NEW MOOE PS Blank Forms 2018 For Himamaylan Division

LIQUIDATION REPORT Serial No.
For the Period: 3RD QTR. C.Y. 2018 Date:
Entity Name : DEPARTMENT OF EDUCATION Responsibility Center Code:

Fund Cluster : 07-001-08-06006 1-01-101-101101
PARTICULARS AMOUNT
To Liquidate the 3RD QTR. MOOE CASH ADVANCE

C.Y. 2018 of SIG-ANG ELEMENTARY SCHOOL with Php 44,337.00
ADA # 101-01-001-2017 MOOE dated January 1, 2018
as per supporting papers hereto attached…
Expenses Amount
TRAVEL 1,000.00
TRAINING 2,450.00
PERIMETER FENCE MATERIALS 29,620.00
LABOR 10,367.00
ELECTRICITY NOCECO BILLS 900.00
TOTAL AMOUNT SPENT 44,337.00
AMOUNT OF CASH ADVANCE PER DV No.: dated: 44,337.00
AMOUNT OF REFUNDED O.R. No.: dated: 0.00
AMOUNT TO BE REIMBURSED 0.00
Certified : Correctness of the Certified: Purpose of Tavel / Certified: Supporting documen

above data: Cash Advance duly accomplishe complete and proper:
RODNEL A. MONCERA EMMA GRACE T. MULETA, CB, CPA

TEACHER-IN-CHARGE SGOD Chief Accountant III
JEV No.:
Date: Date: Date:
To be filled-up by the Accounting
personnel.
Amount of Check
Breakdown of Expenses
Kindly Fill-up the DV number from your Disbursement

Voucher together with the date.
Appendix 32
DEPARTMENT OF EDUCATION Fund Cluster :

Schools Division of Himamaylan City 07-001-08-06006
Date :
DISBURSEMENT VOUCHER DV No. :
Mode of
MDS Check Commercial Check ADA Others (Please specify)
Payment
TIN/Employee No.: ORS/BURS No.:

Payee
Himamaylan CS
Address
DISTRICT OF HIMAMAYLAN I
Responsibili
Particulars ty Center
MFO/PAP Amount
To payment of the 1ST QTR. MOOE CASH ADVANCE ₱0.00

C.Y 2018 of Himamaylan CS as per
supporting papers hereto attached…
Amount
Travel Expenses
Training Expense
Office Supplies Expense
Repair & Maintenance - School Bldg.
ELEM 310400100002000
Electricity Expense
Telephone Expense - Mobile
Other General Services
Fidelity Bond Premium
LBP Account
0425 - 0050 - 00
DISTRICT #:
Branch : LBP - Bacolod Main
Amount Due ₱0.00

A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.
BERNIE L. LIBO-ON, Ph.D

OIC-Assistant Schools Division Superintendent
B. Accounting Entry:
Account Title UACS Code Debit Credit
19901010
Advances to Operating Expenses 0.00
00
10104040
Cash, MDS - Regular 0.00
00
TOTAL 0.00 0.00

C. Certified: D. Approved for Payment
Cash available
Subject to Authority to Debit Account (when applicable)
Su
proper
Signature Signature
Printed
Name EMMA GRACE T. MULETA, CB, CPA Printed Name FELICIANO C. BUENAFE, JR., CESO VI
Accountant III OIC - Schools Division Superintendent

Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative
Date Date
E. Receipt of Payment JEV No. :
Check/ Date Bank Name & Account Number:
ADA No. : :
Check/ Date
ADA No. : : LBP Account #: 0425 - 0050 - 00
Signature Date 0 Date :
: : Printed Name
Official Receipt No. & Date/Other Documents
PLEASE PRINT IN LONG BOND PAPER!!!!
Amount here
Indicate the purpose of Cash Advance and Breakdown the expenses

