QSU-PROC-F001 Rev. 00 (Feb. 11, 2019)

Republic of the Philippines
QUIRINO STATE UNIVERSITY

Diffun Quirino
PURCHASE REQUEST
Entity Name: QUIRINO STATE UNIVERSITY Fund Cluster: ________________
Office/Section : PR No.: ______________ Date: ____________

Responsibility Center Code : ___________
Stock/
Unit Item Description Quantity Unit Cost
Property No.
meter/s Flat Cord AWG Wire 1.6mm Ø 50.00 45.00

pcs Heavy Duty Faucet 1/2"Ø Copper 40.00 350.00
pcs Electrical Tape - big 20.00 50.00
pcs Thread Seal Tape - big 5.00 150.00
pcs LED Bulb 9 watts 30.00 200.00
bottles WD-40 Anti Rust Lubricant 3.00 250.00
pcs 1/2" x 1/2" Angle Valve 10.00 300.00
pcs Lavatory Hose 1/2"x1/2"x1' 5.00 250.00
pcs Lavatory Hose 1/2"x1/2"x2' 5.00 250.00
TOTAL:
Purpose:
Materials for the repair of Comfort Rooms for accreditation purposes.
Requested by: Approved by:

Signature :
Printed Name :
CRISTOBAL B. LASLAS SAMUEL O. BENIGNO, Ph.D.
Designation : Repair & Maintenance Engineer President
QSU-PROC-F001
Rev. 00 (Feb. 11, 2019)
_____________
___________
Total Cost
2,250.00
14,000.00
1,000.00
750.00
6,000.00
750.00
3,000.00
1,250.00
1,250.00
30,250.00
by:
BENIGNO, Ph.D.
dent
QSU-PROC-F001
Rev. 00 (Feb. 11, 2019)
Diffun Quirino
PURCHASE REQUEST

Stock/
Property No.
pcs Goose Faucet 5.00 350.00

pcs Faucet heavy duty 15.00 250.00
pcs 3/4" 90 deg elbow PPR 10.00 180.00
set PVC Door 0.7mx2.10m with Jamb 9.00 7,500.00
set Cubicle Door with Jamb 9.00 5,500.00
set Water Closet 20.00 10,000.00
set Urinal 4.00 5,500.00
pcs P-Trap 9.00 95.00
pcs Host 2' 10.00 150.00
pcs Angle Valve 1/2" x 1/2" 11.00 280.00
pcs Bidet 7.00 265.00
pcs Floor Drain 16.00 95.00
pcs PVC orange 3" 5.00 210.00
pcs Lavatory Faucet 10.00 280.00
pcs Mirror Glass ( 0.60m x 0.60m ) 10.00 450.00
TOTAL:
Purpose:
Improvement of CR in Campus

Signature :
Printed Name :
DENNIS S. OPIANO SAMUEL O. BENIGNO, Ph.D.
Designation : OIC Director-Physical Plant & Site President
Development
QSU-PROC-F001
Rev. 00 (Feb. 11, 2019)
_____________
___________
Total Cost
1,750.00
3,750.00
1,800.00
67,500.00
49,500.00
200,000.00
22,000.00
855.00
1,500.00
3,080.00
1,855.00
1,520.00
1,050.00
2,800.00
4,500.00
-
363,460.00
by:
BENIGNO, Ph.D.
dent
QSU-PROC-F001
Rev. 00 (Feb. 11, 2019)
Diffun Quirino
PURCHASE REQUEST

Stock/
Property No.
Labor to Undertake the following

scope of works:
sq.m. Demolition works 63.00 70.00
sq.m. Ceiling works 63.00 280.00
sq.m. Painting works 63.00 90.00
TOTAL:
Purpose:
Labor for the Repair of Ceiling of An.Sci. Building.

Signature :
Printed Name :
JAYPEE ANGELO P. MANUEL SAMUEL O. BENIGNO, Ph.D.
Designation : Staff-Physical Plant & Site Development President
QSU-PROC-F001
Rev. 00 (Feb. 11, 2019)
_____________
___________
Total Cost
4,410.00
17,640.00
5,670.00
27,720.00
by:
BENIGNO, Ph.D.
dent
QSU-PROC-F001
Rev. 00 (Feb. 11, 2019)
Diffun Quirino
PURCHASE ORDER
Supplier: _____________________________________________ P.O. No. : _____________________

Address: _____________________________________________ Date : _______________________
TIN : Mode of Procurement :
Gentlemen:
Please furnish this Office the following articles subject to the terms and conditions cont
herein:
Place of Delivery : QUIRINO STATE UNIVERSITY - MAIN CAMPUS Delivery Term : __________________
Date of Delivery : ________________________________ Payment Term : __________________
Stock/
Property Unit Description Quantity Unit Cost
No.
TOTAL:
(Total Amount in Words):
In case of failure to make the full delivery within the time specified above, a penalty of one-tenth
of one percent for every day of delay shall be imposed on the undelivered item/s.
Conforme: Very truly yours,
__________________________ SAMUEL O. BENIGNO, Ph.D.

