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Republic of the Philippines

PROVINCIAL GOVERNMENT OF SAMAR


Catbalogan City, Samar

PURCHASE REQUEST
PR No.
Department
Date:
SAI No.
Office/Section
Alobs No.
Item QTY Unit Issue Description Unit Price Total

x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x

GRAND TOTAL ₱0.00


Purpose For Provincial Assessor's Office Use

Signature

Name

Designation Requisitioning Officer/Provincial Assessor Provincial Governor

Date
Republic of the Philippines
PROVINCIAL GOVERNMENT OF SAMAR
Catbalogan City, Samar

PURCHASE REQUEST
PR No.
Department OFFICE OF THE GOVERNOR
Date:
SAI No.
Office/Section
Alobs No.
Item QTY Unit Issue Description Unit Price Total

Steel Filing Cabinet Lateral (4


1 2 unit ₱21,050.00 ₱42,100.00
drawers)
Steel Filing Cabinet Vertical (4
2 2 unit ₱17,560.00 ₱35,120.00
drawers)

------------------------------------------------------ nothing follows ------------------------------------------------------

GRAND TOTAL ₱77,220.00


Purpose For Provincial Assessor's Office Use

Signature

Name ALEJO P. QUITALIG SHAREE ANN T. TAN

Designation Requisitioning Officer Provincial Governor

Date
Republic of the Philippines
PROVINCIAL GOVERNMENT OF SAMAR
Catbalogan City, Samar

PURCHASE REQUEST
PR No. 2018-11-01
Department Provincial Assessor's Office
Date: November 15, 2018
SAI No.
Office/Section
Alobs No.
Item QTY Unit Issue Description Unit Price Total

1 10 bottles Black Printer Ink (70 mL) ₱320.00 ₱3,200.00

Yellow Colored Printer Ink (70


2 10 bottles ₱320.00 ₱3,200.00
mL)

Cyan Colored Printer Ink (70


3 10 bottles ₱320.00 ₱3,200.00
mL)

Magenta Colored Printer Ink (70


4 10 bottles ₱320.00 ₱3,200.00
mL)

5 30 bottles Black Pigmented Ink (70 mL) ₱825.00 ₱24,750.00

--------------------------------------------------- nothing follows ---------------------------------------------------

GRAND TOTAL ₱37,550.00


Purpose For Provincial Assessor's Office Use

Signature

Name ATTY. ERICSON MABAO, RN, REA SHAREE ANN T. TAN

Designation Requisitioning Officer/Provincial Assessor Provincial Governor


Date
Republic of the Philippines
PROVINCIAL GOVERNMENT OF SAMAR

PURCHASE REQUEST
PR No. 2018-11-02
Department Provincial Assessor's Office
Date: November 22, 2018
SAI No.
Office/Section
Alobs No.
Item QTY Unit Issue Description Unit Price Total

1 250 pieces Book Cover with Bolts (Maroon) ₱680.00 ₱170,000.00

2 130 pieces Bolts (2") ₱28.00 ₱3,640.00


--------------------------------------------------- nothing follows ---------------------------------------------------

GRAND TOTAL ₱173,640.00


Purpose For Provincial Assessor's Office Use (General Revision of Real Property Units)

Signature

Name ATTY. ERICSON MABAO, RN, REA SHAREE ANN T. TAN

Designation Requisitioning Officer/Provincial Assessor Provincial Governor

Date