as enumerated in the Budgetary Requirements for the Quarter.
1S
T
Q
TR
.
M Appendix 11
O
OBLIGATION
O REQUEST AND STATUS Serial No. :
E DEPARTMENT OF EDUCATION Date :
CA Schools Division of Himamaylan City Fund
07-001-08-06006
Cluster:
S
Payee H 0
A
Office Himamaylan CS
D
VA
Address DISTRICT OF HIMAMAYLAN I
N
CE UACS
Responsibility C.
Particulars MFO/PAP Object Amount
Center Y. Code
ELEM 20 To obligate the payment of the 1ST 310400100002000
17 MOOE CASH ADVANCE C.Y. 2018
QTR.
of
of Himamaylan CS
TE
as per supporting papers hereto attached…
A
M
IN
Travel Expenses 0.00
AY
Training Expense 0.00
A
U Office Supplies Expense 0.00
A Repair & Maintenance - School Bld 0.00
N Electricity Expense 0.00
EL Telephone Expense - Mobile 0.00
E Other General Services 0.00
M. Fidelity Bond Premium 0.00
SC
H
O TOTAL ₱0.00
OL
A. Certified: Charges to appropriation/alloment are B. Certified: Allotment available and
as
necessary,pelawful and under my direct supervision;and obligated for the purpose/adjustment
supportingrdocuments valid, proper and legal: necessary as indicated above:
su
pp
ort
Signature
Printed in Signature:
:
Name: g
___________ pa
___________ JUAN DE LA CRUZ Printed Name: DINAH N. SALAZAR
pe
___________
Position rs
___ Principal I Position: Administrative
: he Requesting Office/Authorized Head,Officer
Budget V - Finance
Head,
ret Division/Unit/Authorized
Date Representative
o Date: Representative
:
att
ac
C. he STATUS OF OBLIGATION
d Reference Amount
… Balance
ORS/JEV/Check/ADA/TRA Obligation Payable Payment Not Yet
Date Particulars
No. Due
(a) (b) (c) (a-b)
Appendix 11
07-001-08-06006
Responsibility Center MFO/PAP

Amount
Elementary 302050002
High School 302050003
Expenses UACs Object Code

TRAVEL 50201010 00
TRAINING 50202010 00
OFFICE SUPPLIES 50203010 00
0.00 FUEL, OIL & OTHER LUBRICANTS 50203090 00
0.00 OTHER SUPPLIES & MAT. EXP. 50203990 00
0.00 WATER 50204010 00
0.00 ELECTRICITY 50204020 00
0.00 TELEPHONE EXPENSE - MOBILE 50205020 01
0.00 REPAIR & MAINT. - SCHL. BLDG. 50213040 02
0.00 FIDELITY BOND PREMIUNS 50215020 00
0.00 LABOR & WAGES (HS Watchman) 50216010 00
Agricultural & Marine Expenses 50203100 00
₱0.00 OTHER GENERAL SERVICES 50212990 00

DRUGS & MEDICINES 50203070 00
available and
pose/adjustment
ed above:
H N. SALAZAR
tive Officer
Head, Budget V - Finance
on/Unit/Authorized
epresentative
Balance
Due and
Demandabl
e
(b-c)
Republic of the Philippines
DEPARTMENT OF EDUCATION
Schools Division of Himamaylan City
Region VI-Western Visayas
Vallega St., Himamaylan City, Negros Occidental
Himamaylan CS
CASH DISBURSEMENTS REGISTER

For the Period: 1ST QTR. C.Y. 2018
TYPE OF WORKING FUND: MOOE C.Y. 2018
ADVANCES FOR OPERATING EXPENSES
(19901010-00)
B R E A K D O W N OF P A Y M E N T S
REFEREN
CE Other
AMOUNT Travel Fidelity Office Repair & Supplies Fuel, Oil & Drugs &
DATE (OR/RER/ PAYEE/ PARTICULARS Training Electricity Water
CHECK Expense Bond Supplies Maintenanc and Other Medicines
BALANCE Expenses Expense Expense
#) (Local) Premiums Expense e -Sch. Bldg. Materials Lubricants Expenses
AMOUNT Exp.
PAYMENTS
RECEIVED
(6=4-5) 50201010-00 50202010-00 50215020-00 50203010-00 50213040-02 50203990-00 50204020-00 50204010-00 50203090-00 50203070-00
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16)
1 01/01/16 101-01-00Name of School Head 0.00

2 0.00
3 0.00
4 0.00
5 0.00
6 0.00
7 0.00
8 0.00
9 0.00
10 0.00
11 0.00
12 0.00
13 0.00
14 0.00
15 0.00
16 0.00
17 0.00
18 0.00
19 0.00
20 0.00
21 0.00
22 0.00
TOTAL 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
CERTIFIED CORRECT: CERTIFIED SUPPORTING DOCUMENTS COMPLETE: NOTED:
JUAN DE LA CRUZ ROSEMARIE M. BALIGUAT, CB EMMA GRACE T. MULETA, CB, CPA

Principal I Senior Bookkeeper - HIMAMAYLAN I Accountant III
DATE: DATE : DATE:

Division of Negros Occidental
Negros Island Region
Cottage Road, Bacolod City
Himamaylan CS
CASH DISBURSEMENTS REGISTER