QSU-PROC-F002
Rev. 00 (Feb. 11, 2019)
Signature over Printed Name of Supplier President
___________________________
Date
Fund Cluster : ___________________________________ ORS/BURS No. : ________________

Funds Available : _________________________________ Date of the ORS/BURS: ___________
Amount : _____________________
Signature over Printed Name of Chief

Accountant/Head of Accounting Division/Unit
QSU-PROC-F002
Rev. 00 (Feb. 11, 2019)
ublic of the Philippines
INO STATE UNIVERSITY
Diffun Quirino
PURCHASE ORDER
P.O. No. : _____________________

Date : _______________________
Mode of Procurement :
ollowing articles subject to the terms and conditions contained
Delivery Term : __________________

Payment Term : __________________
Amount
ry within the time specified above, a penalty of one-tenth (1/10)

imposed on the undelivered item/s.
SAMUEL O. BENIGNO, Ph.D.

QSU-PROC-F002
Rev. 00 (Feb. 11, 2019)
President
ORS/BURS No. : ________________

Date of the ORS/BURS: ___________
Amount : _____________________
QSU-PROC-F002
Rev. 00 (Feb. 11, 2019)
Diffun Quirino
PURCHASE REQUEST

Stock/
Property No.

scope of works:
cu.m. Excavation works 21.00 1,250.00
cu.m. Concrete works 3.00 1,250.00
sq.m. Masonry works 60.00 250.00
sq.m. Painting works 60.00 90.00
TOTAL:
Purpose:
Labor for the Construction of Plant Box in front of ICT Academic Building.

Signature :
Printed Name :
JAYPEE ANGELO P. MANUEL SAMUEL O. BENIGNO, Ph.D.
QSU-PROC-F001
Rev. 00 (Feb. 11, 2019)
_____________
___________
Total Cost
26,250.00
3,750.00
15,000.00
5,400.00
50,400.00
g.
by:
BENIGNO, Ph.D.
dent
QSU-PROC-F001
Rev. 00 (Feb. 11, 2019)
Diffun Quirino
PURCHASE REQUEST

Stock/
Property No.

scope of works:
cu.m. Concrete Works 2.56 2,500.00
TOTAL:
Purpose:
Labor for the Construction of Study Area

Signature :
Printed Name :
ELYZAR R. RICO SAMUEL O. BENIGNO, Ph.D.
QSU-PROC-F001
Rev. 00 (Feb. 11, 2019)
_____________
___________
Total Cost
6,336.00
6,400.00
-
12,736.00
by:
BENIGNO, Ph.D.
dent
QSU-PROC-F001
Rev. 00 (Feb. 11, 2019)
Diffun Quirino
PURCHASE ORDER
Supplier: Rogelio C. Dumalina P.O. No. : _____________________

Address: Ma. Clara, Diffun, Quirino Date : _______________________
TIN : 265-388-302 Mode of Procurement :
Gentlemen:
Please furnish this Office the following articles subject to the terms and conditions cont
herein:
Place of Delivery : QUIRINO STATE UNIVERSITY - MAIN CAMPUS Delivery Term : __________________
Date of Delivery : ________________________________ Payment Term : __________________
Stock/
Property Unit Description Quantity Unit Cost
No.
Labor to Undertake the following scope
of work:
cu.m. Concrete Works 2.56 2,500.00
TOTAL:
(Total Amount in Words): Twelve Thousand Five Hundred Forty Four pesos only.
In case of failure to make the full delivery within the time specified above, a penalty of one-tenth
of one percent for every day of delay shall be imposed on the undelivered item/s.
Conforme: Very truly yours,
__________________________ SAMUEL O. BENIGNO, Ph.D.

QSU-PROC-F002
Rev. 00 (Feb. 11, 2019)
Signature over Printed Name of Supplier President
___________________________
Date
Fund Cluster : ___________________________________ ORS/BURS No. : ________________

Funds Available : _________________________________ Date of the ORS/BURS: ___________
Amount : _____________________
Signature over Printed Name of Chief

Accountant/Head of Accounting Division/Unit
QSU-PROC-F002
Rev. 00 (Feb. 11, 2019)
ublic of the Philippines
INO STATE UNIVERSITY
Diffun Quirino
PURCHASE ORDER
P.O. No. : _____________________

Date : _______________________
Mode of Procurement :
ollowing articles subject to the terms and conditions contained
Delivery Term : __________________

Payment Term : __________________
Amount
6,144.00
6,400.00
12,544.00
ry within the time specified above, a penalty of one-tenth (1/10)

imposed on the undelivered item/s.
SAMUEL O. BENIGNO, Ph.D.

