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Agency Procurement Request: Please Check ( ) Appropriate Box On Action Requested On The Item/S Listed Below

This document is an Agency Procurement Request (APR) form used to request supplies from the Procurement Service. It allows the requesting agency to check the appropriate box to request common supplies from price lists, purchase non-common items by attaching specifications, or certify available funds. The form lists the agency name and address, contact details, APR number, items and descriptions, quantities, units, prices, and total amount. It requires signatures from the agency's property/supply officer and accountant to certify available funds and approval from the agency head.

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157 views2 pages

Agency Procurement Request: Please Check ( ) Appropriate Box On Action Requested On The Item/S Listed Below

This document is an Agency Procurement Request (APR) form used to request supplies from the Procurement Service. It allows the requesting agency to check the appropriate box to request common supplies from price lists, purchase non-common items by attaching specifications, or certify available funds. The form lists the agency name and address, contact details, APR number, items and descriptions, quantities, units, prices, and total amount. It requires signatures from the agency's property/supply officer and accountant to certify available funds and approval from the agency head.

Uploaded by

BrianSantiago
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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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: 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.:___________Date:________

[ ] 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.
For PS Main-Common Use Supplies, please use Form 001 R or Form 001 B
ITEM ITEM AND DESCRIPTION/SPECIFICATIONS/STOCK No. QUANTITY UNIT UNIT PRICE AMOUNT
No.

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

AGENCY HEAD/AUTHORIZED SIGNATURE


AGENCY PROPERTY/SUPPLY OFFICER AGENCY CHIEF ACCOUNTANT
[ ] FUNDS DEPOSITED WITH PS [ ] ___________________ CHECK No. ____________________
IN THE AMOUNT OF: ____________________________________________________________ (P _____________________) ENCLOSED

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