For the Period: 1ST QTR. C.Y. 2018
TYPE OF WORKING FUND: MOOE C.Y. 2017
ADVANCES FOR OPERATING EXPENSES
(19901010-00)
B R E A K D O W N OF P A Y M E N T S
REFEREN
CE Other
AMOUNT Travel Fidelity Office Repair & Supplies Fuel, Oil & Drugs &
DATE (OR/RER/ PAYEE/ PARTICULARS Training Electricity Water
CHECK Expense Bond Supplies Maintenanc and Other Medicines
BALANCE Expenses e -Sch. Bldg.
Expense Expense
#) (Local) Premiums Expense Materials Lubricants Expenses
AMOUNT Exp.
PAYMENTS
RECEIVED
(6=4-5) 50201010-00 50202010-00 50215020-00 50203010-00 50213040-02 50203990-00 50204020-00 50204010-00 50203090-00 50203070-00
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16)
BALANCE FORWARDED 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
23 0.00
24 0.00
25 0.00
26 0.00
27 0.00
28 0.00
29 0.00
30 0.00
31 0.00
32 0.00
33 0.00
34 0.00
35 0.00
36 0.00
37 0.00
38 0.00
39 0.00
40 0.00
GRAND TOTAL 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
CERTIFIED CORRECT: CERTIFIED SUPPORTING DOCUMENTS COMPLETE: NOTED:
JUAN DE LA CRUZ ROSEMARIE M. BALIGUAT, CB EMMA GRACE T. MULETA, CB, CPA

Principal I Senior Bookkeeper - HIMAMAYLAN I Accountant III
DATE: DATE : DATE:
Indicate the Name of your School in CAPITAL LETTERS
Other
Telephone Food TOTAL
General
Expense- Supplies
Services
Mobile Expense
(Watchman)
50205020-01 50212990-00 50203050-00
(17) (18) (19) (20)
Breakdown every transactions per OR #, RER #, DV #, Invoice #, etc.
0.00
0.00 Arrange every transactions in CHRONOLOGICAL ORDER
0.00 per transaction/s.
0.00
0.00 Training
Expense Include the expenses paid in the REGISTRATION & TRAININGs CONDUCTED ONLY.
0.00 s
0.00 Travel Include the expenses paid during the travel (e.g. fare & per
Expense
0.00 diem)
s
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00 0.00 0.00 0.00
T. MULETA, CB, CPA

ountant III
Other
Telephone Food TOTAL
General
Expense- Supplies
Services
Mobile Expense
(Watchman)
50205020-01 50212990-00 50203050-00
(17) (18) (19) (20)

0.00 0.00 0.00 0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00 0.00 0.00 0.00
T. MULETA, CB, CPA

ountant III
Appendix 36
JOURNAL ENTRY VOUCHER JEV No.:________________
Entity Name: DEPARTMENT OF EDUCATION Date :

Fund Cluster: 07-001-08-06006
Responsib
ACCOUNTING ENTRIES
ility UACS Object AMOUNT
Center Accounts and Explanation Code Debit Credit
Elem Advances for Operating Expenses 19901010 00 0.00
Cash, MDS - Regular 10104040 00 0.00
To payment of the 1st Qtr. MOOE Cash Advance C.Y. 2018 of Mr.
JUAN DE LA CRUZ of Himamaylan CS amounting to P0.00, Himamaylan I.
TOTAL 0.00 0.00

Prepared by: Certified Correct:
ROSEMARIE M. BALIGUAT, CB EMMA GRACE T. MULETA, CB, CPA

Senior Bookkeeper - Himamaylan I Accountant III
Appendix 36
JOURNAL ENTRY VOUCHER JEV No.:________________
Entity Name: DEPARTMENT OF EDUCATION Date :

Fund Cluster: 07-001-08-06006
Responsib
ACCOUNTING ENTRIES
ility UACS Object AMOUNT
Center Accounts and Explanation Code Debit Credit
Elem Advances for Operating Expenses 19901010 00 0.00
Cash, MDS - Regular 10104040 00 0.00

To payment of the 1st Qtr. MOOE Cash Advance C.Y. 2018 of Mr.
JUAN DE LA CRUZ of Himamaylan CS amounting to P0.00, Himamaylan I.
TOTAL 0.00 0.00

Prepared by: Certified Correct:

Senior Bookkeeper - Himamaylan I Accountant III
Himamaylan CS
January 03, 2018
FELICIANO C. BUENAFE, JR., CESO VI

OIC - Schools Division Superintendent
Sir:
We would like to request for the processing and release of our 1ST
QTR. MOOE CASH ADVANCE C.Y. 2018 for the following purposes:
Travel Expenses ---------- ₱0.00

Training Expense ---------- ₱0.00
Office Supplies Expense ---------- ₱0.00
Repair & Maintenance - School Bldg. ---------- ₱0.00
Electricity Expense ---------- ₱0.00
Telephone Expense - Mobile ---------- ₱0.00
Other General Services ---------- ₱0.00
Fidelity Bond Premium ₱0.00
TOTAL ---------- ₱0.00
SPG President Teacher League President PTA President

JUAN DE LA CRUZ
Barangay Captain Principal I
Recommending Approval:

Approved:

OIC- Schools Division Superintendent
oses:
Himamaylan CS
BUDGETARY REQUIREMENTS FOR THE QUARTER
FIRST QUARTER:
- Travel Expenses ₱0.00

- Training Expense 0.00
- Office Supplies Expense 0.00
- Repair & Maintenance - School Bldg. 0.00
- Electricity Expense 0.00
- Telephone Expense - Mobile 0.00
- Other General Services 0.00
- Fidelity Bond Premium 0.00
TOTAL ₱0.00
JUAN DE LA CRUZ
Principal I
Recommending Approval:

Approved:
OIC- Schools Division Superintendent
ON
ity
CERTIFICATION OF NO UNLIQUIDATED CASH ADVANCE
To whom it may concern:
Name : JUAN DE LA CRUZ

Position : Principal I
School : Himamaylan CS
School District : DISTRICT OF HIMAMAYLAN I
Purpose of Cash Advance Requ : 1ST QTR. MOOE CASH ADVANCE
C.Y. 2018
This is to certify that the school head whose name appears above has no
unliquidated Cash Advance.
This certification is issued for the above stated purpose/s only.
Issued this 5th day of January, 2017 at Accounting Section, Division Offi
Bacolod City, Negros Occidental.
ROSEMARIE M. BALIGUAT, CB
Senior Bookkeeper - HIMAMAYLAN I
AUTHORITY TO CASH ADVANCE
To whom it may concern:

This authorized the above named School Head of the above stated schoo
Cash Advance for the 1ST QTR. MOOE CASH ADVANCE C.Y. 2018 to be used for
various expenditures.
Given this 8th day of January, 2017 at Division Office, Cottage Road,
Bacolod City, Negros Occidental.

PROGRAM OF WORKS
Name of Project:
School/Location: Himamaylan CS
Fund Source: MOOE 1ST QTR 2018
Scope of Work:
TOTAL
No. QTY. UNIT DESCRIPTION UNIT COST
COST
1 0.00
2 0.00
3 0.00
4 0.00
5 0.00
6 0.00
7 0.00
8 0.00
9 0.00
10 0.00
11 0.00
12 0.00
13 0.00
14 0.00
15 0.00
TOTAL 0.00
Total Cost of Materials 0.00

Labor Cost (35%) 0.00
Total Cost of Project 0.00
Prepared By: Approved By:
JUAN DE LA CRUZ
TIC / SPC Principal I
Noted By: OK as to Fund:
EMMA GRACE T. MULETA, CB, CPA
SGOD Chief Accountant III

Kindly indicate the DESIGNATION of
the School Head
Appendix 60
PURCHASE REQUEST
Entity Name: DEPARTMENT OF EDUCATION Fund Cluster:07-001-08-06006

Office / Section: Himamaylan CS PR No.: Date:
DISTRICT OF HIMAMAYLAN I Responsibility Center Code: 1-01-101-1011
Stock /
Property UNIT ITEM/DESCRIPTION QTY. UNIT COST TOTAL COST
No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Purpose:
Requested By: Approved By:
Signature
Printed Name JUAN DE LA CRUZ
Designation TIC / SPC Principal I
Your ALOBS No. is the same with your
OBR No..
Indicate the main purpose of your

request in complete details.
Please indicate if the in charged of the

project is your TIC or SPC
PR No. :
Package :
Supplier :
Address :
Tel. No. :
Name of Authorized
Representative
In accordance with your Invitation for Sealed Quotations for the above mentioned package and
subject to all conditions and requirement thereof, we/I will perform the above service at a total cost in Phi
Pesos of
down as follows: (P_____________ ) broken down follows:
Qty Unit Agency Specification Bidder's Specifications Unit Cost Total Amount
TOTAL
conformity with the specifications and at the price/s we have quoted above.
We understand that you are not bound to accept the lowest or any quotation that you receiv
Date this _____ day of _______________, 2018.
Printed Name & Signature
This form to be submitted Position/Designation

not later than
Bid Opening
NOTE : for Canvasser
ount
NO ERASURES / ALTERATIONS in the QUOTATION and it should be
HANDWRITTEN (ballpen) by the SUPPLIER.
NOT LATER THAN DATE should be AFTER your date above.
BID OPENING DATE is AFTER your NOT LATER THAN date.
NOTE : for is the purpose of your QUOTATION.