QSU-PROC-F002
Rev. 00 (Feb. 11, 2019)
President
ORS/BURS No. : ________________

Date of the ORS/BURS: ___________
Amount : _____________________
QSU-PROC-F002
Rev. 00 (Feb. 11, 2019)
Diffun Quirino
PURCHASE REQUEST

Stock/
Property No.
1 pcs. 1-1/2"Ø Stainless Steel Pipe schd 40 6.00 2,100.00

2 pcs. 3/4" Ø Stainless Steel Pipe schd 40 8.00 1,600.00
3 box 1/4 Stainles Steel Electrode 1.00 950.00
4 box Grinding Disc 4" 1.00 3,500.00
5 box Cutting Disc (105x1x16mm) 1.00 2,800.00
Paper Grinding Disc (flap disc
6 pcs. 100x16mm) 10.00 280.00
7 Stainless steel wall mount staircase
pcs. Buping Disc (100x16mm) 10.00 350.00
handrail bracket w/ base plate cover 1-
8 pcs. 1/2" 3.00 2,000.00
9 pcs. Round End Cap stainless steel (1-1/2 4.00 200
10 l.s. Labor ( 35% of the Material Cost) 1.00 16,012.50
TOTAL:
Purpose:
For the Stair Railings of Administration Building, Cabarroguis Campus, Cabarroguis Quirino.

Signature :
Printed Name :
BALTAZAR G. DAMANCE SAMUEL O. BENIGNO, Ph.D.
Designation : OIC-Campus Administrator President
QSU-PROC-F001
Rev. 00 (Feb. 11, 2019)
_____________
___________
Total Cost
12,600.00
12,800.00
950.00
3,500.00
2,800.00
2,800.00
3,500.00
6,000.00
800.00
16,012.50
61,762.50
uis Quirino.
by:
BENIGNO, Ph.D.
dent
QSU-PROC-F001
Rev. 00 (Feb. 11, 2019)
Diffun Quirino
PURCHASE REQUEST

Stock/
Property No.
pcs .40mx.40m unglazed tile ( floor tile) 438.00 125.00

pcs .40mx.40m unglazed tile ( wall tile) 635.00 125.00
bag Tile Grout 20.00 120.00
bag ABC Tile Adhesive Cement 30.00 280.00
bag Cement 114.00 265.00
cu.m. Sand 11.00 600.00
TOTAL:
Purpose:

Signature :
Printed Name :
Development
QSU-PROC-F001
Rev. 00 (Feb. 11, 2019)
_____________
___________
Total Cost
54,750.00
79,375.00
2,400.00
8,400.00
30,210.00
6,600.00
181,735.00
by:
BENIGNO, Ph.D.
dent
QSU-PROC-F001
Rev. 00 (Feb. 11, 2019)
Diffun Quirino
PURCHASE REQUEST

Stock/
Property No.
pcs 1/4" Marrine Plywood 16.00 450.00

box 5/32" Blind Rivet 2.00 280.00
pcs Metal Drillbit 5.00 120.00
pcs Bulb 25 Watts 5.00 350.00
pcs Door Knob (kwikset) 13.00 1,100.00
pcs LED Light 12.00 800.00
pcs Switch one Gang 12.00 250.00
roll Electrical Tape big 5.00 55.00
TOTAL:
Purpose:

Signature :
Printed Name :
Development
QSU-PROC-F001
Rev. 00 (Feb. 11, 2019)
_____________
___________
Total Cost
7,200.00
560.00
600.00
1,750.00
14,300.00
9,600.00
3,000.00
275.00
37,285.00
by:
BENIGNO, Ph.D.
dent
QSU-PROC-F001
Rev. 00 (Feb. 11, 2019)
Diffun Quirino
PURCHASE REQUEST

Stock/
Property No.
gal Semi-Gloss Latex White 6.00 600.00

Lit Raw Sienna 1.00 220.00
pcs Roller Brush w/ Pan 3.00 110.00
pcs Paint Brush 2" 5.00 75.00
roll Gasa Tape 2.00 50.00
gal Easytite 1.00 600.00
pair Paleta 3.00 85.00
pcs #80 Sand Paper 20.00 85.00
TOTAL:
Purpose:

