ABSTRACT OF PRICE OF CANVASS

(Furnishing & Delivery) Date: _________________________

QUOTATION (Hauling of Materials of) Time: _________________________
FOR (Furnishing other Public) Opened: _______________________
(Services, etc.)
DESCRIPTION OF SUPPLIES, MATERIALS NAMES OF REGISTERED BIDDERS
No. of Item
EQUIPMENT & SERVICES, ETC. CONTRACTOR OR DEALERS

AMOUNT OF BOND (IF REQUIRED) P ______________________________

IF WE HEREBY CERTIFY to the correctness of the above abstract of price
quotation received and opened in the Office of ______________________________________

Canvasser
 Republic of the Philippines
Department of Education
___________________________________________
(Agency)

Name of Merchant

Address

Please quote the current price of the items described hereunder for the use of government in the purchase of the same.
Quotation should be deposited in the bidders for the bids in this office not later than ______(AM/PM)_____________

Qty UNIT ARTICLES UNIT PRICE TOTAL COST

TOTAL

CANVASSED BY:

I hereby certify that the current prices in this establishment are those
under column "Unit Price" and "Total Cost".

Signature of Merchant
 Appendix 62

INSPECTION AND ACCEPTANCE REPORT

Entity Name : ______________________________ Fund Cluster : ___________

Supplier : ______________________________________________ IAR No. : _______________

PO No./Date : ___________________________________________ Date : _________________
Requisitioning Office/Dept. : _______________________________ Invoice No. : ____________
Responsibility Center Code : _______________________________ Date : _________________
Stock/
Description Unit Quantity
Property No.

INSPECTION ACCEPTANCE

Date Inspected : ________________________ Date Received : _____________________

Inspected, verified and found in order as to Complete

quantity and specifications
Partial (pls. specify quantity)

____________________________________________ ___________________________________
Inspection Officer/Inspection Committee Supply and/or Property Custodian
 Appendix 61

PURCHASE ORDER
______________________
Entity Name

Supplier : _____________________________________________ P.O. No. : ____________________________

Address : _____________________________________________ Date : _______________________________
TIN : ________________________________________________ Mode of Procurement : _________________
Gentlemen:
Please furnish this Office the following articles subject to the terms and conditions contained herein:

Place of Delivery : ___________________________________ Delivery Term : ________________________

Date of Delivery : ____________________________________ Payment Term : ________________________

Stock/
Unit Description Quantity Unit Cost Amount
Property No.

(Total Amount in Words)

In case of failure to make the full delivery within the time specified above, a penalty of one-tenth (1/10) of one percent for
every day of delay shall be imposed on the undelivered item/s.

Conforme: Very truly yours,

__________________________ ________________________________
Signature over Printed Name of Supplier
Signature over Printed Name of Authorized Official

___________________________ _____________________________
Date Designation

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

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153
 Appendix 60

PURCHASE REQUEST

Entity Name: _______________________ Fund Cluster: __________________

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

_________________________ Responsibility Center Code : ___________

Stock/ Property
Unit Item Description Quantity Unit Cost Total Cost
No.

Purpose: ____________________________________________________________
_______________________________________________________________
_______________________________________________________________

Requested by: Approved by:

Signature : _________________________ ___________________________
Printed Name : _________________________ ___________________________
Designation : _________________________ ___________________________

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 Appendix 46

REIMBURSEMENT EXPENSE RECEIPT

Entity Name: _________________ Fund Cluster : ________________

Date : _______________________ RER No. : ___________________

RECEIVED from ______________________________________

(Name)

_________________________________________________ the amount

(Official Designation)

of __________________________________________ (P__________)
(In Words) (in Figures)

in payment for _______________________________________________

(Payments for subsistence, services,

_________________________________________________________
rental or transportation should show inclusive dates,

_________________________________________________________
purpose, distance, inclusive points of travel, etc.)
PAYEE
Name/Signature __________________________________________
Address ________________________________________________

WITNESS
Name/Signature __________________________________________
Address ________________________________________________

123
 Appendix 44

LIQUIDATION REPORT Serial No.: _________________

Period Covered ________________ Date: _____________________

Responsibility Center Code:

Entity Name : _____________________________________________
Fund Cluster : _____________________________________________
__________________________

PARTICULARS AMOUNT

TOTAL AMOUNT SPENT

AMOUNT OF CASH ADVANCE PER DV NO.______DTD. ______
AMOUNT REFUNDED PER OR NO. ________DTD. ___________
AMOUNT TO BE REIMBURSED
A Certified: Correctness of the B Certified: Purpose of travel / C Certified: Supporting
above data cash advance duly accomplished documents complete and proper

________________________ ________________________ ________________________

Signature over Printed Name Signature over Printed Name Signature over Printed Name
Claimant Immediate Supervisor Head, Accounting Division Unit

JEV No.: ___________________

Date: ______________________ Date: _____________________ Date: _____________________

 Appendix 32

Fund Cluster :
Entity Name
Date :
DISBURSEMENT VOUCHER DV No. :

Mode of MDS Check Commercial Check ADA Others (Please specify)

Payment
_________________

Payee TIN/Employee No.: ORS/BURS No.:

Address

Responsibility
Particulars MFO/PAP Amount
Center

Amount Due
A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

________________________________________
Printed Name, Designation and Signature of Supervisor

B. Accounting Entry:
Account Title UACS Code Debit Credit

C. Certified: D. Approved for Payment

Cash available
Subject to Authority to Debit Account (when applicable)
Supp
proper

Signature Signature

Printed
Printed Name
Name

Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative

Date Date

E. Receipt of Payment JEV No.

Check/ Date : Bank Name & Account Number:
ADA No. :
Signature : Date : Printed Name: Date

Official Receipt No. & Date/Other Documents

92