11/29/2018 Untitled Document

CENTRAL LUZON DOCTORS` HOSPITAL EDUCATIONAL INSTITUTION, INC.

Romulo Highway, San Pablo, Tarlac City, Tarlac

RECEIVING REPORT RR No. D-00011-2

DATE
Supplier : IX-XI HARDWARE : 2/2/2015 P.O. NO. P-000040-3

Address : Block 8 San Nicolas, Tarlac City Inv. No/Del. R. No 08366,08362

Date of Invoice/ Actual Receipt 1/30/2015 Terms

QTY UNIT CODE ITEM / PARTICULARS / DESCRIPTION EXP. DATE UP AMOUNT

1.0 PC(s) 105-00383 GI PIPE, 2" / DIAMETER X 20 FT S-40 3,515.00 3,515.00

3.0 PC(s) 105-00396 GI ELBOW, 2" / DIAMETER 133.00 399.00

1.0 PC(s) 105-00368 GI TEE, 2" / DIAMETER 174.00 174.00

2.0 PC(s) 105-00417 GI BUSHING, 2" X 1" / - 92.00 184.00

2.0 PC(s) 105-00389 GI NIPPLE, 2" / DIAMETER X 3" 40.00 80.00

2.0 PC(s) 105-00362 GI UNION PATENTE, 2" / DIAMETER 272.00 544.00

2.0 PC(s) 105-00364 GI UNION PATENTE, 1" / DIAMETER 96.50 193.00

1.0 PC(s) 105-00385 GI PIPE / DIAMETER X 20 FT S-40 1,594.00 1,594.00

2.0 PC(s) 105-00399 GI ELBOW, 1" / DIAMETER 44.00 88.00

3.0 PC(s) 105-00392 GI NIPPLE, 1" / DIAMETER X 3" 21.00 63.00

2.0 PC(s) 105-00392 GI NIPPLE, 1" / DIAMETER X 2" 17.50 35.00

3.0 PC(s) 105-00392 GI NIPPLE, 1" / DIAMETER X 4" 29.80 89.40

10.0 PC(s) 105-00455 TEFLON TAPE 3/4 / - 25.00 250.00

2.0 PC(s) 105-00456 GASKET SHELAC / - 75.00 150.00

4.0 PC(s) 105-00471 GI COUPLING / 2" 100.00 400.00

3.0 PC(s) 105-00470 AIR VOLUME CONTROL / - 1,200.00 3,600.00

Received By : Verified By: Certified Correct By :

Rodelio Salvador Randell Tabaquero Mrs. Sonia P. Quirino

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