Signature :
Printed Name :
Development
QSU-PROC-F001
Rev. 00 (Feb. 11, 2019)
_____________
___________
Total Cost
2,600.00
330.00
375.00
100.00
600.00
255.00
1,700.00
5,960.00
by:
BENIGNO, Ph.D.
dent
QSU-PROC-F001
Rev. 00 (Feb. 11, 2019)
Diffun Quirino
PURCHASE REQUEST

Stock/
Property No.
meters 100mm² THHN Phelpdodge 20.00 616.00
pc
200A Industrial type CB 3pole Bol-On 1.00 10,000.00
pcs 125A Comercial type CB 3pole Bolt-

On 2.00 10,000.00
100A Comercial type CB 3pole Bolt-
pcs
On 2.00 10,000.00
pcs Secondary Bracket 3pole 4.00 405.00
pcs Solder List Connector (25-500) 3.00 650.00
pc Pull Box (4x4x12) 1.00 650.00
pc Entrance Cap gown w/ adaptor 1.00 1,750.00
pcs PVC pipe orange 90mm 2.00 900.00
pc PVC adaptor 90mm w/ lock 1.00 250.00
pc 150A Commercial type CB 2pole 1.00 6,500.00
pc Secondary Bracket 2 spool 1.00 350.00
meters 60mm² THHN Phelpdodge 36.00 405.00
pcs Blank Plate 2.00 100.00
TOTAL:
Purpose:
For Replacement of Electrical Materials for ICT and RDET building

Signature :
Printed Name :
BALTAZAR G. DAMANCE SAMUEL O. BENIGNO, Ph.D.
Designation : Campus Administrator President
QSU-PROC-F001
Rev. 00 (Feb. 11, 2019)
_____________
___________
Total Cost
12,320.00
10,000.00
20,000.00
20,000.00
1,620.00
1,950.00
650.00
1,750.00
1,800.00
250.00
6,500.00
350.00
14,580.00
200.00
91,970.00
by:
BENIGNO, Ph.D.
dent
QSU-PROC-F001
Rev. 00 (Feb. 11, 2019)
Diffun Quirino
PURCHASE REQUEST

Stock/
Property No.
Bags Portland Cement 47.00 260.00

cu.m. Sand (S-1) 5.00 600.00
pcs CHB 4" 730.00 10.50
pcs C-Purlins 2 x 3 x 4mm thk 12.00 425.00
box Welding Rod (5kls/box) 2.00 450.00
gal Gray Primer 2.00 600.00
pcs Marine Plywood 23.00 450.00
pcs Tekscrew 800.00 2.50
pcs Paint Brush 2" 10.00 65.00
pcs Roller brush w/ Pan 3.00 110.00
pail Semi-gloss Latex white 2.00 2,400.00
lit Raw Siena 2.00 185.00
gal Flat Wall 1.00 600.00
Bags Skim Coat 5.00 250.00
gal Wall Putty 2.00 600.00
gal Easy tite 2.00 450.00
set Panel Door 2.00 3,500.00
gal Royal Blue QDE 7.00 600.00
gal Sophie Shirt Gray 1.00 600.00
gal 0136_Charcoal 1.00 600.00
gal Vulcaseal 1.00 450.00
l.s Roll-up including installation

(2.75mx2.8m) 1.00 30,000.00
set Door Knob Kwickset 2.00 1,100.00
TOTAL:
Purpose:
For the Construction of Supply Warehouse
QSU-PROC-F001
Rev. 00 (Feb. 11, 2019)
Signature :
Printed Name :
RICHARD P. PABLO SAMUEL O. BENIGNO, Ph.D.
Designation : Director-Physical Plant and Site Development President
QSU-PROC-F001
Rev. 00 (Feb. 11, 2019)
_____________
___________
Total Cost
12,220.00
3,000.00
7,665.00
5,100.00
900.00
1,200.00
10,350.00
2,000.00
650.00
330.00
4,800.00
370.00
600.00
1,250.00
1,200.00
900.00
7,000.00
4,200.00
600.00
600.00
450.00
30,000.00
2,200.00
97,585.00
QSU-PROC-F001
Rev. 00 (Feb. 11, 2019)
by:
BENIGNO, Ph.D.
dent
QSU-PROC-F001
Rev. 00 (Feb. 11, 2019)
Diffun Quirino
PURCHASE REQUEST

