Region V

w v is io n m c a m a i o n i s in m
Freedom Sports Complex, SanJose, POi, CamarinesSur **

Tele/Fax 477-83-54 ,

DIVISION MEMORANDUM NO. s.2018 V I Ml

'-2 1 OF
To : Assistant Schools Division Superintendents
CID and SGOD Chiefs
Unit/Section Heads
Education Program Supervisors
Public Schools District Supervisors
All Elementary and Secondary School Heads
All Others Concerned

q^ L /
from CECILLE BERNADETTE P. RIVERA, CESO V
Schools Division Superintendent C^°

Subject REVISED CHECKLIST OF SUPPORTING DOCUMENTS

Date August 1, 2018

Please be guided of the attached revised checklist o f supporting documents prescribed by the
COA. This shall be attached to the liquidation reports of cash advances granted starting August 1,2018
onwards.

Immediate and wide dissemination of this memorandum is desired.

 (Name of School)

C H E C K L IS T OF SUPPO R TING D O C U M EN TS
P A Y M E N T for SUPPLIES AND M A TER IALS
(with amount of less than 1k)

Payee:
School Acvitity:
Amount:
Check No.

No. Required Documents Date REMARKS

Disbursement Voucher
1 photo copy of check
2 Approved Purchase Request
3 Sales Invoice/ Official Receipt
4 Inspection and Acceptance Report
 (Name of School)

CHECKLIST OF SUPPORTING DOCUMENTS

PROCUREMENT OF GOODS-ALTERNATIVE MODE ADOPTED

Supplier:
Items/Goods Purchased:
Program/Activity/Purpose:
Duration:
Amount:
Check No:

No. Documents Date REMARKS

Disbursement Voucher
1 Photo copy of the check
2 Certification that the items/goods are included in the
approved APP-certified by the Supply Officer
and verified by the BAC Sec.
3 Approved Purchase Request
-date, number, other required data indicated
- duly stamped received by the BAC Secretariat
4 Activily/Project Proposal-if applicable
-date of preparation indicated
-duly certified by the end-user/coordinator
-approved by SDS if the amount is 50K and above or ASDS
if the amount is below 50K
-duly stamped received by the BAC Secretariat
5 Agency Procurement Request -
stamped11no stock available" or "not included in
price list”
6 BAC Resolution No.:
-recommending the approval of the adoption of the
alternative mode of procurement
7 Three Requests for Quotations (RfQ)-
7. a l.R fO of:
7.b 2. RfD of:
7.c 3, RfO of:
8 Abstract of Quotations and Award
- duly dated
-duly certified by the BAC
- declaration of the supplier with the lowest
quotation, indicated
9 Approved Purchase Order
-duly stamped received by COA
- date, number, delivery terms, etc. indicated
-duly stamped received by the supplier
-conformed/signed by Supplier, over printed name
10 Proof o f PhilGEPS Posting if amount exceeds P50K
lO.a l . RF Q
lO.b 2 . Resolution to Award (RTA)
lO.c 3. Notice o f Award (NOA)
lO.d 4. Purchase Order or Contract
lO.e 5. Notice to Proceed (NTP)
11 Delivery Receipt
-dated
-with itemized listings of the goods
- with printed name and signature of the Dep ED
official who received the items

Page 1 of 2
 12 Inspection and Acceptance Report
-date, number, etc. -indicated
-with itemized listing of the goods
13 Requisition Sc Issue Slip (RIS)
14 Picture of items purchased located in the school storage room
for purchase of office supplies
15 Official receipt/Sales invoice No:
16 BIR Withholding Tax Form- from sources (2306 and 2307)
ADDITIONAL REQUIREMENTS

FOR SEMI-EXPENDABLE ITEMS

(costing below P15,000)
17 Approved Project Proposal
18 Inventory Custodian Slip
19 Picture of semi-expendable items purchased

FOR SHIRTS/SPORTS UNIFORMS -

20 Specifications of the shirts/uniforms showing the color,
design, kind of letterings and other specifications
(this should be indicated in the PR)
21 Colored drawings or colored print-outs of the shirt/uniform
22 Certified distribution list of the t shirts/uniforms with the
following columnar headings : a) name, b) designation/
sports event, c) description/kind of uniform received.
d) quantity of item received, e) date received, f) signature

FOR CATERING SERVICE

23 Menu plan to be served for the entire duration of the
24 activity on a daily basis (this should be indicated in the PR and RFQ)
25 Daily inspection report indicating the actual set of menu served
26 Certified daily attendance sheet indicating the time in and
time out of attendees