ABSTRACT OF SEALED CANVASS
Office / End User : Himamaylan CS

Date / Place : / :
Package :0
S U P P L I E R / C O N T R A C T O R / P R O
QTY UNIT ITEM / DESCRIPTION
TOTAL 0.00 0.00

School Facilites Coordinator School Property Custodian BAC Member
P.R.: 0 Note that your Abstract Date must be
after your Bid Opening Date.
T R A C T O R / P R O V I D E R
0.00
JUAN DE LA CRUZ Indicate the DESIGNATION of SCHOOL
Principal I HEAD
Appendix 61
PURCHASE ORDER
Supplier: P.O. No.: 0

Address: Date:
TIN: Mode of Procurement:Shopping/Canvass
Gentlemen:
Please furnish this Office the following articles subject to the terms and conditions contained herein:
Place of Delivery: Himamaylan CS Delivery Term: 10 working days

Cash on
Date of Delivery: Payment Term: Delivery
STOCK / UNIT
UNIT ITEM/DESCRIPTION QTY. AMOUNT
PROPERTY No. COST
1 0.00
2 0.00
3 0.00
4 0.00
5 0.00
6 0.00
7 0.00
8 0.00
9 0.00
10 0.00
11 0.00
12 0.00
13 0.00
14 0.00
15 0.00
16 0.00
17 0.00
18 0.00
19 0.00
20 0.00
21 0.00
22 0.00
23 0.00
24 0.00
25 0.00
26 0.00
27 0.00
28 0.00
29 0.00
30 0.00
TOTAL 0.00
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) or one (1) percent for every day of delay shall be imposed on the undelivered item/s
Conforme: Very truly yours,

JUAN DE LA CRUZ
Signature over Printed Name of Supplier Signature over Printed Name of Authorized Official
Principal I
Date Designation
Fund Cluster : 07-001-08-06006 ORS/BURS No. :

Funds Available ORS/BURS Date :
Amount: ₱0.00
Accountant III
Note that your PO Date must be after
your Abstract Date.
Canvass
Your AMOUNT is the TOTAL AMOUNT
OF YOUR CASH ADVANCE.
Appendix 32
DEPARTMENT OF EDUCATION Fund Cluster :

Schools Division of Himamaylan City MOOE C.Y. 2017 1ST
Date :
DISBURSEMENT VOUCHER DV No. :
Mode of MDS Check Commercial Check ADA Others (Please specify)

Payment
TIN/Employee No.: ORS/BURS No.:
Payee
Himamaylan CS
Address
Himamaylan District
Responsibility
Particulars Center
MFO/PAP Amount
To payment of the
ELEM 310400100002000
Himamaylan
Amount Due ₱0.00

A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.
Public Schools District Supervisor
B. Accounting Entry:
Account Title UACS Code Debit Credit
C. Certified: D. Approved for Payment

Cash available
Subject to Authority to Debit Account (when applicable)
Sup
proper
Signature Signature
Printed
Printed Name
Name
School Treasurer School Head/PSDS
Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative
Date Date
E. Receipt of Payment JEV No. :
Check/ Date Bank Name & Account Number:
ADA No. : :
Signature Date 0 Date :
: : Printed Name
Official Receipt No. & Date/Other Documents
Provide School Based DV No. for School Reference.
Amount here
Indicate the purpose of your DV such as payment for your Office Supplies,
Other General Services (Watchman), etc.
Appendix 62
INSPECTION AND ACCEPTANCE REPORT
Entity Name : DEPARTMENT OF EDUCATION Fund Cluster:07-001-08-06006

Supplier: 0 IAR No.:
P.O. No. / Date: 0 / 12/30/99 Date:
Requisitioning Office / Dept.: Himamaylan CS Invoice No.:
Responsibility Center Code : 1-01-101-101101 Date:
Stock /
Property No.:
Description Unit Quantity
INSPECTION ACCEPTANCE
Date of Inspected: Dated Received
Inspected, verified and Complete

found in order as to
quantity and specifications Partial (please specify quanti
NAME OF INSPECTOR
NAME OF SUPPLY / CUSTODIAN

NAME OF INSPECTOR Supply and / or Property Custodian
NAME OF INSPECTOR
Inspection Officer / Inspection Committee

Write the Name of the Inspectors below the Line and their
respective signature above it.
Appendix 17

PRE - REPAIR INSPECTION REPORT
Item / Description:
Property Number: Property Accountability Receipt
Aquisition Cost: Acquisition Date:
Nature and Scope of Last Repair if an
Complaints / Defect
Parts / Components to be Repaired / Repla
FINDINGS / OBSERVATIONS:
Property Inspector / Date
POST - REPAIR INSPECTION REPORT
Job Order No.: Amount: Invoice No.: Amount:

FINDINGS / COMMENTS:
0
Property Inspector / Date
JOB REQUEST
DepEd - Schools Division of Himamaylan City
(Agency)
Department: DISTRICT OF HIMAMAYLAN I JR No.: Date:
Section/SchoolHimamaylan CS SAL No.: Date:
ALOBS No.: Date:
STOCK ESTIMATED ESTIMATED
UNIT JOB DESCRIPTION QTY
No. UNIT COST COST
TOTAL
Purpose:

