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Please quote your lowest price on the item/s listed below, subject to the General Condition on the
Philippine Bidding Documents on Goods, stating the shortest time of delivery and submit your quotation duly
signed by your representative not later than ________________________.
VIGILUS D. CREDO
NOTE: BAC Chairman
1. ALL ENTRIES MUST BE TYPEWRITTEN
2. DELIVERY PERIOD WITHIN SEVEN (7) CALENDAR DAYS
3. WARRANTY SHALL BE FOR A PERIOD OF THREE (3) 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 THIRTY (30) CALENDAR DAYS
5. G-EPS REGISTRATION CERTIFICATE SHALL BE ATTACHED UPON SUBMISSION OF THE QUOTATION, IF AVAILABLE.
6. BIDDERS SHALL SUBMIT ORIGINAL BROCHURES SHOWING CERTIFICATIONS OF THE PRODUCT BEING OFFERED.
ITEM
ITEM & DESCRIPTION QTY. Unit Unit Price TOTAL
NO.
1 Canon Continuous Ink Flow System (CIS) 1 unit
2 Services CIS Installation 1 unit
Printed Name/Signature
Date
PURCHASE REQUEST
Tampilisan, Zamboanga del Norte
LGU
PR No.: Date:
Department: BAC SAI No.: Date:
Section: OR No. Date:
4,300.00
No.:
OBLIGATION REQUEST
PAYEE CLICK HAUS COMPUTER SALES & SERVICES
OFFICE
ADDRESS Baybay, Liloy Zamboanga del Norte
Responsibilit ACCOUN
PARTICULARS F.P.P AMOUNT
y Center T CODE
IT Equipment Php 3,850.00
No.:
OBLIGATION REQUEST
PAYEE CLICK HAUS COMPUTER SALES & SERVICES
OFFICE
ADDRESS Baybay, Liloy Zamboanga del Norte
Responsibilit ACCOUN
PARTICULARS F.P.P AMOUNT
y Center T CODE
IT Equipment Php 3,850.00
TOTAL Php 3,850.00
A. CERTIFIED: B. CERTIFIED:
Charges to appropriation/allotment necessary,
lawful and under my direct supervision Existence of available appropriation
Supporting documents valid, proper and legal
Signature Signature
Printed Date: Printed Date:
SHERRY LOU P. DAPROSA OLIVIA G. EBORDE
Name Name
Municipal Accountant Municipal Treasurer
Position Position
(Head,Accounting Unit/Authorized Representative) (Head,Treasury Unit/Authorized Representative)
APPROVED FOR PAYMENT: RECEIVED PAYMENT:
C D
Signature Check No.: Bank Name: Date:
Printed Date: Signature
ANGELES R. CARLOTO II
Name Printed Date:
NamHAUS COMPUTER SALES & SERVICES
CLICK
Municipal Mayor OR. No./Other Documents JEV No. Date:
Position
(Local Chief Executive/Authorized Representative)
ACCOUNTING ENTRIES
Responsibility Accounts and Explanation Account PR Amount
Center Debit Credit
T O T A L
Prepared by: Approved by:
JULITO P. LADEZA
Municipal Accountant
ACCOUNTING ENTRIES
T O T A L
Prepared by: Approved by:
JULITO P. LADEZA
Municipal Accountant
PURCHASE ORDER
Tampilisan, Zamboanga del Norte
LGU
Supplier CLICK HAUS COMPUTER SALES & SERVICES P.O. No.
Address Baybay, Liloy Zamboanga del Norte Date
Mode of Procurement:
Gentlemen:
Please furnish this office the following articles subject to the terms and conditions contained herein:
Date
(In case of Negotiated Purchase pursuant toSection 369 (a) of RA 7160, this portion must
be accomplished).
Certified Correct:
THIS IS TO CERTIFY that the requirements of R.A. No. 9184 otherwise known Total 3,850.00 Total 3,900.00 Total 4,000.00
as the Government Procurement Reform Act ( Rule XVI - Sec.52 ) had been complied with. WE HEREBY CERTIFY to the correctness and authenticity of the above Abstract
of Bids to the best of our knowledge.
-
INSPECTION ACCEPTANCE
Date Received:
Inspected, verified and found OK X Complete
as to quantity and specifications. Partial
LUCITO P. CERNA
Municipal Agriculturist
X
MARY JANE K. CALUMBA
CYNTHIA D. ABIL Property Custodian/ GSO Designate
RCO II
Inventory Estimated
Quantity Unit Description
Item No. Useful Life
1 pc. Flash Drive 8gb
1 pc. Power Supply 600W
Date Date
R e q ui s i t i o n Issuance
Stock No. Unit Description Quantity Quantity Remarks
unit Canon Continuous Ink Flow System (CIS) 1 1
Signature:
Printed Name: VIGILUS D. CREDO ANGELES R. CARLOTO II PRAXIDES C. ARCINO VIGILUS D. CREDO
Designation: Municipal Engineer Municipal Mayor Asst. Mun. Treasurer Municipal Engineer
Date: