DISBURSEMENT VOUCHER
SK of Barangay:
City/Municipality:
Province:
Payee:
Address:
TIN:
Particulars
A. Certified as to availability of the B. Certified as to availability of cash, C. Certified as to necessity, validity,
budget or funds received for specific and completeness and propriety of propriety, and legality of claim; and
purpose supporting documents Approved for payment:
(Signature Over Printed Name) (Signature Over Printed Name) (Signature Over Printed Name)
Budget Monitoring Officer SK Treasurer SK Chairperson
Date : Date : Date :
D. Received Payment: Check No.:
Date:
Bank
Name:
Signature Over Printed Name of Payee/ Authorized Representative Bank
Date Branch:
OR No.:
Date:
DV No.:
Date :
Amount
rtified as to necessity, validity,
riety, and legality of claim; and
Approved for payment:
Signature Over Printed Name)
SK Chairperson
Date :
PURCHASE REQUEST
SK of Barangay: PR No.:
City/Municipality: Date:
Province:
Item No. Qty. Unit of Item description Estimated
Measurement Unit Cost
Total Estimated Amount
Purpose:
Requested by: Approved by:
Signature over Printed Name Requesting SK Official _ Signature over Printed Name
Date SK Chairperson
Date
No.:
e:
Estimated
Amount
d by:
Signature over Printed Name
person
e
Standard Form Number SF-Good-60
Revised on May 24, 2004
Standard Form Title: Request for Quotation
Date: ______________________
Quotation No. _______________
_______________________
_______________________
Please quote your lowest price on the terms listed below subject to the General conditions on the last
page, stating the shortest time of delivery and submit your duly signed by your representative not later than
______________________ in the return envelope attached herewith.
Note: 1. All entries must be typewritten.
2. Delivery period within _____________________ calendar days.
3. Warranty shall be a period of six (6) months for supplies & materials, one (1) year for equipment,
from date of acceptance by the procuring entity.
4. Price validity shall be for a period of ___________ Calendar days.
5. G-EPS registration certificate shall be attached upon submission of the quotation.
6. Bidders shall submit original brochures showing certification of the product being offered.
Item No. Item & Description Qty. Unit Price Total Cost
Total
After having carefully read and accepted your General Condition, I/We quote you on the item at prices
noted above.
Printed Name/Signature
Tel. No./Cellphone No./Email Add
Date
BIDS AND AWARDS COMMITTEE
(Goods and Services)
_______________________________
Barangay, Municipality Province
ABSTRACT OF QUOTATION
Supplier Name
Item Quantity Unit Particulars
Unit Price Total
We hereby certify that the above abstract of quotation was opened on _________________________ and the lowest calcul
____________________________.
_______________________ _______________________
BAC MEMBER BAC MEMBER
_______________________ _______________________
BAC MEMBER BAC MEMBER
DS COMMITTEE
Services)
_______________
ipality Province
QUOTATION
Supplier Name Supplier Name
Unit Price Total Unit Price Total
______________ and the lowest calculated and responsive quotation is
_______________________
BAC MEMBER
_______________________
END-USER
PURCHAS
ORDER
SK of Barangay: City/Municipality:
Tel. No.: Province:
Supplier: PO No.:
Address: Date:
Tel. No.: TIN: Mode of Procurement:
Gentlemen: Please deliver to this office the following articles subject to the terms and conditions contained herein:
Place of Delivery: Delivery Term:
Date of Delivery: Payment Term:
Item No. Unit of Item Description
Measurement
(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 sh
Conforme: Very truly yours,
_
Signature over Printed Name of Supplier
Signature over Printed Name of SK Chairperson
Date
Date
Availability of the budget or funds received for specific purpose:
Signature over Printed Name of Budget Monitoring Officer Date
PURCHASE An
ORDER nex
15
ent:
tained herein:
Quantity Unit Cost Amount
ent for every day of delay shall be imposed on the undelivered item/s.
Annex 16
INSPECTION AND ACCEPTANCE REPORT
SK of Barangay: IAR No.:
City/Municipality: Date:
Province:
Supplier: _ PO No.: Invoice No.: _ Date:
_ Date: Requesting SK
Official:
Item No. Item Description Unit of
Measurement
INSPECTION ACCEPTANCE
Date Inspected: _ Date Received:
Inspected, verified as to quantity and specifications Complete
Signature over Printed Name Partial (Pls. specify quantity Received)
Head, Inspection and Appraisal Committee Signature over Printed Name SK Treasurer
Annex 16
.: _ Date:
Quantity
NCE
ived)
Treasurer
REQUISITION AND ISSUE SLIP
SK of Barangay: RIS No.:
City/Municipality: Date:
Province:
Requisition Issue
Stock No. Unit of Item Description Quantity Quantity Remarks
Measurement
Purpose:
Requested by: Approved by: Issued by: Received by:
Signature
Printed Name
Designation
Date
INVENTORY CUSTODIAN SLIP
SK of Barangay: ICS No.:
City/Municipality: Date:
Province:
Unit of Amount
Quantity Measurement Unit Total Item Description Stock No.
Cost Cost
Received by: Issued by:
Signature over Printed Name and Designation of Signature over Printed Name SK Treasurer
Recipient/End-User Date
Date
PROPERTY ACKNOWLEDGEMENT RECEIPT
SK of Barangay: PAR No.:
City/Municipality: Date:
Province:
Quantity Unit of Item Description Property Date Amount
Measurement No. Acquired
Received by: Issued by:
Signature over Printed Name Signature over Printed Name SK Treasurer
and Designation of Recipient/End-User Date
Date
LIQUIDATION REPORT LR No.:
SK of Barangay, City/Municipality, Province Date:
PARTICULARS AMOUNT
TOTAL AMOUNT SPENT
AMOUNT OF CASH ADVANCE PER DV NO. DTD.
AMOUNT REFUNDED PER O.R. NO. DTD.
AMOUNT TO BE REIMBURSED
A. Certified: Correctness of the above B. Certified: Purpose of cash advance C. Certified: Supporting documents are
data duly accomplished complete and proper
Signature over Printed Name Signature over Printed Name SK Signature over Printed Name SK
Accountable SK Official Chairperson Treasurer
Date Date Date
SK of Barangay City/Municipality Province
SK CHAIRPERSON’S CERTIFICATION
T
o
:
T Sir/Madam:
h This is to certify that the following checks were duly issued by SK of Barangay ,
e (Ito ay pagpapatunay na ang mga tseke na nakalista sa ibaba ay na-isyu ng SK ng Barangay ,
B complete with respective Disbursement Vouchers and supporting documents.
a na kompleto ng kani-kanilang Disbursement Vouchers at kalakip na mga dokumento.)
n Account No. Check No. Date Payee Amount Purpose
k
M
a
n
a
g The undersigned attests to the truthfulness of the foregoing facts, under pain of
e (Pinapatotohanan ng may lagda ang mga nakasaad sa itaas batid ang
r liability for falsification, pursuant to Article 171(4) of the Revised Penal Code of the Philippines.
pananagutan sa kasong “Falsification”, sang-ayon sa Artikulo 171(4) ng Revised Penal Code ng Pilipinas.)
V
SK Chairperson er
( y
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PROCUREMENT TIMELINES (Sample)
PROCESS Signatories Date
1 Issuance of Purchase of Request End - users 1/2/2021
SK Chariman
BAC Resolution on the mode of
2 BAC Secretary 2/2/2021
procurement
BAC Members
Approval by: SK Chairman
Issuance of Request on Price
3 BAC Chairman 3/2/2021
Quotation
Supplier ( sent out 3 RFQ)
deadline of submission by supplier
must be at least 3 working days 8/2/2021
from date of issuance
4 Abstract of Quotation BAC Members 9/2/2021
End - user
BAC Resolution Recommending
5 BAC Secretary 10/2/2021
Award
BAC Members
Approval by: SK Chairman
6 Notice of Award SK Chairman 11/2/2021
Received by : Supplier
7 Issuance of Purchase Order Supplier 11/2/2021
SK Chairman
BMO
8 Notice to Proceed SK Chairman 12/2/2021
Received by: Supplier
9 Delivery of Goods/ Services Supplier see (Purchase Order)
Issuance of Inspection and
10 Inspector 02/18/2021
Acceptance Report
SK Treasurer
11 Issuance of RIS End - User 02/18/2021
SK Treasurer
SK Chairman
Issuance of ICS SK Treasurer 02/18/2021
End -user
Issuance of PAR SK Treasurer 02/18/2021
End- user
12 Disbursement Voucher BMO 2/19/2021
SK Treasurer
SK Chairman
Payee/Supplier (Received)
Small Value Procurement:
1. Approved APP
2. Business Permit
3. Latest Income Tax Return
4. Philgeps Registration Number
5. Omnibus Sworn Statement