Signature:
Name: 0 JUAN DE LA CRUZ
Designation: TIC / SPC Principal I
Date:
JR No. :
Package :
Carpenter :
Address :
Tel. No. :
Name of Authorized
Representative
In accordance with your Invitation for Sealed Quotations for the above mentioned package and
subject to all conditions and requirement thereof, we/I will perform the above service at a total cost in Philippine
Pesos of
down as follows: (P ) broken down follows:
ITEM No. AGENCY SPECIFICATION BIDDER's SPECIFICATION AMOUNT
TOTAL COST
TOTAL
conformity with the specifications and at the price/s we have quoted above.
We understand that you are not bound to accept the lowest or any quotation that you rece
Date this _____ day of ____________________, __________.
Printed Name & Signature
This form to be submitted Address / Location

not later than
Bid Opening
NOTE : for Canvasser
kage and
n Philippine
NO ERASURES / ALTERATIONS in the QUOTATION and it should be

HANDWRITTEN (ballpen) by the SUPPLIER.
NOT LATER THAN DATE should be after your date above.
BID OPENING DATE is AFTER your NOT LATER THAN date.
NOTE : for is the purpose of your QUOTATION.

ABSTRACT OF SEALED CANVASS
Office / End User : Himamaylan CS J.R.:

Date / Place : / :
Package :
SUPPLIER / CONTRACTOR / PROVIDER

QTY ITEM / DESCRIPTION
GRAND TOTAL 0.00 0.00 0.00 0.00
JUAN DE LA CRUZ
School Facilites Coordinator School Property Custodian BAC Member Principal I
JOB ORDER
Job Order No.: 0 Date:

Job Request No.: 0 Date:
Description of Works:
UNIT PRICE TOTAL
₱0.00
Received By:
Date Received:
Project Fund:
Date Work Begin: Date Work Completed:
Inspected By: Date of Inspection:
School Inspector
JUAN DE LA CRUZ
SPC/TIC Principal I
OK as to Fund:

Accountant III
Date
CERTIFICATE OF COMPLETION
Name of Project:
School & Address:

Fund Source:
Appropriation:
Mode of Implementation:
We hereby certify that the above stated projects has been duly a
and all works incorporated herein was done in accordance with the approved Program of Work, Plans and Spe
JUAN DE LA CRUZ
CERTIFICATE OF INSPECTION
This is to certify that the above stated / named project with details listed above has been inspe
and verified in accordance with the Program of Work, plan/s and specification/s and workmanship on (date o
inspection and was found 100% completed, hence, recommended for full paym
SGOD Chief SPC / Designated School Inspector
CERTIFICATE OF ACCEPTANCE
Date
We hereby accept the above stated project that was found to be 100% completed in ccordance w
Program of Works, plan/s and specification/s, and the workmanship is satisfactory.
0 JUAN DE LA CRUZ
Himamaylan CS
JOB ORDER
PERIOD OF EMPLOYMENT FUNDING

NAME DESIGNATION RATE/MONTH
FROM TO CHARGES
The said Job Order shall automatically cease upon the expiration as stipulated above, unless renewed. However, services of any o
names be terminated prior to the expiration of this Job Order for lack of funds or when their services are no longer needed. The ab
attest that he/she is not related within the third degree (fourth degree in case of LGU's) of consanguinity or affinity of the 1.) hirin
representative of the hiring agency, that he/she has not been previously dismissed from government service by reason of an adm
that he/she has not already reached the compulsory retirement age of sixty five (65). Furthermore, the service rendered hereunde
or will never be accredited as government service. That the said appointee does not possess false eligibility.
Prepared by: Certified as to existence of available Recommending Approval:

appropriations / obligations:
JUAN DE LA CRUZ DINAH N. SALAZAR BERNIE L. LIBO-ON, Ph.D

Principal I Administrative Officer V OIC- Assistant Schools Division Superintendent
ntal
Indicate the Name of your School in CAPITAL LETTERS
OFFICE OF
ACKNOWLEDGEMENT
ASSIGNMENT
This Job Order is applicable only for the Watchman.
ewed. However, services of any or all of the above-

ices are no longer needed. The above-named hereby
nguinity or affinity of the 1.) hiring authority and of 2.)
ment service by reason of an administrative offense;
re, the service rendered hereunder is not considered
se eligibility.
Approved:
FELICIANO C. BUENAFE, JR., CESO VI Kindly indicate the Designation of the School Head, e.g.
OIC-Schools Division Superintendent Principal I, Principal II, Principal III, Head Teacher I - III.
Appendix 63
REQUISITION AND ISSUE SLIP
Entity Name: DEPARTMENT OF EDUCATION Fund Cluster: 07-001-08-06006
Division: Schools Division of Himamaylan City Responsibility Center Code1-01-101-101101

