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Appendix 61

PURCHASE ORDER
______________________
Entity Name

Supplier : _____________________________________________ P.O. No. : ____________________________


Address : _____________________________________________ Date : _______________________________
TIN : ________________________________________________ Mode of Procurement : _________________
Gentlemen:
Please furnish this Office the following articles subject to the terms and conditions contained herein:

Place of Delivery : ___________________________________ Delivery Term : ________________________


Date of Delivery : ____________________________________ Payment Term : ________________________

Stock/
Unit Description Quantity Unit Cost Amount
Property No.

(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
every day of delay shall be imposed on the undelivered item/s.

Conforme: Very truly yours,

__________________________ ________________________________
Signature over Printed Name of Supplier
Signature over Printed Name of Authorized Official

___________________________ _____________________________
Date Designation

Fund Cluster : ___________________________________ ORS/BURS No. : ______________________


Funds Available : _________________________________ Date of the ORS/BURS: _______________

Amount : ____________________________
________________________________________
Signature over Printed Name of Chief Accountant/Head of
Accounting Division/Unit

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