Stock/
Property No.
2 QDE White gals 750.00

2 Qde Red gals 750.00
5 Paint Brush 4" gals 75.00
TOTAL:
Purpose:
For the Repainting of basketball court.

Signature :
Printed Name :
RICHARD P. PABLO SAMUEL O. BENIGNO, Ph.D.
Designation : Director-Physical Plant and Site Development President
QSU-PROC-F001
Rev. 00 (Feb. 11, 2019)
_____________
___________
Total Cost
1,500.00
1,500.00
375.00
3,375.00
by:
BENIGNO, Ph.D.
dent
QSU-PROC-F001
Rev. 00 (Feb. 11, 2019)

QSU-PROC-F001 Rev. 00 (Feb. 11, 2019)

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Republic of the Philippines

QUIRINO STATE UNIVERSITY

Entity Name: QUIRINO STATE UNIVERSITY Fund Cluster: ________________

Office/Section : PR No.: ______________ Date: ____________

meter/s Flat Cord AWG Wire 1.6mm Ø 50.00 45.00

Requested by: Approved by:

Entity Name: QUIRINO STATE UNIVERSITY Fund Cluster: ________________

Office/Section : PR No.: ______________ Date: ____________

pcs Goose Faucet 5.00 350.00

Requested by: Approved by:

Entity Name: QUIRINO STATE UNIVERSITY Fund Cluster: ________________

Office/Section : PR No.: ______________ Date: ____________

Labor to Undertake the following

Requested by: Approved by:

Supplier: _____________________________________________ P.O. No. : _____________________

Conforme: Very truly yours,

__________________________ SAMUEL O. BENIGNO, Ph.D.

Fund Cluster : ___________________________________ ORS/BURS No. : ________________

Signature over Printed Name of Chief

P.O. No. : _____________________

ollowing articles subject to the terms and conditions contained

Delivery Term : __________________

ry within the time specified above, a penalty of one-tenth (1/10)

SAMUEL O. BENIGNO, Ph.D.

ORS/BURS No. : ________________

Entity Name: QUIRINO STATE UNIVERSITY Fund Cluster: ________________

Office/Section : PR No.: ______________ Date: ____________

Labor to Undertake the following

Requested by: Approved by:

Entity Name: QUIRINO STATE UNIVERSITY Fund Cluster: ________________

Office/Section : PR No.: ______________ Date: ____________

Labor to Undertake the following

Requested by: Approved by:

Supplier: Rogelio C. Dumalina P.O. No. : _____________________

Conforme: Very truly yours,

__________________________ SAMUEL O. BENIGNO, Ph.D.

Fund Cluster : ___________________________________ ORS/BURS No. : ________________

Signature over Printed Name of Chief

P.O. No. : _____________________

ollowing articles subject to the terms and conditions contained

Delivery Term : __________________

ry within the time specified above, a penalty of one-tenth (1/10)

SAMUEL O. BENIGNO, Ph.D.

ORS/BURS No. : ________________

Entity Name: QUIRINO STATE UNIVERSITY Fund Cluster: ________________

Office/Section : PR No.: ______________ Date: ____________

1 pcs. 1-1/2"Ø Stainless Steel Pipe schd 40 6.00 2,100.00

Requested by: Approved by:

Entity Name: QUIRINO STATE UNIVERSITY Fund Cluster: ________________

Office/Section : PR No.: ______________ Date: ____________

pcs .40mx.40m unglazed tile ( floor tile) 438.00 125.00

Requested by: Approved by:

Entity Name: QUIRINO STATE UNIVERSITY Fund Cluster: ________________

Office/Section : PR No.: ______________ Date: ____________

pcs 1/4" Marrine Plywood 16.00 450.00

Requested by: Approved by:

Entity Name: QUIRINO STATE UNIVERSITY Fund Cluster: ________________

Office/Section : PR No.: ______________ Date: ____________

gal Semi-Gloss Latex White 6.00 600.00

Requested by: Approved by:

Entity Name: QUIRINO STATE UNIVERSITY Fund Cluster: ________________

Office/Section : PR No.: ______________ Date: ____________

meters 100mm² THHN Phelpdodge 20.00 616.00

Office/Section : PR No.: __ Date:

Office/Section : PR No.: __ Date:

Office/Section : PR No.: __ Date:

Supplier: _________________________ P.O. No. : _

Fund Cluster : ___________________ ORS/BURS No. :

Office/Section : PR No.: __ Date:

Office/Section : PR No.: __ Date:

Fund Cluster : ___________________ ORS/BURS No. :

Office/Section : PR No.: __ Date:

Office/Section : PR No.: __ Date:

Office/Section : PR No.: __ Date:

Office/Section : PR No.: __ Date:

Office/Section : PR No.: __ Date:

Office/Section : PR No.: __ Date:

Office/Section : PR No.: __ Date: