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Division: RIS No.

Office: SAI No.


Stock No. Unit
ltrs diesel fuel
xxxxxxxxxxx nothing follows xxxxxxxxxxxx
Atty.Isagani D.Cuello
R E Q U I S I T I O N ISSUANCE
Description Quantity Quantity Remarks
REQUISITION AND ISSUE SLIP
DEPARTMENT OF AGRARIAN REFORM, NEGROS OCCIDENTAL
(Agency)
Responsibility Center Code Office of the PARAD
DAR
Printed Name:
For the use of RP service vehicle with plate no.WCN-821
Requested by: Approved by:
Purpose:
Received by: Issued by:
Designation:
Date:
ISSUANCE
Remarks
REQUISITION AND ISSUE SLIP
DEPARTMENT OF AGRARIAN REFORM, NEGROS OCCIDENTAL
(Agency)
For the use of RP service vehicle with plate no.WCN-821
Received by:
Department of Agrarian Reform Date:
Section PARAD SAI No. Date: 12/3/2013
Date:
Quantity Unit of Issue Stock No.

25 pax

25 pax


Purpose:

PR No. ______________________
ALOBS NO.:
Printed Name:
Designation
2 snacks and 3 meals with lodging for 1 day
Thursday, December 05, 2013
xxxxxxxxxxxx nothing follows xxxxxxxxx
To be served to more or less 25 pax for the
Signature


Unit Cost
PURCHASE REQUEST
DEPARTMENT OF AGRARIAN REFORM, NEGROS OCCIDENTAL
(Agency)
Remarks
2 snacks and 3 meals with lodging for 1 day
No.


ITEM DESCRIPTION Estimated Cost Estimated
Requested by:
ATTY. SALVACION TAN-VENUS
PARAD-South
Approved by:
LUCRECIA TABERNA
PARO II-South
Mass-Processing with the Operations Division
(Redoc unit) for the issuance of individual
CLOAs to FBs and FWBs.
Wednesday, December 04, 2013



PURCHASE REQUEST
DEPARTMENT OF AGRARIAN REFORM, NEGROS OCCIDENTAL
(Agency)
Remarks

Estimated Cost
Approved by:
LUCRECIA TABERNA
PARO II-South
Supplier : AR NO. _______________________
P.O. NO. : Date: Invoice No. Date _____________
Requisition Office/Dept. PARAD, NEGROS OCCIDENTAL
ITEM NO.
8/23/2013
Lunch
xxxxxxxxnothing followsxxxxxxxxx



Date Inspected: 23-Aug-13 Date Received:
Inspected, verified and found OK Complete
as to quantity and specifications
Partial
pax
pax
INSPECTION & ACCEPTANCE REPORT
DEPARTMENT OF AGRARIAN REFORM, NEGROS OCCIDENTAL
(Agency)
AM snacks 100
DESCRIPTION UNIT QUANTITY

To be served to more or less 100 pax for the PARAD on wheels
20
Pm snacks 100
activity
PARAD-South
RHEA B. HIPONIA
Inspection Officer
ATTY. SALVACION TAN-VENUS
pax

I N S P E C T I O N A C C E P T A N C E

Payee
Office
Address
Responsibility Account
Center Code
Certified Certified
Charges to appropriation/allotment necessary,lawful Supporting documents complete and proper. Allotment available and obligated for the purpose
and under my direct supervision as indicated above
Supporting documents valid, proper and legal
Signature Signature
Printed Printed
Name Name
Date: Date:
The FOREST PARK RESORT
Bacolod City
Particulars P.P.A
Republic of the Philippines
DEPARTMENT OF AGRARIAN REFORM
Provincial Agrarian Reform Office
Negros Occidental
OBLIGATION REQUEST
Total
For obligation of services rendered for more
or less 25 pax for the mass-processing with
the Operations Division-Redoc Unit on
December 4-5, 2013 in the total amount of
SIXTY THOUSAND PESOS ONLY ---------------
EVELYN Q. COLIMBO LEONY M. LAMELA
Position:
CARPO-ADMIN & FINANCE
Position:
OIC-Budget Officer
Head, Requesting Office/Authorized Representative Head,Budget Unit/Authorized Representative
A
B
No.
PhP 60,000.00
Allotment available and obligated for the purpose
The FOREST PARK RESORT
Bacolod City
Amount
Republic of the Philippines
DEPARTMENT OF AGRARIAN REFORM
Provincial Agrarian Reform Office
Negros Occidental
PhP 60,000.00
LEONY M. LAMELA
OIC-Budget Officer
Head,Budget Unit/Authorized Representative
MODE OF PAYMENT No.:
MDS check Commercial Check ADA Others Date:
Payee/ Office: TIN/ Employee No.: OS/ BUS No.:
Responsibility Center: Date:
Address: Title: Code:
To payment of food and accommodation rendered on account
of Mass-processing with the Operations Division - Redoc Unit on
December 4-5, 2013 as per statement of account attached in the Php 60,000.00
amount of ------------------------------------------------------------------------
Amount Due: Php 60,000.00
A. Certified: Supporting documents complete and proper. B. Approved for payment:
Cash available
Subject to ADA (where applicable)
Signature: ___________________________ Signature:
Printed Name: ________________________ Printed Name:
Position: Position: PARO II
(Head, Accounting Unit/ Authorized Representative)
Date: Date:
C. Received Payment: Check/ ADA No.:___________ D. Journal Entry Voucher
Date:____________________
Signature: _____________________ __________________________ Bank Name:_______________ No.: ______________
OR No./ Other relevant document
Printed Name: THE FOREST PARK RESORT issued: ____________________ Date: ______________
Accountant II Provincial Agrarian Reform Officer II
(Agency Head/ Authorized Representative)
THE FOREST PARK RESORT
Bacolod City
Particulars
Amount
MERCY C. CABAYAO LUCRECIA S. TABERNA
Republic of the Philippines
DEPARTMENT OF AGRARIAN REFORM
Provincial Agrarian Reform Office
Negros Occidental
DISBURSEMENT VOUCHER
Supplier GONZALES NEWSPAPER AGENCY P.O No.
Address: Lanzones St., Capitol Heights, Bacolod City Date : June 1, 2013
Mode of Procurement
Gentlemen: Subscription agreement
Place of Delivery: PARAD Neg. Occ. Delivery Term:
Date of Delivery: Payment Term:
Item No. Unit Quantity D E S C R I P T I O N UNIT COST AMOUNT
1. pcs 19 Newspaper Philippine Star June 1-30, 2013
issues national 26.00 494.00
2. pcs 19 Newspaper Philippine Inquirer June -30, 2013
issues national 23.00 437.00
3. pcs 19 Newspaper Visayan Daily Star June 1-30, 2013
issues local 12.00 228.00
1,159.00
x - - - - - - - nothing follows - - - - - - - - - x vvvvvvvvvvvvv
For official use of PARAD office Negros Occidental Re: for
information on current news, events happenings, gov't. orders/
issuances and other issues on various agrarian related cases.
( 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 to every day of delay shall be imposed.
Conforme: Very truly yours,
____________________________
(Signature over printed name) ENRIQUE C. PADERES DR. DEV.
_____________________________ (Authorized Official)
(Date)
Requisitioning Office/Dept. Funds Available: Amount: _____________________
MERCY C. CABAYAO ALOBS NO. ____________________
Chief Accountant Authorized Official
ATTY. ISAGANI D. CUELLO
Please furnish this office the following articles subject to the terms & conditions contained herein:
PURCHASE ORDER
Department of Agrarian Reform, Negros Occidental
(Agency)