Office: Himamaylan CS RIS No.:
STOCK
REQUISITION ISSUE
AVAILABLE?
Stock No. Unit Description Qty Yes No Qty Remarks
Purpose:
Requested by: Approved by: Issued by: Received by:
Signature
Printed Name JUAN DE LA CRUZ 0
Designation Principal I School Property Custodian 0
Date
06006
-101101
REQUESTED BY and RECEIVED BY the TEACHER or END

USER or WHOEVER REQUESTED FOR IT.
Appendix 59
INVENTORY CUSTODIAN SLIP

Entity Name: DEPARTMENT OF EDUCATION
Fund Cluster: 07-001-08-06006 ICS No.:
AMOUNT ESTIMATED
INVENTORY
QUANTITY UNIT Unit Total DESCRIPTION USEFUL LIFE
ITEM No.
(In Years)
Cost Cost
Received from: Received by:
Signature Over Printed Name Signature Over Printed Name
Position / Office Position / Office

Date Date
Provide School Based ICS NO.
AUTHORITY TO TRAVEL
Date : January 01, 2018
Full Name of Personnel Signature Designation Office/Station

To: NAME OF
JUANA DE LA CRUZ 0
SCHOOL
NATURE OF TRAVEL :
FUND SOURCE :
INCLUSIVE DATE OF TRAVEL :
DESTINATION :
PURPOSE :
Recommending Approval: Approved By:
SCHOOL HEAD/ASDS ASDS/SDS

Appendix 45

--------------------------------------------------------------------
ITINERARY OF TRAVEL
Entity Name : DEPARTMENT OF EDUCATION

Fund Cluster: 07-001-08-06006
Name: Date of Travel:

Position Purpose of Travel:
Official Station
TIME Means of Per

Date Place to be visited Transportation Others TOTAL
Departure Arrival Transportation Diems
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
TOTAL -
Prepared by :
I certify that: (1) I have reviewed the

foregoing itinerary, (2) the travel is necessary to the
service, (3) the period covered is reasonable and (4)
the expenses claimed are proper. TEACHER/SCHOOL HEAD
Approved by :
JUAN DE LA CRUZ
SCHOOL HEAD/ASDS ASDS/SDS
Appendix 47
CERTIFICATION OF TRAVEL COMPLETED
Entity Name : DEPARTMENT OF EDUCATION Fund Cluster: 07-001-08-06006

OIC - Schools Division Superintendent Station
I HEREBY CERTIFY THAT I have completed the travel as authorized in the Travel
Order / Itinerary of Travel No. dated under conditions indicated below:
( x ) Strictly in accordance with the approved itinerary.
( ) Cut short as explained below. Excess payment in the amount Php

was refund on O.R. No. dated .
( ) Extended as explained below, additional itinerary was submitted.
( ) Other deviation as explained below.
Explanation or Justification:
Evidence of travel:
Travel Order, Certificate of Appearance, Itinerary of Travel, Tickets, Receipts, etc.
Respectfully submitted:
TEACHER/SCHOOL HEAD
On evidence and information of which I have the knowledge, the travel was actually
undertaken.
Approved:
JUAN DE LA CRUZ
SCHOOL HEAD/ASDS
ORDER OF PAYMENT
DepEd - Schools Division of Himamaylan City
January 31, 2018

Date
THE CASH COLLECTING OFFICER
Cash Unit
Please issue Official Receipt in favor of:
JUAN DE LA CRUZ
Name
in the amount of
ONLY (P0.00)
for payment of (be specifi PAYMENT OF REFUND OF 1ST QTR MOOE CASH ADVANCE
C.Y. 2018 OF Himamaylan CS, Himamaylan I.
Purpose
Cash Advance: ₱ 44,337.00

per Bill No. Amount Spent: (44,337.00)
dated Refund ₱ 88,674.00
Please deposit in the collections under/bank account/s
No. Name of Bank Amount
LBP (Treasury) ₱ 88,674.00

Accountant III
District: Himamaylan I
School: Himamaylan CS
Cash Advance: 44,337.00
Disbursement Voucher No.
Amount: (44,337.00)
Check / ADA No.:
Date of Check / ADA:
Type of Fund: MOOE C.Y. 2018
Journal Entry Voucher for payment of refund
ACCOUNT
ACCOUNTS TITLE DEBIT CREDIT
CODE
Cash Collecting Officer 10101010 - 00 ₱ 88,674.00
Advances for Operating Expense19901010 - 00 ₱ 88,674.00
Subsidy from National Government 40300 00 - 00 88,674.00

Cash Collecting Officer 10101010 - 00 88,674.00
TOTAL ₱ 88,674.00 ₱ 88,674.00
Current Year: Subsidy from National Government 40300000 - 00
Prior Years: Accumulated Surplus (Deficit) 30101010 - 00

Appendix 12
Serial No. :
NOTICE OF OBLIGATION REQUEST AND STATUS ADJUSTMENT
Date :
DEPARTMENT OF EDUCATION Fund Cluster 07-001-08-06006
For: DINAH N. SALAZAR

Administrative Officer V
Please adjust ORS No16-03-12546 dated 1/5/2018

due to the following changes:
Responsibility Center to
Particulars to
MFO / PAP to
Account Code to
Amount to
Please adjust ROAD dor excess/under obligation per attached

JEV No. 2017-01-025618dated 1/5/2017
Prepared by: Approved by:

Senior Bookkeeper - HIMAMAYLAN I Accountant III
Certified Correct: Verified by:
JUAN DE LA CRUZ DINAH N. SALAZAR

Principal I Administrative Officer V

NEW MOOE PS Blank Forms 2018 For Himamaylan Division

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LIQUIDATION REPORT Serial No.

For the Period: 3RD QTR. C.Y. 2018 Date:

Entity Name : DEPARTMENT OF EDUCATION Responsibility Center Code:

To Liquidate the 3RD QTR. MOOE CASH ADVANCE

TOTAL AMOUNT SPENT 44,337.00

AMOUNT OF CASH ADVANCE PER DV No.: dated: 44,337.00

AMOUNT OF REFUNDED O.R. No.: dated: 0.00

AMOUNT TO BE REIMBURSED 0.00

Certified : Correctness of the Certified: Purpose of Tavel / Certified: Supporting documen

RODNEL A. MONCERA EMMA GRACE T. MULETA, CB, CPA

Kindly Fill-up the DV number from your Disbursement

DEPARTMENT OF EDUCATION Fund Cluster :

TIN/Employee No.: ORS/BURS No.:

To payment of the 1ST QTR. MOOE CASH ADVANCE ₱0.00

Amount Due ₱0.00

BERNIE L. LIBO-ON, Ph.D

TOTAL 0.00 0.00

Subject to Authority to Debit Account (when applicable)

Accountant III OIC - Schools Division Superintendent

Indicate the purpose of Cash Advance and Breakdown the expenses

Responsibility Center MFO/PAP

Expenses UACs Object Code

₱0.00 OTHER GENERAL SERVICES 50212990 00

CASH DISBURSEMENTS REGISTER

1 01/01/16 101-01-00Name of School Head 0.00

CERTIFIED CORRECT: CERTIFIED SUPPORTING DOCUMENTS COMPLETE: NOTED:

JUAN DE LA CRUZ ROSEMARIE M. BALIGUAT, CB EMMA GRACE T. MULETA, CB, CPA

Republic of the Philippines

CASH DISBURSEMENTS REGISTER

CERTIFIED CORRECT: CERTIFIED SUPPORTING DOCUMENTS COMPLETE: NOTED:

JUAN DE LA CRUZ ROSEMARIE M. BALIGUAT, CB EMMA GRACE T. MULETA, CB, CPA

50205020-01 50212990-00 50203050-00

(17) (18) (19) (20)

Breakdown every transactions per OR #, RER #, DV #, Invoice #, etc.

T. MULETA, CB, CPA

50205020-01 50212990-00 50203050-00

(17) (18) (19) (20)

0.00 0.00 0.00 0.00

T. MULETA, CB, CPA

JOURNAL ENTRY VOUCHER JEV No.:________________

Entity Name: DEPARTMENT OF EDUCATION Date :

Cash, MDS - Regular 10104040 00 0.00

TOTAL 0.00 0.00

ROSEMARIE M. BALIGUAT, CB EMMA GRACE T. MULETA, CB, CPA

JOURNAL ENTRY VOUCHER JEV No.:________________

Entity Name: DEPARTMENT OF EDUCATION Date :

Cash, MDS - Regular 10104040 00 0.00

TOTAL 0.00 0.00

ROSEMARIE M. BALIGUAT, CB EMMA GRACE T. MULETA, CB, CPA

January 03, 2018

FELICIANO C. BUENAFE, JR., CESO VI

Travel Expenses ---------- ₱0.00

SPG President Teacher League President PTA President

BERNIE L. LIBO-ON, Ph.D

FELICIANO C. BUENAFE, JR., CESO VI

BUDGETARY REQUIREMENTS FOR THE QUARTER

- Travel Expenses ₱0.00

BERNIE L. LIBO-ON, Ph.D

CERTIFICATION OF NO UNLIQUIDATED CASH ADVANCE

To whom it may concern:

Name : JUAN DE LA CRUZ

This certification is issued for the above stated purpose/s only.

AUTHORITY TO CASH ADVANCE