FOR MEDICINES
27 License to Operate of the Drug Distributor
28 Certificates of Product Registrations of the medicines

FOR IDs
29 Certification from the Registrar/Admin Officer/Advisers as
to the number of enrollees

30 SUPPLIER’S LEGAL DOCUMENTS:

For Small Value Procurement:
Mayors Permit or BIR Certificate of Registration
Philgeps Registration Number
Income and Business Tax Returns (if amount exceeds P500K)
Omnibus Sworn Statement (if amount exceeds P50K)

For Shopping:
Mayor’s/Business Permit
Philgeps number

Submitted by: Verified by:

(School Head) (Bookkeeper)

Page 2 of 2
 (Name of School)

C H E C K L IS T OF SUPPO R TIN G D O C U M EN TS
PR O CUREM ENT OF GOODS FROM PS-DBM

Supplier:
Items/Goods Purchased:
Program/Activity/Purpose:
Duration:
Amount:
Check No:

No. Documents Date REMARKS

Disbursement Voucher
1 Photo copy of the check
2 Certification that the items/goods are included in the
approved APP-certified by the Supply Officer
and verified by the BAC Sec.
3 Agency Procurement Request -
4 Approved Purchase Order
-duly stamped received by COA
- date, number, delivery terms, etc. indicated
-duly stamped received by the DBM-PS
-duly conformed/signed by the DBM-PS
5 Delivery Receipt
-dated
-with itemized listings of the goods
- with printed name and signature of the Dep ED
official who received the items
6 Inspection and Acceptance Report
-date, number, etc. -indicated
-with itemized listing of the goods
7 Official receipt No:
8 Requisition & Issue Slip (RIS)
9 Inventory Custodian Slip (ICS) for non-consumable
supplies or small equipment
10 Picture of supplies/materials purchased located in the
school storage room

Submitted by: Verified by:

(School Head) (Bookkeeper)

 (Name of School)

CHECKLIST OF SUPPORTING DOCUMENTS

FUEL/GRASS CUTTING

Payee:
Duration of labor worked:
Amount:
Check No:

No. Date REMARKS

Disbursement Voucher
1 Photo copy of the check
2 Approved Pruchase Request
3 Certification that the items/goods are included in the
approved APP- certified by the Supply Officer
and BAC Sec.
4 Inspection and Acceptance Report
5 Official receipt of the gasoline
6 Official receipt of 2T oil, if applicable

Submtted by: Verified by:

(School Head) (Bookkeeper)

 (Name of School)

CHECKLIST OF SUPPORTING DOCUMENTS

LABOR/GRASS C U TTIN G

Payee:
Duration of labor worked:
Amount:
Check No:

No. Date REMARKS

Disbursement Voucher
1 Photo copy of the check
2 Approved Purchase Request
3 Pre and Post Inspection Report
4 Pictures taken before, during and after the grass
cutting were made (taken same position/angle/place)
5 Accomplishment report of the laborer
- signed by the laborer
-certified by the School Head
-specific date/s and areas where the grass cutting
were made, duly indicated

Dates Areas No. of Liters Used

6 RER
7 ID or CTC of the laborer

Submtted by: Verified by:

(School Head) (Bookkeeper)

 (Name of School)

CHECKLIST OF SUPPORTING DOCUMENTS

HAULING EXPENSES

Payee:
Goods/items hauled
Amount:
Check No:

No. Date REMARKS

I f the amount is IK or above:
Disbursement Voucher
1 Photo copy of the check
2 Approved Purchase Request
3 BAC Resolution No.:
-recommending the approval of the adoption of the
alternative mode of procurement
Three Requests for Quotations (RfQ)-
4.a l.R fQ of:
4.b 2. RfO of:
4.c 3. RfO of:
5 Abstract of Quotations and Award
-duly dated
-duly certified by the BAC
-declaration of the supplier with the lowest quotation
specifically indicated
6 Purchase Order/Contract of Agreement
-duly stamped received by COA
- date, number, delivery terms, etc. indicated
-duly atamped received by the supplier
7 Inspection and Acceptance Reporrt
8 official receipt/sales invoice (if any) OR No:
9 RER
10 Photo copy of the Driver’s License
11 Photo copy of the LTO registration
of the vehicle
12 Certified list of the items/goods hauled, showing their
quantities that warranted the hauling thereof
signed by the hired driver
13 Picture of hauled items situated inside the hired vehicle

I f the amount is below IK (for short-distance hauling,

upland and/or not passable roads)
Disbursement Voucher
1 Photo copy of the check
2 RER
-amounts in words and in figures written by payee
3 Accomplishment Report
4 Picture of hauled items

Submtted by: Verified by:

(School Head) (Bookkeeper)

 * j (Name of School)

REPAIRS AND M A IN TEN A N C E OF BUILDINGS

(materials only)

Supplier:
Items/Goods Purchased:
Type of building repaired/maintained;
Check No:
Amount:

No. Documents Date REMARKS

Disbursement Voucher
1 Photo copy of the check
2 Certification that the items/goods are included in the
approved APP- certified by the Supply Officer
and verified by the BAC Secretariat
3 Approved Purchase Request
-date, number, other required data indicated
- duly stamped received by the BAC Secretariat
4 Approved Program of Work
5 BAC Resolution No.:
-recommending the approval of the adoption of the
alternative mode of procurement
Three Requests for Quotations (RfQ)-
6.a l.R fQ o f:
6.b 2. Rft} of:
6.c 3. RfO of:
7 Abstract of Quotations and Award
-duly dated
-duly certified by the BAC
-declaration of the supplier with the lowest quotation
specifically indicated
8 Approved Purchase Order
-duly stamped received by COA
- date, number, delivery terms, etc. indicated
-duly atamped received by the supplier
-conformed/signed by Supplier, over printed name
9 Proof of PhilGEPS Posting if amount exceeds P50K
9.a l.RFQ
9.b 2. Notice of Award (NOA)
9.c 3. Notice to Proceed (NTP)
9.d 4. Purchase Order or Contract
10 Delivery Receipts DR NO:
-dated
-printed name and signature of the official who
received the items indicated
-with itemized listing of the procured goods
11 Inspection and Acceptance Report
-date, number, etc. -indicated
-.with the itemized listing of the goods

Page 1 of 2
 12 official receipt/sales invoices of supplier No:
13 BIR Withholding Tax Form-from Sources (2306 and 2307)
14 Report of Waste Materials
-specific action as to disposal of the waste materials
duly indicated (If waste/scrap materials reported in RWM
are re-used such as fence, extension etc. attach pictures

15 SUPPLIER’S LEGAL DOCUMENTS:

For Small Value Procurement:
Mayors Permit or BIR Certificate of Registration
Philgeps Registration Number
Income and Business Tax Returns (if amount exceeds P500K)
Omnibus Sworn Statement (if amount exceeds P50K)

Submitted by: Verified by:

(School Head) (Bookkeeper)
 (Name of School)

CHECKLIST OF SUPPORTING DOCUMENTS

REPAIRS AND MAINTENANCE OF SCHOOL BUILDINGS & FACILITIES
(LABOR)

Payee:
Duration of labor worked:
Type of Building/Facility repaired/maintained:
Check No:
Amount:

No. : Documents Date REMARKS

IF THE AM OUNT IS ABOVE 3K
Disbursement Voucher
1 Photo copy o f the check
2 Certification - as to inclusion in the approved APP
3 Copy o f the approved Program o f Work (POW)
4 Approved Purchase Request
5 BAC Resolution -recommending the adoption of
alternative mode o f procurement
6 Three Requests for Quotations (RfQ)
6.a RfO 1
6b RfO 2
6.c RfO 3
7 Abstract o f Quotations and Award
-duly dated
-duly certified by the BAC
-with the declaration of the labour with the
lowest quotation
8 Pakyaw Contract
-specific name o f project indicated
-specific dates of the number o f labor works duly indicated
-amount of labor cost indicated
-notarized on or before the 1st day of labor work
9 Labor Payroll (for 2 or more laborers)
10 Pre and Post Inspection Report-Division PFU Coordinator
11 Certificate o f Acceptance of the School Head
12 Pictures taken before, during and after repair
(taken in the same position/angle)
13 ID or CTC of the laborer

IF THE AMOUNT IS BELOW 3K (petty repairs)

Same requirement as above except:
- POW no longer required
- pre and post inspection report - School Facilities in-charge

Submitted by: Verified by:

(School Head) (Bookkeeper)

 (Name of School)

CHECKLIST OF SUPPORTING DOCUMENTS

REPAIR/MAl NTEN ANCE-EQUI PM EN T

Supplier:
Equipment repaired/maintained:
Check No:
Amount:

No. Documents Date REMARKS

Disbursement Voucher
1 Photo copy of the check
2 Approved Purchase Request
-date, number, other required data indicated
- duly stamped received by the BAC Secretariat
3 Copy of the Inventory Custodian Slip/ARE
4 Certification from the Property Custodian/Supply
Officer of the cause/s of the damages that will
warrant repair/maintenance
5 BAC Resolution No.:
-recommending the approval of the adoption of the
alternative mode of procurement
Three Requests for Quotations (RfQ)-
6.a 1. RfO o f :
6.b 2. RfO of:
6.c 3. RfO of:
7 Abstract of Quotations and Award
-duly dated
-duly certified by the BAC
-declaration of the supplier with the lowest quotation
specifically indicated
8 Approved Purchase Order
-duly stamped received by COA
- date, number, delivery terms, etc. indicated
-duly atamped received by the supplier
9 Official receipt/sales invoice of the supplier
10 BIR Withholding Tax Form-from Sources
11 Report of Waste Materials
-specific action as to disposal of the waste materials
duly indicated
12 Pre and Post Inspection Inspection Report
13 Warranty
14 LEGAL DOCUMENTS:
For Small Value Procurement
Mayor’s/Business Permit
Philgeps number
Income and Business Tax Returns
Omnibus Sworn Statement

Submitted by: Verified by:

(School Head) (Bookkeeper)

 (Name of School)

C H E C K L IS T OF SUPPOR TING D O CUM EN TS

R EIM BUR SEM EN T OF TR AVELIN G/TRAIN IN G EXPENSES

Payee:
Position/Designation:
Purpose of Travel:
Duration of Travel:
Amount:
Check No:

No. Required Documents Date REMARKS

Disbursement Voucher
1 duplicate copy of check
2 Original copy of the letter of invitation
of host/sponsoring agency/organization
3 Memorandum from SDS (if applicable)
4 Travel Order
5 Approved Itinerary of Travel
6 Certificate of Travel Completed
7 Original copy of Certificate of Appearance
with original initial of the activity coordinator
8 Official receipt for the registration fee
9 Office receipt for the hotel accomodation
if lodging cost exceeds P400.00
10 certification from the School Head as to
the absolute necessity of the cost of the
hotel accommodation if the lodging cost
exceeded the P 400.00 cost per day
11 Passenger copies of the bus/van tickets
12 paper/electronic plane tickets
13 boarding pass
14 terminal fee tickets
15 RER for taxi fare, motorboat, habal-habal

Affidavit of loss shall not be considered as appropriate replacement.

Submitted by: Verified by:

(School Head) (Bookkeeper)

 (Name of School)

C H E C K L IS T OF SUPPO R TIN G D O C U M EN TS
P A YM EN T OF POSTPAID INTERNET/ M OBILE PHONE

Payee:
Consumption Period/Billed Period:
Amount:
Check No:

No. Required Documents Date REMARKS

Disbursement Voucher
1 duplicate copy of check
2 Statement of Account
3 Official receipt

Submitted by: Verified by:

(School Head) (Bookkeeper)

 (Name of School)

C H E C K L IS T OF SUPPO R TIN G D O C U M EN TS
P A Y M E N T OF PREPAID INTERNET/ M OBILE PHONE

Payee:
Consumption Period/Billed Period:
Amount:
Check No:

No. Required Documents Date REMARKS

Disbursement Voucher
1 Duplicate copy of check
2 Official receipt
3 Actual used card

Submitted by: Verified by:

(School Head) (Bookkeeper)

 (Name of School)

C H E C K L IS T OF SUPPO R TING D O C U M EN TS
P A YM EN T OF TE LE P H O N E BILLS

Payee:
Billed period;
Amount:
Check No:

No. Required Documents Date REMARKS

Disbursement Voucher
1 duplicate copy of check
2 Statement of Account
3 Official receipt of telephone company
4 Certification by the Head Agency that all
National Direct Dial (NDD), natural
operator assisted calls and international
assisted calls are offcials calls

Submitted by: Verified by:

(School Head) (Bookkeeper)

 (Name of School)

C H E C K L IS T OF SUPPO R TING D O C U M EN TS
P A YM EN T OF ELEC TR IC BILL

Payee:
Consumption Period/Billed Period:
Amount:
Check No:

No. Required Documents Date REMARKS

Disbursement Voucher
1 duplicate copy of check
2 Statement of Account
3 Official Receipt
4 BIR Withholding Tax Form-from Sources

Submitted by: Verified by:

(School Head) (Bookkeeper)

 (Name of School)

C H E C K L IS T OF SUPPO R TING D O C U M EN TS
P A YM EN T OF W A TER C ON SUM PTIO N BILL

Payee:
Consumption Period/Billed Period:
Amount:
Check No:

No. Required Documents Date REMARKS

Disbursement Voucher
1 duplicate copy of check
2 Statement of Account
3 Official Receipt
4 BIR Withholding Tax Form-from Sources

Submitted by: Verified by:

(School Head) (Bookkeeper)

 (Name of School)

CHECKLIST OF SUPPORTING DOCUMENTS

FIDELITY BOND

Payee:
Amount:
Check No:
Effectivity date of the bond:
Risk No.
Amount of the bond:

No. Date REMARKS

Disbursement Voucher
1 Photo copy of the check
2 Confirmation letter (if available)
3 Authority to Accept Payment (ATAP)
4 Validated bank deposit

Submtted by: Verified by:

(School Head) (Bookkeeper)

 (Name of School)

CHECKLIST OF SUPPORTING DOCUMENTS

NOTARIAL FEES

Payee:
Amount:
Check No:

No. Date REMARKS

Disbursement Voucher
1 Photo copy of the check
2 Approved Purchase Request
3 Official receipt of the notary official/lawyer
4 Photo copy of the document notarized

Submtted by: Verified by:

(School Head) (Bookkeeper)

 (Name of School)

C H E C K L IS T OF SUPPO R TING D O CUM EN TS

P A YM EN T - TA R PA U LIN

Payee:
School Acvitity:
Amount:
Check No.

No. Required Documents Date REMARKS

If the amount is below IK
Disbursement Voucher
1 photo copy of check
2 Approved Purchase Request indicating
the school activity where the tarpaulin
will be used.
3 Official Receipt
4 Picture of the tarpaulin

I f the amount is IK or above:

Will follow the same procedure on regular
procurement process

Submitted by: Verified by:

(School Head) (Bookkeeper)

 (Name of School)

C H E C K L IS T OF SUPPO R TIN G D O C U M EN TS
P A Y M E N T OF JAN ITO R IA L/SEC U R ITY SERVICES

Payee:
Pay Period:
Amount:
Check No:

No. Required Documents Date Remarks

Disbursement Voucher
1 photo copy of check

For janitorial/ security services-

2 Job Order contract
3 Accomplishment report prepared and
signed by the laborer and verified by
the School Head - specifying the area
and rooms cleaned, and the dates
4 DTR
5 RER
-amounts in words and in figures written by payee

For General Services -

(procured on some cases only, such as
cutting of tree branches after typhoon,
removal of debris after typhoon, etc.)
1 Disbursement Voucher
2 photo copy of check
3 Purchase Request
4 Accomplishment Report
5 RER
-amounts in words and in figures written by payee

Submitted by: Verified by:

(School Head) (Bookkeeper)

 (Name of School)

CHECKLIST OF SUPPORTING DOCUMENTS

REIMBURSEMENT-PHOTO COPYING OF DOCUMENTS

Payee:
Amount:
Check No:

No. \ DOCUMENTS Date REMARKS

IF THE AMOUNT IS 1,000 AND BELOW
Disbursement Voucher
1 Photo copy o f the check
2 Certification that the items/goods are included in the
approved APP-certified by the Supply Officer
and verified by the BAC Sec.
3 Approved Purchase Request
-date, number, other required data indicated
- duly stamped received by the BAC Secretariat
- description, no. of pages & copies duly indicated
4 Inspection and Acceptance Report
- duly dated
-quantities of test papers per subject-indicated
5 Official receipts OR No:
6 BIR Withholding Tax Form-from Sources (2306/ 2307)
7 Distribution list duly received by subject teacher s/advisers

IF THE AMOUNT IS MORE THAN PI,000.00

8 BAC Resolution No..

-recommending the approval o f the adoption o f the
alternative mode o f procurement
9 Three Requests for Quotations (RfQ)-
9.a l .R f Q o f :
9.b 2. RfO of:
9.c 3. RfO of:
10 Abstract o f Quotations and Award
-duly dated
-duly certified by the BAC
-declaration o f the supplier with the lowest quotation
specifically indicated
11 Approved Purchase Order
-duly stamped received by COA
- date, number, delivery terms, etc. indicated
-duly atamped received by the supplier
-conformed/signed by Supplier, over printed name

Page 1 of 2
 12 LEGAL DOCUMENTS:
For Small Value Procurement
Mayor’s/Business Permit
Philgeps number
Income and Business Tax Returns
Omnibus Sworn Statement

Submtted by: Verified by:

(School Head) (Bookkeeper)

Page 2 of 2