APR FORM revised May 2015 FORM NO.

002
NAME AND ADDRESS OF AGENCY ACCT. CODE
REQUESTING AGENCY
AGENCY CONTROL No.
TEL. NOS.

AGENCY PROCUREMENT REQUEST PS APR No.

To: THE PROCUREMENT SERVICE

DBM Compound, RR Road (Date Prepared)
Cristobal St., Paco, Manila

PLEASE CHECK (√ ) APPROPRIATE BOX ON ACTION REQUESTED ON THE ITEM/S LISTED BELOW

[ ] Please issue common-use supplies/materials per Price List No. __________________________ dated _________________
Mode of delivery: [ ] Pick-up (Fast Lane) [ ] Pick-up (Schedule) [ ] Delivery (door-to-door)

In case fund is not sufficient:[ ] Reduce Quantity [ ] Bill Us [ ] Charge to Unutilized Deposit, APR No.:___________Dat

[ ] Please purchase for our agency non-common items. Attached herewith :

[ ] Complete Specifications [ ] Obligation Request (ObR) [ ] Others, pls. specify_______________
[ ] Certificate of Budget Allocation (CBA) [ ] Payment _______________________________

This form shall be prepared for requisitions of Common-Use goods from the PS Depots & Sub-Depots; and for orders
of Consumables & Non-Common Use Supplies from the PS Main.
ITEM For PS Main-Common Use Supplies, please use Form 001 R or Form 001 B
No. ITEM AND DESCRIPTION/SPECIFICATIONS/STOCK No. QUANTITY UNIT UNIT PRICE AMOUNT
1
2
3
4
5
6
7
8
9
10
11

TOTAL AMOUNT ₱ -
NOTE: ALL SIGNATURES MUST BE OVER PRINTED NAME
STOCKS REQUESTED ARE CERTIFIED TO BE FUNDS CERTIFIED AVAILABLE: APPROVED:
WITHIN APPROVED PROGRAM:

SDO/Property Custodian Cluster Bookkeeper School Head

[ ] FUNDS DEPOSITED WITH PS [ ] ___________________ CHECK No. ____________________

IN THE AMOUNT OF: ____________________________________________________________ (P _____________________) ENCLOSED
 Appendix 60

PURCHASE REQUEST
Entity Name: Fund Cluster: 01
PR No.: _________________ Date: ________________
Office /
Resposibility Center Code:
Section:
70010814003
Stock/ Property
No.
Unit Item Description Quantity Unit Cost Total Cost

Purpose:

Requested by: Approved by:

Signature: _________________________
Printed Name: __________________________
Designation: School Head
 Department of Education-Schools Division of Benguet

School

REQUEST FOR QUOTATION

Gentlemen:
Please quote your lowest possible price of the articles described hereunder to the Procurement service:
Please submit your quotation not later than on
Date of Delivery:
Price validity:

Bidders Specification
Purchaser's (Please include detailed
Item No. Quantity Unit Unit Cost Total Amount ABC
Specifications brand/ specifications in the
space provided)

Please avoid erasure/s, if unavoidable, pls. affix your initials on all erasures.

School Head

We propose and guarantee to supply and deliver any or all items in conformity with the specification and at the price/s we have quoted.

Company Name (as written in the Official Receipt)

Name and Signature:

Address
Tel No.:
Fax No.:
 Department of Education-Schools Division of Benguet

ABSTRACT OF BIDS

School
ABSTRACT OF BID OF QUOTATION RECEIVED UNDER CIRCULAR PROPOSAL NO. ________ DATED __________ OPENED ON
_____________________ at the .
NAME OF BIDDERS
QUAN ARTICLES AND
ITEM UNIT
TITY DESCRIPTION
Unit Cost Total Cost Unit Cost Total Cost Unit Cost Total Cost

We hereby certify that the bids of quotation received were open at the Award is hereby given to the bidders for items checked in red ink.
date and hour indicated and the prices offered are stated below. Price quoted being the lowest and the most advantageous to the government

Member Member School Head / BAC Chairman

Member Alternate Member

 PURCHASE ORDER

School

Supplier: P.O. No.:

Address: Date:
TIN: Mode of Procurement: Shopping

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/
Property Unit Description Quantity Unit Cost Amount
No.

-
(Total Amount in Words)

In case of failure to make 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.

Conforme: Very Truly Yours,

___________________________
Signature over Printed Name of Supplier ___________________________________
School Head
_________________________________
Date

Fund Cluster: 01 ORS/BURS No. : ______________________

Funds Available: Date of the ORS/BURS: _______________
Amount : ____________________________

_______________________
Cluster Bookkeeper