES EXPENSES SUPPLIES MAINTENANCE ACCOUNT ACCOUNT AMOUNT
check #) RECEIVED (6=4-5) (751) (753) (755) OF SCH. BLDG.(812) NAME CODE
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13)
42,150.00
Name of School
Division of Davao City
FOR THE PERIOD _________________________________
CASH DISBURSEMENTS REGISTER
CASH ADVANCE
BREAKDOWN OF PAYMENTS
OTHER ACCOUNTS
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.

Date Reference/ Name of Payee Nature of Payment Amount
Payroll No.
DV No.
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
TOTAL -
Principal
STATEMENT / SUMMARY OF EXPENSES
Republika ng Pilipinas
KAGAWARAN NG EDUKASYON
Rehiyon XI
SANGAY NG LUNGSOD NG DABAW
MALABOG NATIONAL HIGH SCHOOL
Supplier:
IAR No: _________ P.O. NO __________Date: _____________ Invoice No.___________ Date: ________
Requisitioning Office/Dept.: ______________________________________________________
Stock
No.
Unit Quantity
card 1
card 1
pc 1,300
sets 210
pc 210
pc 350
pc 675
pc 525
bill 2
tube 3
sets 72
CHYTCHY DALDE
School Inspector
LILIA
JUYO
JUYO
Division Inspector
Description
INSPECTION & ACCEPTANCE REPORT
Department of Education
Sch ID Cards
smart cellcard
Sun cellcard
RODEL C. PINERO
SupplyOfficer/Property Custodian
INSPECTION ACCEPTANCE
Date Inspected: _______________________
As to quantity & specifications.
Date Received: __________________

English act shts
Aral Pan 3 Act Shts
ECCD Checklist
THERESE ROCABERTE
School Inspector
F138 1 &II
F138 III
F138 5 &6
Bayantel bill
Toner
Complete
Partial (Pls. Specify qty)
Inspected, verify & found in order
/
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 inspector)
( 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. INFIESTO
Name
Name of School
Attendance Sheet
School Feeding Program
For 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
Grade
Level
Aug.____
2014
Aug.____
2014
Aug.____
2014
Aug.____
2014
Day 10
Aug.____
2014
LIST OF DOCUMENTS ATTACHED TO LIQUIDATION REPORTS
1. Purchase Request
2. BAC Resolution (Mode of Procurement)
3. Canvass
4. Abstract of Bids
5. BAC Resolution (Award of Contract/PO)
6. Purchase Order
7. Liquidation Report
8. Report of Disbursment
9. Cash Disbursement Register
10. Summary of Expenses
11. Inspection and Acceptance Report
12. Attendance Sheet
13. Menu on the Scheduled Date
14. Official Receipts/RER